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
101 to 125 of 303 Research Studies DisplayedWorsham CM, Woo J, Jena AB
Adverse events and emergency department opioid prescriptions in adolescents.
Understanding the risks associated with opioid prescription in adolescents is critical for informing opioid policy, but the risks are challenging to quantify given the lack of randomized trial data. Using a regression discontinuity design, the investigators exploited a discontinuous increase in opioid prescribing in the emergency department (ED) when adolescents transitioned from "child" to "adult" at age eighteen to estimate the effect of an ED opioid prescription on subsequent opioid-related adverse events.
AHRQ-funded; HS026753.
Citation: Worsham CM, Woo J, Jena AB .
Adverse events and emergency department opioid prescriptions in adolescents.
Health Aff 2021 Jun;40(6):970-78. doi: 10.1377/hlthaff.2020.01762..
Keywords: Children/Adolescents, Emergency Department, Opioids, Medication, Adverse Drug Events (ADE), Adverse Events, Patient Safety, Practice Patterns
Bernard DM, Encinosa W, Cohen J
AHRQ Author: Bernard DM Encinosa W Cohen J Fang Z
Patient factors that affect opioid use among adults with and without chronic pain.
Investigators sought to determine patient characteristics associated with opioid use among adults with and without chronic pain treatment. Using MEPS data, they found that health-related attitudes affect both adults with and without chronic pain treatment similarly. Adults with self-reliant health attitudes were less likely to start and more likely to discontinue opioid use. Exercise was associated with higher probability of choosing no analgesic treatments over using opioids and also with higher probability of discontinuing opioid use in the year following opioid initiation for those electing to use them.
AHRQ-authored.
Citation: Bernard DM, Encinosa W, Cohen J .
Patient factors that affect opioid use among adults with and without chronic pain.
Res Social Adm Pharm 2021 Jun;17(6):1059-65. doi: 10.1016/j.sapharm.2020.07.036..
Keywords: Medical Expenditure Panel Survey (MEPS), Opioids, Medication, Pain, Chronic Conditions
Simon CB, Klein JW, Bradley KA
Primary care patients with opioid use disorder have a high prevalence of pain and mental health and other substance use disorders.
One potential challenge of treating OUD in primary care is comorbidity. Mental health and substance use disorders and chronic pain are common in patients with Opioid Use Disorders (OUDs) in specialty OUD treatment settings and on confidential surveys, but the prevalence of such comorbidity in primary care patients with OUD has not been confirmed. This brief report addressed that gap.
AHRQ-funded; HS023173.
Citation: Simon CB, Klein JW, Bradley KA .
Primary care patients with opioid use disorder have a high prevalence of pain and mental health and other substance use disorders.
J Gen Intern Med 2021 Jun;36(6):1799-801. doi: 10.1007/s11606-020-05820-3..
Keywords: Opioids, Medication, Substance Abuse, Behavioral Health, Primary Care
Hubbard CC, Evans CT, Calip GS
Characteristics associated with opioid and antibiotic prescribing by dentists.
The objective of this study was to identify county-level characteristics that may be high-impact targets for opioid and antibiotic interventions to improve dental prescribing. The investigators concluded that dental prescribing of opioids was decreasing, whereas dental antibiotic prescribing was increasing. High prescribing of antibiotics was associated with high prescribing of opioids. The investigators suggested that strategies focused on optimizing dental antibiotics and opioids are needed given their impact on population health.
AHRQ-funded; HS025177.
Citation: Hubbard CC, Evans CT, Calip GS .
Characteristics associated with opioid and antibiotic prescribing by dentists.
Am J Prev Med 2021 May;60(5):648-57. doi: 10.1016/j.amepre.2020.11.017..
Keywords: Antibiotics, Opioids, Medication, Practice Patterns
Zubiago J, Murphy M, Guardado R
Increased HIV testing in people who use drugs hospitalized in the first wave of the COVID-19 pandemic.
During the COVID-19 pandemic, due to lapses in harm reduction services, several public health experts forecasted subsequent increases in diagnosis of HIV in PWUD. As many inpatient hospitals reworked patient flow during the COVID-19 surge, the investigators hypothesized that HIV testing in PWUD would decrease. To answer this question, they compiled a deidentified list of hospitalized patients with electronic medical record indicators of substance use-a positive urine toxicology screen, prescribed medications to treat opioid use disorder, a positive CIWA score, or a positive CAGE score-admitted between January, 2020 and August, 2020.
AHRQ-funded; HS026008.
Citation: Zubiago J, Murphy M, Guardado R .
Increased HIV testing in people who use drugs hospitalized in the first wave of the COVID-19 pandemic.
J Subst Abuse Treat 2021 May;124:108266. doi: 10.1016/j.jsat.2020.108266..
Keywords: Human Immunodeficiency Virus (HIV), Opioids, Substance Abuse, Alcohol Use, Hospitalization, COVID-19, Public Health, Screening
Anderson KE, Saloner B, Eckstein J
Quality of buprenorphine care for insured adults with opioid use disorder.
This retrospective cohort study evaluated the quality of treatment for insured adults with opioid use disorder (OUD) in the United States. A total of 45,210 commercially insured and Medicare Advantage (MA) enrollees 18 years or older from the OptumLabs Data Warehouse database with an OUD diagnosis in 2018 were analyzed. The treatment analyzed was use of buprenorphine. Only 1 in 10 eligible individuals with OUD initiated buprenorphine within 365 days of diagnosis with 2850 individuals (6.3%) initiating buprenorphine within 14 days of diagnosis. Of the 4600 individuals who received buprenorphine, half were maintained in care with 180 days or more of covered treatment. Treatment quality was generally lower for individuals with MA compared with commercial coverage as well as Hispanic and Black adults compared with White adults.
AHRQ-funded; HS000029.
Citation: Anderson KE, Saloner B, Eckstein J .
Quality of buprenorphine care for insured adults with opioid use disorder.
Med Care 2021 May;59(5):393-401. doi: 10.1097/mlr.0000000000001530..
Keywords: Opioids, Medication, Substance Abuse, Quality of Care
Bunting AM, Frank D, Arshonsky J
Socially-supportive norms and mutual aid of people who use opioids: an analysis of Reddit during the initial COVID-19 pandemic.
This study looked at the effect big events like the COVID-19 pandemic can have on transforming social structures, social interactions, and social norms. The social media site Reddit.com was used to collect data on the impact of COVID-19 and opioid use. Posts from March to May 2020 were collected from the two most popular opioid subreddits. Out of 2000 posts, 300 were found to be relevant to the study. The pandemic led to robust social support and mutual aid on Reddit including advice on coping with social isolation, withdrawal, managing cravings, and accessing recovery resources.
AHRQ-funded; HS026120.
Citation: Bunting AM, Frank D, Arshonsky J .
Socially-supportive norms and mutual aid of people who use opioids: an analysis of Reddit during the initial COVID-19 pandemic.
Drug Alcohol Depend 2021 May 1;222:108672. doi: 10.1016/j.drugalcdep.2021.108672..
Keywords: Opioids, Medication, Substance Abuse, COVID-19, Infectious Diseases, Social Media
Griffith KN, Feyman Y, Auty SG
County-level data on U.S. opioid distributions, demographics, healthcare supply, and healthcare access.
Researchers created a dataset to provide a new level of precision that may be leveraged by scholars, policymakers, or data journalists who are interested in studying the opioid epidemic. Other researchers may use this dataset to identify patterns in opioid distribution over time and characteristics of counties or states which were disproportionately impacted by the epidemic. These data may also be joined with other sources to facilitate studies on the relationships between opioid pill volume and a wide variety of health, economic, and social outcomes.
AHRQ-funded; HS026395.
Citation: Griffith KN, Feyman Y, Auty SG .
County-level data on U.S. opioid distributions, demographics, healthcare supply, and healthcare access.
Data Brief 2021 Apr;35:106779. doi: 10.1016/j.dib.2021.106779.
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Keywords: Opioids, Medication, Substance Abuse
Tsui JI, Akosile MA, Lapham GT
Prevalence and medication treatment of opioid use disorder among primary care patients with hepatitis C and HIV.
Hepatitis C and HIV are associated with opioid use disorders (OUD) and injection drug use. Medications for OUD can prevent the spread of HCV and HIV. The objective of this retrospective observational cohort study was to describe the prevalence of documented OUD, as well as receipt of office-based medication treatment, among primary care patients with HCV or HIV.
AHRQ-funded; HS026369.
Citation: Tsui JI, Akosile MA, Lapham GT .
Prevalence and medication treatment of opioid use disorder among primary care patients with hepatitis C and HIV.
J Gen Intern Med 2021 Apr;36(4):930-37. doi: 10.1007/s11606-020-06389-7..
Keywords: Opioids, Medication, Substance Abuse, Behavioral Health, Hepatitis, Human Immunodeficiency Virus (HIV), Primary Care
Anderson KE, Alexander GC, Niles L
Quality of preventive and chronic illness care for insured adults with opioid use disorder.
Investigators sought to measure quality of non-opioid use disorder (OUD) preventive and chronic illness care and care coordination for individuals with OUD compared with individuals without OUD. They used deidentified data on outpatients throughout the United States from claims for commercially insured and Medicare Advantage enrollees aged 18 years or older with diagnosis codes for OUD. They found that individuals with OUD have moderately lower quality of care across preventive and chronic illness care and care coordination for non-OUD care compared with individuals without OUD. They recommended more attention to measurement and improvement of non-OUD care for these individuals.
AHRQ-funded; HS000029.
Citation: Anderson KE, Alexander GC, Niles L .
Quality of preventive and chronic illness care for insured adults with opioid use disorder.
JAMA Netw Open 2021 Apr;4(4):e214925. doi: 10.1001/jamanetworkopen.2021.4925..
Keywords: Opioids, Medication, Substance Abuse, Quality Indicators (QIs), Quality of Care, Behavioral Health, Chronic Conditions, Prevention
Moriya AS, Xu L
AHRQ Author: Moriya AS
The complex relationships among race/ethnicity, social determinants, and opioid utilization.
The objective of this study was to examine individual- and community-level factors associated with racial/ethnic differences in individuals' opioid prescription use. The investigators found that the average annual rate of any outpatient opioid prescription use was higher for non-Hispanic whites than for non-Hispanic blacks and Hispanics. The smaller difference between non-Hispanic blacks and whites was not explained by the differences in the risk factors, while almost all the difference between Hispanics and non-Hispanic whites could be explained by the differences in the means of the risk factors.
AHRQ-authored.
Citation: Moriya AS, Xu L .
The complex relationships among race/ethnicity, social determinants, and opioid utilization.
Health Serv Res 2021 Apr;56(2):310-22. doi: 10.1111/1475-6773.13619..
Keywords: Medical Expenditure Panel Survey (MEPS), Racial and Ethnic Minorities, Social Determinants of Health, Opioids, Medication, Disparities
Afshar M, Sharma B, Bhalla S
External validation of an opioid misuse machine learning classifier in hospitalized adult patients.
This study looks at new methods to make opioid misuse screening in hospitals less resource-intensive, which causes it to occur rarely. The objective of this study is to externally validate the author’s previously published and open-source machine learning classifier by implementing it a different hospital to identify cases of opioid misuse. An observational cohort of 56,227 adult hospitalizations from October 2017 to December 2019 was used during a hospital-wide substance use screening program with manual screening. A manually completed Drug Abuse Screening Test served as the reference standard to validate a convolutional neural network (CNN) classified with coded word embedding features to capture electronic health record (EHR) clinical notes. Manual screening was completed in 67.8% of patients with 1.1% identified with opioid misuse. The opioid misuse classifier had good discrimination during external validation and may help overcome manual screening barriers.
AHRQ-funded; HS026385.
Citation: Afshar M, Sharma B, Bhalla S .
External validation of an opioid misuse machine learning classifier in hospitalized adult patients.
Addict Sci Clin Pract 2021 Mar 17;16(1):19. doi: 10.1186/s13722-021-00229-7..
Keywords: Opioids, Medication, Substance Abuse, Screening, Hospitalization
Nourjah P, Kato E
AHRQ Author: Nourjah P, Kato E
"One size does not fit all" and other lessons learned from grants for implementation of the AHRQ medication assisted treatment for opioid use disorder in rural primary care.
This article summarizes lessons learned from five AHRQ grants to implement Medication for Opioid Use Disorder (MOUD) in rural primary care practices. The experience of these projects suggests that recruiting providers in rural areas and engaging them to initiate and sustain provision of MOUD is very difficult. Implementation of MOUD in rural primary care is challenging but success is more likely if implementers are attentive to the needs of individual providers, are flexible and can tailor implementation to the local situation, and can provide on-going support.
AHRQ-authored.
Citation: Nourjah P, Kato E .
"One size does not fit all" and other lessons learned from grants for implementation of the AHRQ medication assisted treatment for opioid use disorder in rural primary care.
Subst Abus 2021;42(2):136-39. doi: 10.1080/08897077.2021.1891600..
Keywords: Implementation, Opioids, Substance Abuse, Primary Care, Rural Health, Medication
Cole ES, DiDomenico E, Green S
The who, the what, and the how: a description of strategies and lessons learned to expand access to medications for opioid use disorder in rural America.
This study looked at the problems of treatment access for opioid use disorder (OUD) in rural areas within the United States. Providers must complete 8-24 hours of training to obtain the Drug Addiction Treatment Act (DATA) 2000 waiver to have the legal authority to prescribe buprenorphine. The authors executed 5 AHRQ-funded dissemination and implementation grants to study and address barriers to providing Medications for Opioid Use Disorder Treatment (MOUD), including psychosocial supports. Obtaining the DATA 2000 waiver was found to be just one component of meaningful treatment using MOUD, and there are other significant barriers that providers face daily. The researchers’ initiatives and common lessons learned across their grants are summarized and recommendations are offered how primary care providers can be better supported to expand access to MOUD across rural America.
AHRQ-funded.
Citation: Cole ES, DiDomenico E, Green S .
The who, the what, and the how: a description of strategies and lessons learned to expand access to medications for opioid use disorder in rural America.
Subst Abus 2021;42(2):123-29. doi: 10.1080/08897077.2021.1891492..
Keywords: Opioids, Medication, Primary Care, Rural Health, Substance Abuse, Access to Care
Rapoport AB, Fine DR, Manne-Goehler JM
High inpatient health care utilization and charges associated with injection drug use-related infections: a cohort study, 2012-2015.
This study described the characteristics of patients hospitalized with injection drug use-related infection over a multiyear period in a region highly impacted by the opioid epidemic. Findings revealed a longer average length of stay with subsequent higher cost, a higher percentage of 30-day readmissions, disproportionate public payer mix representation, and higher rates of discharge to alternate facilities for ongoing care as compared with the total inpatient cohort.
AHRQ-funded; HS026215.
Citation: Rapoport AB, Fine DR, Manne-Goehler JM .
High inpatient health care utilization and charges associated with injection drug use-related infections: a cohort study, 2012-2015.
Open Forum Infect Dis 2021 Mar;8(3):ofab009. doi: 10.1093/ofid/ofab009..
Keywords: Opioids, Substance Abuse, Hospitalization, Healthcare Costs, Healthcare Utilization
Agarwal AK, Lee D, Ali Z
Patient-reported opioid consumption and pain intensity after common orthopedic and urologic surgical procedures with use of an automated text messaging system.
This prospective study looked at the number of opioid tablets taken compared to the number prescribed after orthopedic and urologic surgery at a large urban academic health center in Pennsylvania from May to December 2019 with the use of an automated text messaging system. Of the 919 study participants, 80.7% (742) underwent orthopedic procedures and 19.2% underwent urologic procedures. Among those who underwent orthopedic procedures, 384 were women, 491 were White, and the median age was 48 years; with almost 70% outpatient procedures. Among those who underwent urologic procedures, 84.8% were men, 80.7% were White, and the median age was 56 years; 62% had an outpatient procedure. Orthopedic patients were prescribed an average of 20 tablets and urologic patients 7 tablets. The majority of patients (64.1%) used less than half of the amount prescribed, and 256 orthopedic and 77 urologic patients did not use any opioids. The findings suggest that clinicians can tailor prescriptions to limit excess quantities of prescribed opioids.
AHRQ-funded; HS026372.
Citation: Agarwal AK, Lee D, Ali Z .
Patient-reported opioid consumption and pain intensity after common orthopedic and urologic surgical procedures with use of an automated text messaging system.
JAMA Netw Open 2021 Mar;4(3):e213243. doi: 10.1001/jamanetworkopen.2021.3243..
Keywords: Opioids, Medication, Pain, Orthopedics, Surgery
Wyse JJ, Lovejoy J, Holloway J
Patients' perceptions of the pathways linking chronic pain with problematic substance use.
This study examined how patients with chronic pain perceive their relationship between their substance use disorder (SUD) and chronic pain. About one-half of patients with SUDs experience chronic pain. The authors conducted qualitative interviews with 34 patients involved in SUD treatment who were also diagnosed with chronic pain. The interviews revealed 3 primary pathways. One group described SUD as development independently from their experiences of chronic pain. A second group described turning to substances to self-manage or cope with the chronic pain. A third group described encounters with opioid medications as the causal agent.
AHRQ-funded; HS026370.
Citation: Wyse JJ, Lovejoy J, Holloway J .
Patients' perceptions of the pathways linking chronic pain with problematic substance use.
Pain 2021 Mar;162(3):787-93. doi: 10.1097/j.pain.0000000000002077..
Keywords: Opioids, Substance Abuse, Medication, Pain, Chronic Conditions
Gibson DC, Raji MA, Baillargeon JG
Regional and temporal variation in receipt of long-term opioid therapy among older breast, colorectal, lung, and prostate cancer survivors in the United States.
The authors investigated the geographical and temporal variation in long-term opioid therapy rates for older cancer survivors using SEER-Medicare data. They found that the annual trends in the receipt of long-term opioid therapy significantly varied by region among older cancer survivors. They indicated that variation in a clinical practice suggested the need for more research and interventions in order to improve efficiency, process, cost, and quality of care.
AHRQ-funded; HS026133.
Citation: Gibson DC, Raji MA, Baillargeon JG .
Regional and temporal variation in receipt of long-term opioid therapy among older breast, colorectal, lung, and prostate cancer survivors in the United States.
Cancer Med 2021 Mar;10(5):1550-61. doi: 10.1002/cam4.3709..
Keywords: Elderly, Cancer, Opioids, Medication
McCarthy DM, Kim HS, Hur SI
Patient-reported opioid pill consumption after an ed visit: how many pills are people using?
This study examined opioid use patterns after an emergency department (ED) visit. The study was conducted at an urban academic emergency department and included patients 18 years or older, not chemically using opioids, and had been newly prescribed hydrocodone-acetaminophen. They were asked to complete and return a 10-day medication diary. Two-hundred sixty patients returned completed medication diaries that included treatment for different conditions. The mean age was 45 years and 59% of the sample was female. The median number of pills prescribed was 12. Patients with renal colic used the least number of pills and patients with back pain used the most. Almost all (92.5%) of patients had leftover pills by the end of the 10 days.
AHRQ-funded; HS023459.
Citation: McCarthy DM, Kim HS, Hur SI .
Patient-reported opioid pill consumption after an ed visit: how many pills are people using?
Pain Med 2021 Feb 23;22(2):292-302. doi: 10.1093/pm/pnaa048..
Keywords: Opioids, Medication, Emergency Department, Practice Patterns, Pain
Beetham T, Saloner B, Gaye M
Admission practices and cost of care for opioid use disorder at residential addiction treatment programs in the US.
This study looked at admission practices and cost of care for opioid use disorder at profit and nonprofit residential addiction treatment programs in the US. An audit survey of 613 residential programs was conducted nationally where the caller posed as an uninsured cash-paying individual using heroin and seeking addiction treatment. One-third of callers were offered admission before clinical admission, usually within one day of initial contact. Most programs required up-front payments, with for-profit programs charging almost three times as much ($17,434) as nonprofits ($5,712). Recruitment techniques such as paid transportation was used frequently by for-profit, but not by nonprofit programs. Other practices included admission offers during the call. High up-front payments were common even among programs with third-party accreditation and state licenses. These practices may be an issue for a clinically and financially vulnerable population for costly treatment without assessing other care settings.
AHRQ-funded; HS017589.
Citation: Beetham T, Saloner B, Gaye M .
Admission practices and cost of care for opioid use disorder at residential addiction treatment programs in the US.
Health Aff 2021 Feb;40(2):317-25. doi: 10.1377/hlthaff.2020.00378..
Keywords: Opioids, Substance Abuse, Healthcare Costs
Griffith KN, Feyman Y, Auty SG
Implications of county-level variation in U.S. opioid distribution.
Investigators used a novel dataset to investigate the distributional patterns of prescription opioids; whether opioid pill volume was associated with opioid-related mortality; and whether early state Medicaid expansions were associated with either pill volume or opioid-related mortality. Data on opioid shipments to retail pharmacies for 2006-2013 were obtained from the U.S. Drug Enforcement Administration and were mapped to opioid-related deaths (ORDs) from the CDC. The authors compared characteristics of counties in the highest and lowest quartiles for per capita pill volume (PCPV) to determine if they were associated with ORDs and whether early state Medicaid expansions were associated with either outcome. There were large geographic variations found in opioid distribution driven by differences in demographics, healthcare access, and healthcare supply. Early Medicaid expansion states were found to have reduced opioid pill volume. A one-pill increase in PCPV was associated with a 0.20 increase in ORDs per 100,000 population.
AHRQ-funded; HS026395.
Citation: Griffith KN, Feyman Y, Auty SG .
Implications of county-level variation in U.S. opioid distribution.
Drug Alcohol Depend 2021 Feb 1;219:108501. doi: 10.1016/j.drugalcdep.2020.108501..
Keywords: Opioids, Medication, Substance Abuse, Mortality
Feder SL, Canavan ME, Wang S
Patterns of opioid prescribing among Medicare Advantage beneficiaries with pain and cardiopulmonary conditions.
This study’s objective was to compare patterns of opioid prescribing among older adults reporting pain with cardiopulmonary conditions, cancer, or both. Data from the Surveillance, Epidemiology, and End Results-Medicare Health Outcomes Survey resource linked to Medicare Part D prescription claims was used to identify patients who self-reported moderate- to-severe pain interference with daily activities. Patients included were stratified by 1) self-reported history of cardiopulmonary conditions; 2) were within five years of cancer diagnosis; 3) had both conditions; or 4) neither. Of 10,516 patients identified, 1758 had cardiopulmonary conditions, 3383 cancer, 2861 both, and 2514 neither: with 46% aged 75 or more, 65% non-Hispanic white, and 10% non-Hispanic black. At the time of the survey, 1627 (15.5%) received opioids. Adjusted proportions of opioid use were similar for all conditions, with 14% for cardiopulmonary conditions only, 17% with cancer only, and 17% for both conditions. Patients with neither condition had a 13.1% opioid use rate.
AHRQ-funded; HS022882; HS025164.
Citation: Feder SL, Canavan ME, Wang S .
Patterns of opioid prescribing among Medicare Advantage beneficiaries with pain and cardiopulmonary conditions.
J Palliat Med 2021 Feb;24(2):195-204. doi: 10.1089/jpm.2020.0193..
Keywords: Elderly, Opioids, Medication, Practice Patterns, Medicare
Feliciano JL, Waldfogel JM, Sharma R
Pharmacologic interventions for breathlessness in patients with advanced cancer: a systematic review and meta-analysis.
This systematic review and meta-analysis examined the use of pharmacological interventions for breathlessness in patients with advanced cancer. Studies were identified from database inception to May 2020 using predefined eligibility criteria. Pharmacologic intervention benefits and harms were compared, focusing on breathlessness, anxiety, exercise capacity and health-related quality of life. Out of 7729 unique citations, 19 studies with a total of 1424 patients were included. Opioids were not associated with more effectiveness than placebo for improving breathlessness or exercise capacity. Anxiolytics were also not associated with more effectiveness than placebo for breathlessness or anxiety. There was limited evidence for other pharmacologic interventions. There was some harm, but it was minimal in those short-term studies.
AHRQ-funded; 290201500006I.
Citation: Feliciano JL, Waldfogel JM, Sharma R .
Pharmacologic interventions for breathlessness in patients with advanced cancer: a systematic review and meta-analysis.
JAMA Netw Open 2021 Feb;4(2):e2037632. doi: 10.1001/jamanetworkopen.2020.37632..
Keywords: Cancer: Lung Cancer, Cancer, Respiratory Conditions, Medication, Treatments, Opioids, Evidence-Based Practice, Comparative Effectiveness, Quality of Life, Outcomes, Patient-Centered Outcomes Research
Hirai AH, Ko JY, Owens PL
AHRQ Author: Owens PL, Stocks C
Neonatal abstinence syndrome and maternal opioid-Related diagnoses in the US, 2010-2017.
This study analyzed trends in neonatal abstinence syndrome (NAS) and maternal opioid-Related diagnosis (MOD) in the United States from 2010 to 2017. A cross-sectional analysis was done of the HCUP National Inpatient Sample and State Inpatient Database from 2010 through 2017. Diagnoses of NAS and MOD were found using the ICD-10, CM codes. Significant increases occurred in rates of NAS, from 4.0 to 7.3 per birth hospitalizations and MOD, from 3.5 to 8.2 per 1000 delivery hospitalizations. A census of 47 state databases in 2017 found a large range of NAS rates – from 1.3 per 1000 birth hospitalizations in Nebraska to 53.5 per 1000 hospitalizations in West Virginia with the same ranges found for MOD rates. In all states except Nebraska and Vermont which only had significant MOD increases, NAS and MOD rates rose significantly from 2010 to 2017.
AHRQ-authored; AHRQ-funded; 290201800001C.
Citation: Hirai AH, Ko JY, Owens PL .
Neonatal abstinence syndrome and maternal opioid-Related diagnoses in the US, 2010-2017.
Neonatal abstinence syndrome and maternal opioid-Related diagnoses in the US, 2010-2017..
Keywords: Healthcare Cost and Utilization Project (HCUP), Newborns/Infants, Opioids, Medication, Substance Abuse, Hospitalization, Pregnancy
Hood-Medland EA, White AEC, Kravitz RL
Agenda setting and visit openings in primary care visits involving patients taking opioids for chronic pain.
This study looked at primary care visit opening styles to assess use of agenda and non-agenda setting visit openings and their effects on participant experience with patients taking opioids for chronic pain. The study analyzed 83 video-recorded US primary care visits at a single academic medical center in California. A total of 49 family medicine and internal resident physicians and 83 patients were filmed. The authors developed a coding scheme that assessed the presence of agenda setting, distinct visit opening styles, and the number of total topics, major topics, surprise patient topics, and returns to prior topics discusses. They identified 2 visit opening styles with agenda setting (agenda eliciting, agenda reframing) and 3 non-agenda opening styles (open-ended question, patient launch, physician launch). Only 11% of visits included agenda setting and was associated with fewer surprise patient topics than visits without agenda setting.
AHRQ-funded; HS022236.
Citation: Hood-Medland EA, White AEC, Kravitz RL .
Agenda setting and visit openings in primary care visits involving patients taking opioids for chronic pain.
BMC Fam Pract 2021 Jan 4;22(1):4. doi: 10.1186/s12875-020-01317-4..
Keywords: Primary Care, Opioids, Medication, Pain, Chronic Conditions, Clinician-Patient Communication, Communication, Ambulatory Care and Surgery