National Healthcare Quality and Disparities Report
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
176 to 200 of 321 Research Studies DisplayedChan L, Asriel B, Eaton EF
Potential kidney toxicity from the antiviral drug tenofovir: new indications, new formulations, and a new prodrug.
This review summarizes the recent literature on kidney and bone health in individuals treated with tenofovir disoproxil fumarate (TDF) and the newer prodrug tenofovir alafenamide (TAF). The authors assert that nephrologists should be aware of the potential kidney and bone toxicity of TDF, as well as unique situations in which the newer prodrug TAF may contribute to kidney injury.
AHRQ-funded; HS023009.
Citation: Chan L, Asriel B, Eaton EF .
Potential kidney toxicity from the antiviral drug tenofovir: new indications, new formulations, and a new prodrug.
Curr Opin Nephrol Hypertens 2018 Mar;27(2):102-12. doi: 10.1097/mnh.0000000000000392..
Keywords: Adverse Drug Events (ADE), Medication
Chan L, Asriel B, Eaton EF
Potential kidney toxicity from the antiviral drug tenofovir: new indications, new formulations, and a new prodrug.
This review summarizes the recent literature on kidney and bone health in individuals treated with tenofovir disoproxil fumarate (TDF) and the newer prodrug tenofovir alafenamide (TAF). The authors assert that nephrologists should be aware of the potential kidney and bone toxicity of TDF, as well as unique situations in which the newer prodrug TAF may contribute to kidney injury.
AHRQ-funded; HS023009.
Citation: Chan L, Asriel B, Eaton EF .
Potential kidney toxicity from the antiviral drug tenofovir: new indications, new formulations, and a new prodrug.
Curr Opin Nephrol Hypertens 2018 Mar;27(2):102-12. doi: 10.1097/mnh.0000000000000392..
Keywords: Adverse Drug Events (ADE), Medication
Klinge M, Coppler T, Liebschutz JM
The assessment and management of pain in cirrhosis.
The treatment of pain in patients with cirrhosis is complicated by unpredictable hepatic drug metabolism and a higher risk of adverse drug reactions. The researchers aimed to conduct a scoping review regarding pain management in cirrhosis. As with other populations, a multi-dimensional treatment approach to pain with a focus on physical, behavioral, procedural and pharmacologic treatment is recommended when caring for patients with cirrhosis and pain.
AHRQ-funded; HS022989.
Citation: Klinge M, Coppler T, Liebschutz JM .
The assessment and management of pain in cirrhosis.
Curr Hepatol Rep 2018 Mar;17(1):42-51. doi: 10.1007/s11901-018-0389-7.
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Keywords: Adverse Drug Events (ADE), Care Management, Chronic Conditions, Evidence-Based Practice, Medication, Pain, Patient-Centered Outcomes Research
Ng X, dosReis S, Beardsley R
Understanding systemic lupus erythematosus patients' desired outcomes and their perceptions of the risks and benefits of using corticosteroids.
This qualitative study examined systemic lupus erythematosus (SLE) patients' most desired outcomes and their concerns with corticosteroid use in SLE treatment. The SLE patients' most desired outcomes: reduction in flares, maintenance of normal activities, minimization of treatment side effects, prevention of future organ damage, and finding a cure. The patients’ primary concerns with the adverse effects of corticosteroids: weight gain, organ damage, mood swings/irritability, sleep disturbances, and dental issues.
AHRQ-funded; HS022135.
Citation: Ng X, dosReis S, Beardsley R .
Understanding systemic lupus erythematosus patients' desired outcomes and their perceptions of the risks and benefits of using corticosteroids.
Lupus 2018 Mar;27(3):475-83. doi: 10.1177/0961203317726375.
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Keywords: Adverse Drug Events (ADE), Medication, Patient-Centered Outcomes Research
Smith I, Schmidt R, Halm EA
Do statins increase the risk of esophageal conditions? Findings from four propensity score-matched analyses.
The aim of this study was to examine the association of statins with esophageal conditions. The study concluded that statin therapy was associated with higher odds of being diagnosed with esophagitis and gastroesophageal reflux disease/dyspepsia. Further study is warranted to elucidate the potential role of statins in these commonly diagnosed esophageal conditions.
AHRQ-funded; HS022418.
Citation: Smith I, Schmidt R, Halm EA .
Do statins increase the risk of esophageal conditions? Findings from four propensity score-matched analyses.
Clin Drug Investig 2018 Feb;38(2):135-46. doi: 10.1007/s40261-017-0589-x..
Keywords: Adverse Drug Events (ADE), Heart Disease and Health, Medication, Patient-Centered Outcomes Research, Risk
Kerstenetzky L, Birschbach MJ, Beach KF
Improving medication information transfer between hospitals, skilled-nursing facilities, and long-term-care pharmacies for hospital discharge transitions of care: a targeted needs assessment using the Intervention Mapping framework.
The authors of this study report on the development of a logic model that will be used to explore methods for minimizing patient care medication delays and errors while further improving handoff communication to skilled nurse facilities and long term care pharmacy staff.
AHRQ-funded; HS021984.
Citation: Kerstenetzky L, Birschbach MJ, Beach KF .
Improving medication information transfer between hospitals, skilled-nursing facilities, and long-term-care pharmacies for hospital discharge transitions of care: a targeted needs assessment using the Intervention Mapping framework.
Res Social Adm Pharm 2018 Feb;14(2):138-45. doi: 10.1016/j.sapharm.2016.12.013..
Keywords: Adverse Drug Events (ADE), Hospital Discharge, Hospitals, Long-Term Care, Medical Errors, Medication, Medication: Safety, Nursing Homes, Patient Safety, Transitions of Care
Arms MA, Fleming J, Sangani DB
Incidence and impact of adverse drug events contributing to hospital readmissions in kidney transplant recipients.
This longitudinal cohort study examined 3 cohorts (no readmissions, readmissions not due to an adverse drug event, and adverse drug events contributing to readmissions) of adult kidney recipients transplanted between 2005 and 2010 and followed through 2013. The study results demonstrated that adverse drug events may be associated with a significant increase in the risk of hospital readmission after kidney transplant and subsequent graft loss.
AHRQ-funded; HS023754
Citation: Arms MA, Fleming J, Sangani DB .
Incidence and impact of adverse drug events contributing to hospital readmissions in kidney transplant recipients.
Surgery 2018 Feb;163(2):430-35. doi: 10.1016/j.surg.2017.09.027..
Keywords: Adverse Drug Events (ADE), Patient Safety, Hospital Readmissions, Transplantation
Gray SL, Hart LA, Perera S
Meta-analysis of interventions to reduce adverse drug reactions in older adults.
This review examined the effect of interventions to optimize medication use on adverse drug reactions (ADRs) in older adults. Thirteen randomized controlled trials involving 6,198 older adults were included in the review. It concluded that interventions designed to optimize medication use reduced the risk of any and serious ADRs in older adults.
AHRQ-funded; HS023779.
Citation: Gray SL, Hart LA, Perera S .
Meta-analysis of interventions to reduce adverse drug reactions in older adults.
J Am Geriatr Soc 2018 Feb;66(2):282-88. doi: 10.1111/jgs.15195.
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Keywords: Adverse Drug Events (ADE), Elderly, Medication: Safety, Medication, Patient Safety
Pringle KD, Burke RM, Steiner CA
AHRQ Author: Steiner CA
Trends in rate of seizure-associated hospitalizations among children <5 years old before and after rotavirus vaccine introduction in the United Sates, 2000-2013.
Since rotavirus vaccine introduction, hospitalizations for treatment of acute gastroenteritis have decreased. Researchers assessed whether there has been an associated decrease in seizure-associated hospitalizations. Their analysis provides evidence for a decrease in seizure hospitalizations following rotavirus vaccine introduction in the United States, with the greatest impact in age groups with a high rotavirus-associated disease burden and during rotavirus infection season.
AHRQ-authored.
Citation: Pringle KD, Burke RM, Steiner CA .
Trends in rate of seizure-associated hospitalizations among children <5 years old before and after rotavirus vaccine introduction in the United Sates, 2000-2013.
J Infect Dis 2018 Jan 30;217(4):581-88. doi: 10.1093/infdis/jix589.
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Keywords: Adverse Drug Events (ADE), Children/Adolescents, Healthcare Cost and Utilization Project (HCUP), Hospitalization, Vaccination
Childers CP, Maggard-Gibbons M, Ulloa JG
Perioperative management of antiplatelet therapy in patients undergoing non-cardiac surgery following coronary stent placement: a systematic review.
Researchers conducted a systematic review on the use of antiplatelet therapy (APT) after non-cardiac surgery (NCS) following stent placement surgery done previously. There has been some debate among the American College of Cardiology and American Heart Association as to the guidelines of how long to delay NCS after stent placement. Out of 4,882 articles, only 16 were included in the review. All of them were small. Reviewers looked for rates of cardiac events and/or bleeding events with the different APT strategies used. There did not seem to be much difference in outcomes between the different strategies.
AHRQ-funded; HS025079.
Citation: Childers CP, Maggard-Gibbons M, Ulloa JG .
Perioperative management of antiplatelet therapy in patients undergoing non-cardiac surgery following coronary stent placement: a systematic review.
Syst Rev 2018 Jan 10;7(1):4. doi: 10.1186/s13643-017-0635-z..
Keywords: Adverse Drug Events (ADE), Blood Thinners, Cardiovascular Conditions, Care Management, Medication, Outcomes, Surgery
Leonard CE, Han X, Brensinger CM
Comparative risk of serious hypoglycemia with oral antidiabetic monotherapy: a retrospective cohort study.
The purpose of this study was to examine and compare risks of serious hypoglycemia among antidiabetic monotherapy-treated adults receiving metformin, a sulfonylurea, a meglitinide, or a thiazolidinedione. The investigators found that sulfonylureas were associated with the highest rates of serious hypoglycemia. Among all study drugs, the highest rate was seen with glyburide. Pioglitazone was associated with a lower adjusted hazard for serious hypoglycemia vs metformin, while rosiglitazone and nateglinide had hazards similar to that of metformin.
AHRQ-funded; HS023898.
Citation: Leonard CE, Han X, Brensinger CM .
Comparative risk of serious hypoglycemia with oral antidiabetic monotherapy: a retrospective cohort study.
Pharmacoepidemiol Drug Saf 2018 Jan;27(1):9-18. doi: 10.1002/pds.4337..
Keywords: Risk, Adverse Drug Events (ADE), Adverse Events, Diabetes, Medication
Dulai PS, Siegel CA
Optimization of drug safety profile in inflammatory bowel disease through a personalized approach.
Treatment strategies and treatment options have changed considerably over the past decade for Inflammatory Bowel Disease (IBD). In this review the authors discuss the potential risks of therapy in IBD, opportunities to mitigate those risks, and a personalized approach to consider when using these agents in clinical practice.
AHRQ-funded; HS021747.
Citation: Dulai PS, Siegel CA .
Optimization of drug safety profile in inflammatory bowel disease through a personalized approach.
Curr Drug Targets 2018;19(7):740-47. doi: 10.2174/1389450118666170525114939..
Keywords: Adverse Drug Events (ADE), Adverse Events, Decision Making, Digestive Disease and Health, Medication, Patient-Centered Healthcare
Greenhawt M, Turner PJ, Kelso JM
Administration of influenza vaccines to egg allergic recipients: a practice parameter update 2017.
The purpose of this practice parameter update is to review new data pertaining to the safety of influenza vaccines in egg allergic individuals and provide recommendations regarding annual influenza vaccination in egg allergic individuals. This focused practice parameter answers four questions.
AHRQ-funded; HS024599.
Citation: Greenhawt M, Turner PJ, Kelso JM .
Administration of influenza vaccines to egg allergic recipients: a practice parameter update 2017.
Ann Allergy Asthma Immunol 2018 Jan;120(1):49-52. doi: 10.1016/j.anai.2017.10.020.
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Keywords: Adverse Drug Events (ADE), Guidelines, Prevention, Vaccination
Sun D, Sarda G, Skube SJ
Phenotyping and visualizing infusion-related reactions for breast cancer patients.
Researchers developed and evaluated a phenotyping algorithm to detect Infusion-related reactions (IRRs) for breast cancer patients. They also designed a visualization prototype to render IRR patients' medications, lab tests and vital signs over time. By comparing with the 42 randomly selected doses that are manually labeled by a domain expert, the sensitivity, positive predictive value, specificity, and negative predictive value of the algorithms are 69 percent, 60 percent, 79 percent, and 85 percent, respectively.
AHRQ-funded; HS022085.
Citation: Sun D, Sarda G, Skube SJ .
Phenotyping and visualizing infusion-related reactions for breast cancer patients.
Stud Health Technol Inform 2017;245:599-603.
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Keywords: Adverse Drug Events (ADE), Cancer: Breast Cancer, Medication, Medication: Safety, Patient Safety
Cox ED, Hansen K, Rajamanickam VP
Are parents who feel the need to watch over their children's care better patient safety partners?
In this study, the investigators assessed whether needing to watch over care predicted parent performance of recommended safety behaviors to reduce medication errors and health care-associated infections. The researchers concluded that parents who reported the need to watch over care were more likely to perform behaviors specific to safe medication use (but not hand hygiene) compared with those not reporting this need.
AHRQ-funded; HS018680.
Citation: Cox ED, Hansen K, Rajamanickam VP .
Are parents who feel the need to watch over their children's care better patient safety partners?
Hosp Pediatr 2017 Dec;7(12):716-22. doi: 10.1542/hpeds.2017-0036..
Keywords: Adverse Drug Events (ADE), Adverse Events, Caregiving, Children/Adolescents, Healthcare-Associated Infections (HAIs), Medical Errors, Medication, Patient Safety
Fan Y, Adam TJ, McEwan R
Detecting signals of interactions between warfarin and dietary supplements in electronic health records.
This study detected signals of interactions between warfarin and seven dietary supplements, viz., alfalfa, garlic, ginger, ginkgo, ginseng, St. John's Wort, and Vitamin E by analyzing structured clinical data and unstructured clinical notes from the University of Minnesota Clinical Data Repository. There was a statistically significant association of warfarin concurrently used with supplements which can potentially increase the risk of adverse events, such as gastrointestinal bleeding.
AHRQ-funded; HS022085.
Citation: Fan Y, Adam TJ, McEwan R .
Detecting signals of interactions between warfarin and dietary supplements in electronic health records.
Stud Health Technol Inform 2017;245:370-74.
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Keywords: Adverse Drug Events (ADE), Blood Thinners, Electronic Health Records (EHRs), Medication, Health Information Technology (HIT)
George MD, Baker JF, Hsu JY
Perioperative timing of infliximab and the risk of serious infection after elective hip and knee arthroplasty.
The purpose of this retrospective cohort study was to evaluate the association between infliximab timing and serious infection after elective hip or knee arthroplasty. The investigators concluded that administering infliximab within 4 weeks of elective knee or hip arthroplasty was not associated with a higher risk of short- or long-term serious infection compared to withholding infliximab for longer time periods. They also concluded that glucocorticoid use, especially >10 mg/day, was associated with an increased infection risk.
AHRQ-funded; HS018517.
Citation: George MD, Baker JF, Hsu JY .
Perioperative timing of infliximab and the risk of serious infection after elective hip and knee arthroplasty.
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Keywords: Adverse Drug Events (ADE), Adverse Events, Medication, Medication: Safety, Orthopedics, Patient Safety, Surgery
van den Bogert CA, Miller MJ, Cobaugh DJ
Screening questions for nonsteroidal anti-inflammatory drug risk knowledge.
The aim of this study was to evaluate screening questions for estimating nonsteroidal anti-inflammatory drug (NSAID) risk knowledge. It concluded that screening questions for subjective NSAID risk awareness and health literacy are predictive of objectively tested NSAID knowledge and can be used to triage patients as well as subsequently initiate and direct a conversation about NSAID risk.
AHRQ-funded; HS016956.
Citation: van den Bogert CA, Miller MJ, Cobaugh DJ .
Screening questions for nonsteroidal anti-inflammatory drug risk knowledge.
J Patient Saf 2017 Dec;13(4):217-22. doi: 10.1097/pts.0000000000000143.
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Keywords: Adverse Drug Events (ADE), Health Literacy, Medication, Risk
Zhou M, Wang SV, Leonard CE
Sentinel modular program for propensity score-matched cohort analyses: application to glyburide, glipizide, and serious hypoglycemia.
Sentinel is a program sponsored by the US Food and Drug Administration to monitor the safety of medical products. This cohort assessment was conducted to evaluate the ability of the Sentinel Propensity Score Matching Tool to reproduce, in an expedited fashion, the known association between glyburide (vs. glipizide) and serious hypoglycemia. The study’s findings were consistent with the literature, and demonstrated the ability of the tool to reproduce this known association in an expedited.
AHRQ-funded; HS022193.
Citation: Zhou M, Wang SV, Leonard CE .
Sentinel modular program for propensity score-matched cohort analyses: application to glyburide, glipizide, and serious hypoglycemia.
Epidemiology 2017 Nov;28(6):838-46. doi: 10.1097/ede.0000000000000709..
Keywords: Adverse Drug Events (ADE), Diabetes, Medication: Safety, Medication, Patient Safety
Richards JR, Smith NE, Moulin AK
Unintentional cannabis ingestion in children: a systematic review.
The purpose of this study was to analyze published reports of unintentional cannabis ingestions in children to determine presenting signs and symptoms, route of exposure, treatment, and outcome. The investigators assert that unintentional cannabis ingestion by children is a serious public health concern and is well-documented in numerous studies and case reports; and that clinicians should consider cannabis toxicity in any child with sudden onset of lethargy or ataxia.
AHRQ-funded; HS022236.
Citation: Richards JR, Smith NE, Moulin AK .
Unintentional cannabis ingestion in children: a systematic review.
J Pediatr 2017 Nov;190:142-52. doi: 10.1016/j.jpeds.2017.07.005..
Keywords: Adverse Events, Children/Adolescents, Adverse Drug Events (ADE)
Boyce RD, Jao J, Miller T
Automated screening of emergency department notes for drug-associated bleeding adverse events occurring in older adults.
The purpose of this study was to conduct research to show the value of text mining for automatically identifying suspected bleeding adverse drug events (ADEs) in the emergency department (ED). The investigators found that both models they examined, accurately identify bleeding ADEs using the presence or absence of certain clinical concepts in ED admission notes for older adult patients.
AHRQ-funded; HS024208.
Citation: Boyce RD, Jao J, Miller T .
Automated screening of emergency department notes for drug-associated bleeding adverse events occurring in older adults.
Appl Clin Inform 2017 Oct;8(4):1022-30. doi: 10.4338/aci-2017-02-ra-0036..
Keywords: Adverse Drug Events (ADE), Elderly, Emergency Department, Medication, Medication: Safety
Gianfrancesco MA, Schmajuk G, Haserodt S
Hydroxychloroquine dosing in immune-mediated diseases: implications for patient safety.
Evidence suggests that hydroxychloroquine (HCQ) retinal toxicity is more common than previously thought. Adhering to careful weight-based dosing can significantly reduce the risk of this adverse event and is recommended in recent guidelines. The study authors used electronic health record data from a large health system to examine HCQ dosing over a 5-year period and identify risk factors associated with higher dosage of HCQ.
AHRQ-funded; HS024412.
Citation: Gianfrancesco MA, Schmajuk G, Haserodt S .
Hydroxychloroquine dosing in immune-mediated diseases: implications for patient safety.
Rheumatol Int 2017 Oct;37(10):1611-18. doi: 10.1007/s00296-017-3782-6..
Keywords: Adverse Drug Events (ADE), Patient Safety, Risk, Skin Conditions
Lo Re VR, Zeldow B, Kallan MJ
Risk of liver decompensation with cumulative use of mitochondrial toxic nucleoside analogues in HIV/hepatitis C virus coinfection.
This cohort study was conducted to determine if cumulative mitochondrial toxic nucleoside reverse transcriptase inhibitors (mtNRTI) use increased the risk of hepatic decompensation and death among patients coinfected with human immunodeficiency virus (HIV) and chronic hepatitis C virus (HCV). The findings suggest that cumulative mtNRTI use may increase the risk of hepatic decompensation and death in HIV/HCV coinfection and should be avoided when alternatives exist for HIV/HCV patients.
AHRQ-funded; HS018372.
Citation: Lo Re VR, Zeldow B, Kallan MJ .
Risk of liver decompensation with cumulative use of mitochondrial toxic nucleoside analogues in HIV/hepatitis C virus coinfection.
Pharmacoepidemiol Drug Saf 2017 Oct;26(10):1172-81. doi: 10.1002/pds.4258..
Keywords: Adverse Drug Events (ADE), Hepatitis, Human Immunodeficiency Virus (HIV), Medication, Patient Safety
Bykov K, Schneeweiss S, Glynn RJ
Updating the evidence of the interaction between clopidogrel and CYP2C19-inhibiting selective serotonin reuptake inhibitors: a cohort study and meta-analysis.
The aim of this study was to assess clinical outcomes following initiation of a CYP2C19-inhibiting selective serotonin reuptake inhibitor (SSRI) versus initiation of other SSRIs among patients treated with clopidogrel and to update existing evidence on the clinical impact of clopidogrel-SSRI interaction. It concluded that the updated evidence still indicates a small decrease in clopidogrel effectiveness associated with concomitant exposure to clopidogrel and CYP2C19-inhibiting SSRIs.
AHRQ-funded; HS023122.
Citation: Bykov K, Schneeweiss S, Glynn RJ .
Updating the evidence of the interaction between clopidogrel and CYP2C19-inhibiting selective serotonin reuptake inhibitors: a cohort study and meta-analysis.
Drug Saf 2017 Oct;40(10):923-32. doi: 10.1007/s40264-017-0556-8.
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Keywords: Adverse Drug Events (ADE), Medication, Evidence-Based Practice, Patient-Centered Outcomes Research
Ing C, Hegarty MK, Perkins JW
Duration of general anaesthetic exposure in early childhood and long-term language and cognitive ability.
A study was done of children age 10 years who had volatile anaesthetic (VA) exposure sometime during their early childhood. Researchers were trying to determine if the duration of exposure affected long-term language and cognitive ability. Data was obtained from the Western Australian Pregnancy Cohort (Raine) Study. The cohort was divided by duration of total VA exposure before age three years. They concluded that children exposed to less than 35 minutes VA did not differ from unexposed children, but there were lower language scores in children who had experienced greater than 35 minutes.
AHRQ-funded; HS022941.
Citation: Ing C, Hegarty MK, Perkins JW .
Duration of general anaesthetic exposure in early childhood and long-term language and cognitive ability.
Br J Anaesth 2017 Sep 1;119(3):532-40. doi: 10.1093/bja/aew413..
Keywords: Adverse Drug Events (ADE), Children/Adolescents, Medication, Neurological Disorders, Patient Safety