National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
Data
- Data Infographics
- Data Visualizations
- Data Tools
- Data Innovations
- All-Payer Claims Database
- Healthcare Cost and Utilization Project (HCUP)
- Medical Expenditure Panel Survey (MEPS)
- AHRQ Quality Indicator Tools for Data Analytics
- State Snapshots
- United States Health Information Knowledgebase (USHIK)
- Data Sources Available from AHRQ
Search All Research Studies
AHRQ Research Studies Date
Topics
- Access to Care (12)
- Adverse Drug Events (ADE) (24)
- Adverse Events (15)
- Alcohol Use (3)
- Ambulatory Care and Surgery (7)
- Antibiotics (1)
- Arthritis (1)
- Asthma (1)
- Back Health and Pain (4)
- Behavioral Health (57)
- Cancer (7)
- Cancer: Breast Cancer (2)
- Cancer: Lung Cancer (2)
- Cardiovascular Conditions (1)
- Caregiving (2)
- Care Management (12)
- Children's Health Insurance Program (CHIP) (1)
- Children/Adolescents (16)
- Chronic Conditions (44)
- Clinical Decision Support (CDS) (3)
- Clinician-Patient Communication (5)
- Communication (7)
- Community-Based Practice (2)
- Comparative Effectiveness (7)
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) (1)
- COVID-19 (5)
- Critical Care (1)
- Decision Making (5)
- Dementia (1)
- Dental and Oral Health (9)
- Depression (2)
- Digestive Disease and Health (1)
- Disparities (7)
- Education: Continuing Medical Education (1)
- Education: Curriculum (1)
- Education: Patient and Caregiver (2)
- Elderly (24)
- Electronic Health Records (EHRs) (1)
- Electronic Prescribing (E-Prescribing) (1)
- Emergency Department (20)
- Emergency Medical Services (EMS) (3)
- Evidence-Based Practice (17)
- Falls (1)
- Family Health and History (1)
- Guidelines (13)
- Healthcare Cost and Utilization Project (HCUP) (10)
- Healthcare Costs (8)
- Healthcare Delivery (6)
- Healthcare Utilization (10)
- Health Information Technology (HIT) (11)
- Health Insurance (6)
- Health Literacy (2)
- Hepatitis (2)
- Hospital Discharge (7)
- Hospitalization (14)
- Hospital Readmissions (4)
- Hospitals (5)
- Human Immunodeficiency Virus (HIV) (8)
- Implementation (7)
- Infectious Diseases (4)
- Injuries and Wounds (5)
- Inpatient Care (6)
- Long-Term Care (4)
- Medicaid (13)
- Medical Errors (1)
- Medical Expenditure Panel Survey (MEPS) (7)
- Medicare (7)
- Medication (257)
- Medication: Safety (27)
- Mortality (15)
- Neurological Disorders (1)
- Newborns/Infants (4)
- Nursing Homes (3)
- Obesity (3)
- Obesity: Weight Management (1)
- (-) Opioids (303)
- Orthopedics (8)
- Outcomes (9)
- Pain (91)
- Palliative Care (2)
- Patient-Centered Healthcare (4)
- Patient-Centered Outcomes Research (17)
- Patient Adherence/Compliance (1)
- Patient and Family Engagement (2)
- Patient Experience (2)
- Patient Safety (25)
- Patient Self-Management (1)
- Policy (20)
- Practice Patterns (68)
- Pregnancy (6)
- Prevention (10)
- Primary Care (31)
- Primary Care: Models of Care (4)
- Provider (17)
- Provider: Clinician (3)
- Provider: Nurse (1)
- Provider: Pharmacist (12)
- Provider: Physician (7)
- Provider: Physician Assistant (1)
- Public Health (3)
- Quality Improvement (2)
- Quality Indicators (QIs) (1)
- Quality of Care (4)
- Quality of Life (1)
- Racial and Ethnic Minorities (10)
- Respiratory Conditions (3)
- Risk (15)
- Rural/Inner-City Residents (2)
- Rural Health (14)
- Screening (5)
- Sepsis (1)
- Sex Factors (2)
- Sickle Cell Disease (2)
- Social Determinants of Health (3)
- Social Media (1)
- Social Stigma (4)
- Stroke (1)
- Substance Abuse (154)
- Surgery (35)
- Teams (2)
- Telehealth (3)
- Tools & Toolkits (1)
- Training (3)
- Transitions of Care (2)
- Treatments (4)
- Vulnerable Populations (4)
- Women (5)
- Young Adults (4)
AHRQ Research Studies
Sign up: AHRQ Research Studies Email updates
Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
176 to 200 of 303 Research Studies DisplayedHeins SE, Frey KP, Alexander GC
Reducing high-dose opioid prescribing: state-level morphine equivalent daily dose policies, 2007-2017.
This paper looked at current state-level policies in the United States from January 2007-May 2017 limiting high morphine equivalent daily dose (MEDD) prescribing. State-level threshold policies were reviewed using LexisNexis and Westlaw Next for legislative acts and Google for nonlegislative state-level policies. State websites were also reviewed to identify additional policies. Policies were then independently double-coded on the categories: state, agency/organization, policy type, effective date, threshold level, and policy exceptions. Currently 22 states have at least 1 MEDD policy, most commonly guidelines (14 states). Other states have prior authorizations (4 states), rules/regulations (4 states), legislative acts (3 states), claim denials (2 states), and alert systems/automatic patient reports (2 states). Thresholds vary widely (30-300 mg MEDD), with higher thresholds corresponding to more restrictive policies (claim denial), and lower thresholds corresponding to less restrictive policies (guidelines). The majority of policies exclude patients with terminal illnesses or acute pain.
AHRQ-funded; HS025557.
Citation: Heins SE, Frey KP, Alexander GC .
Reducing high-dose opioid prescribing: state-level morphine equivalent daily dose policies, 2007-2017.
Pain Med 2020 Feb;21(2):308-16. doi: 10.1093/pm/pnz038..
Keywords: Opioids, Medication, Policy, Practice Patterns, Substance Abuse
Herzig SJ, Stefan MS, Pekow PS
Risk factors for severe opioid-related adverse events in a national cohort of medical hospitalizations.
The objective of this study was to identify independent risk factors for severe opioid-related adverse drug events (ORADEs) in hospitalized patients. This retrospective cohort study used data from medical patients hospitalized at US non-federal and acute care facilities with at least one pharmacy charge. They excluded patients with metastatic, hospice, or palliative care billing codes. Out of 731,208 hospitalizations there was a severe ORADE in 2727 (0.4%) of patients. Independent risk factors included advanced age, female gender, comorbidities, organ failures on admission, medication co-administrations, and characteristics of the opioids themselves. These risk factors can be used to inform physician decision-making and conversations with patients about risk.
AHRQ-funded; HS026215.
Citation: Herzig SJ, Stefan MS, Pekow PS .
Risk factors for severe opioid-related adverse events in a national cohort of medical hospitalizations.
J Gen Intern Med 2020 Feb;35(2):538-45. doi: 10.1007/s11606-019-05490-w..
Keywords: Opioids, Medication, Adverse Drug Events (ADE), Adverse Events, Risk, Hospitalization
Parchman ML, Ike B, Osterhage KP
Barriers and facilitators to implementing changes in opioid prescribing in rural primary care clinics.
This paper discusses the barriers and facilitators to implementing changes in opioid prescription in rural areas using the Six Building Blocks evidence-based program to reduce opioid prescription in primary care practices. The program was implemented at 6 rural and rural-serving organizations with 20 clinic locations over a 15-month period. Interviews and focus groups with conducted with the organizations at the end of the program period. Facilitators included a desire to help patients and their community; external pressures to make changes in opioid management; a desire to reduce workplace stress; external support for the clinic; supportive clinic leadership; and receptivity of patients. Barriers included competing demands on clinicians and staff; a culture of clinician autonomy; inadequate data systems; and a lack of patient resources in rural areas.
AHRQ-funded; HS023750.
Citation: Parchman ML, Ike B, Osterhage KP .
Barriers and facilitators to implementing changes in opioid prescribing in rural primary care clinics.
J Clin Transl Sci 2020 Jan 10;4(5):425-30. doi: 10.1017/cts.2019.448..
Keywords: Opioids, Medication, Rural Health, Primary Care, Primary Care: Models of Care, Implementation, Pain, Chronic Conditions, Healthcare Delivery
Chin KK, Carroll I, Desai K
Integrating adjuvant analgesics into perioperative pain practice: results from an academic medical center.
This study evaluated adjuvant analgesic gabapentin use after total knee arthroplasty (TKA) surgery and its effects on opioid use, pain, and readmissions. This retrospective observational study included 4,046 TKA recipients from 2009 to 2017 using electronic health records from an academic tertiary care medical institute. Overall, there was an 8.72% annual increase in gabapentin use which was associated with a significant decrease in opioid consumption in modeled estimates. Patients receiving gabapentin had similar discharge and follow-up pain scores, and 30-day unplanned readmission rates compared with patients receiving no adjuvant analgesics.
AHRQ-funded; HS024096.
Citation: Chin KK, Carroll I, Desai K .
Integrating adjuvant analgesics into perioperative pain practice: results from an academic medical center.
Pain Med 2020 Jan;21(1):161-70. doi: 10.1093/pm/pnz053..
Keywords: Opioids, Medication, Pain, Surgery, Orthopedics
Neill LA, Kim HS, Cameron KA
Who is keeping their unused opioids and why?
The purpose of this study was to gain a better understanding of patients' reasoning for keeping unused opioid pills. This manuscript describes a sample of patients who kept their unused opioids and presents qualitative data detailing their personal reasoning for keeping the unused pills. Awareness of the range of motivations underpinning this behavior may inform the development of tailored education and risk communication messages to improve opioid disposal.
AHRQ-funded; HS023459.
Citation: Neill LA, Kim HS, Cameron KA .
Who is keeping their unused opioids and why?
Pain Med 2020 Jan;21(1):84-91. doi: 10.1093/pm/pnz025..
Keywords: Opioids, Medication, Medication: Safety, Patient Safety
Ferguson WJ, Johnston J, Clarke JG
Advancing the implementation and sustainment of medication assisted treatment for opioid use disorders in prisons and jails.
Four jail and prison systems partnered with researchers to document their adoption of medication assisted therapy (MAT) for incarcerated individuals with opioid use disorders using their established treatment protocols. Despite efforts at all four sites to increase utilization of MAT, only one site achieved sustained growth in the proportion of individuals treated over the course of the project. Recommendations included adoption of evidence-based MATs for opioid use disorders in prisons and jails with persistent effort to identify and overcome challenges and dedicated funding to sustain programs.
AHRQ-funded; HS024243.
Citation: Ferguson WJ, Johnston J, Clarke JG .
Advancing the implementation and sustainment of medication assisted treatment for opioid use disorders in prisons and jails.
Health Justice 2019 Dec 12;7(1):19. doi: 10.1186/s40352-019-0100-2..
Keywords: Opioids, Medication, Substance Abuse, Vulnerable Populations
McCarthy DM, Curtis LM, Courtney DM
A multifaceted intervention to improve patient knowledge and safe use of opioids: results of the ED EMC(2) randomized controlled trial.
Despite increased focus on opioid prescribing, little is known about the influence of prescription opioid medication information given to patients in the emergency department (ED). The objective of this study was to evaluate the effect of an Electronic Medication Complete Communication (EMC(2)) Opioid Strategy on patients' safe use of opioids and knowledge about opioids. The study found that the EMC(2) tools improved demonstrated safe dosing, but these benefits did not translate into actual use based on medication dairies. The text-messaging intervention did result in improved patient knowledge.
AHRQ-funded; HS023459.
Citation: McCarthy DM, Curtis LM, Courtney DM .
A multifaceted intervention to improve patient knowledge and safe use of opioids: results of the ED EMC(2) randomized controlled trial.
Acad Emerg Med 2019 Dec;26(12):1311-25. doi: 10.1111/acem.13860..
Keywords: Opioids, Medication, Medication: Safety, Patient Safety, Health Literacy, Education: Patient and Caregiver, Clinician-Patient Communication, Communication, Health Information Technology (HIT)
Salvador J, Bhatt S, Fowler R
Engagement with Project ECHO to increase medication-assisted treatment in rural primary care.
The purpose of this study was to understand the barriers and facilitators that affect engagement with Project ECHO (Extension for Community Healthcare Outcomes) to implement medication-assisted treatment (MAT) in primary care settings. This brief report identified key systematic challenges that may directly limit primary care providers' engagement in telementoring models such as Project ECHO.
AHRQ-funded; HS025345.
Citation: Salvador J, Bhatt S, Fowler R .
Engagement with Project ECHO to increase medication-assisted treatment in rural primary care.
Psychiatr Serv 2019 Dec;70(12):1157-60. doi: 10.1176/appi.ps.201900142..
Keywords: Opioids, Medication, Substance Abuse, Primary Care, Rural Health, Telehealth, Health Information Technology (HIT)
Tam CA, Dauw CA, Ghani KR
New persistent opioid use after outpatient ureteroscopy for upper tract stone treatment.
The purpose of this study was to measure the incidence of persistent opioid use following ureteroscopy (URS). Over 100 Americans die every day from opioid overdose. Recent studies suggest that many opioid addictions surface after surgery. The investigators concluded that nearly 1 in 16 opioid-naive patients developed new persistent opioid use after URS. New persistent opioid use was associated with the amount of opioid prescribed at the time of URS. The authors suggest that, given these findings, urologists should re-evaluate their post-URS opioid prescribing patterns.
AHRQ-funded; HS024525; HS024728.
Citation: Tam CA, Dauw CA, Ghani KR .
New persistent opioid use after outpatient ureteroscopy for upper tract stone treatment.
Urology 2019 Dec;134:103-08. doi: 10.1016/j.urology.2019.08.042..
Keywords: Opioids, Medication, Substance Abuse, Surgery, Practice Patterns
Rentsch CT, Edelman EJ, Justice AC
Patterns and correlates of prescription opioid receipt among US Veterans: a national, 18-year observational cohort study.
A better understanding of predisposition to transition to high-dose, long-term opioid therapy after initial opioid receipt could facilitate efforts to prevent opioid use disorder (OUD). In this study, the investigators extracted data on 69,268 patients in the Veterans Aging Cohort Study who received any opioid prescription between 1998 and 2015. They identified four distinguishable dose trajectories. The authors indicate that their measures could potentially be used in future prevention research, including genetic discovery.
AHRQ-funded; HS021112; HS023258.
Citation: Rentsch CT, Edelman EJ, Justice AC .
Patterns and correlates of prescription opioid receipt among US Veterans: a national, 18-year observational cohort study.
AIDS Behav 2019 Dec;23(12):3340-49. doi: 10.1007/s10461-019-02608-3..
Keywords: Opioids, Medication, Substance Abuse, Human Immunodeficiency Virus (HIV), Pain, Chronic Conditions
Kurian S, Baloy B, Baird J
Attitudes and perceptions of naloxone dispensing among a sample of Massachusetts community pharmacy technicians.
AHRQ-funded; HS024021.
Citation: Kurian S, Baloy B, Baird J .
Attitudes and perceptions of naloxone dispensing among a sample of Massachusetts community pharmacy technicians.
J Am Pharm Assoc 2019 Nov-Dec;59(6):824-31. doi: 10.1016/j.japh.2019.08.009..
Keywords: Medication, Medication: Safety, Opioids, Substance Abuse, Provider: Pharmacist, Provider, Patient Safety
Klueh MP, Sloss KR, Dossett LA
Postoperative opioid prescribing is not my job: a qualitative analysis of care transitions.
This qualitative study aimed to describe transitions of care for postoperative opioid prescribing and to identify barriers and facilitators of ideal transitions for potential intervention targets. Results identified potential interventions aimed at changing physician behaviors regarding transitions of care for postoperative opioid prescribing. Implementation of these interventions could improve coordination of care for patients with persistent postoperative opioid use.
AHRQ-funded; HS026030.
Citation: Klueh MP, Sloss KR, Dossett LA .
Postoperative opioid prescribing is not my job: a qualitative analysis of care transitions.
Surgery 2019 Nov;166(5):744-51. doi: 10.1016/j.surg.2019.05.033..
Keywords: Opioids, Medication, Pain, Transitions of Care, Practice Patterns
Moore AB, Navarrett S, Herzig SJ
Potentially inappropriate use of intravenous opioids in hospitalized patients.
This study examined the frequency of potentially inappropriate intravenous (IV) opioid use in hospitalized patients. The researchers looked at patients hospitalized at a tertiary medical center. Patients with cancer, receiving comfort care, or gastrointestinal dysfunction were excluded. Using guidelines from the Society of Hospital Medicine IV doses were defined as potentially inappropriate if administered more than an initial IV does in patients who did not have nil per os status. Of the 200 patients in the study, 31% were administered potentially inappropriate IV opioids at least once during hospitalization, and 33% of all IV doses were potentially administered inappropriately.
AHRQ-funded; HS026215.
Citation: Moore AB, Navarrett S, Herzig SJ .
Potentially inappropriate use of intravenous opioids in hospitalized patients.
J Hosp Med 2019 Nov 1;14(10):678-80. doi: 10.12788/jhm.3225..
Keywords: Opioids, Medication, Inpatient Care, Decision Making
Colloca L, Lee SE, Luhowy MN
Relieving acute pain (RAP) study: a proof-of-concept protocol for a randomised, double-blind, placebo-controlled trial
This study hypothesizes that dose-extending placebos can be an effective treatment in relieving clinical acute pain in trauma patients who take opioids. Publishing this study protocol will enable researchers and funding bodies to stay up to date in their fields by providing exposure to research activity that may not be otherwise widely publicized.
AHRQ-funded; HS022135.
Citation: Colloca L, Lee SE, Luhowy MN .
Relieving acute pain (RAP) study: a proof-of-concept protocol for a randomised, double-blind, placebo-controlled trial
BMJ Open 2019 Nov 11;9(11):e030623. doi: 10.1136/bmjopen-2019-030623..
Keywords: Back Health and Pain, Pain, Chronic Conditions, Opioids, Medication
Andereck JW, Reuter QR, Allen KC
A quality improvement initiative featuring peer-comparison prescribing feedback reduces emergency department opioid prescribing.
This study compared opioid prescribing rates in emergency departments before and after a quality improvement initiative featuring peer-comparison feedback. All 117 ED prescribers at an urban academic medical center were provided regular feedback on their opioid prescribing rate compared to their de-identified peers. Pre-intervention rates were 8.6% compared to post-intervention at 4.8%.
AHRQ-funded; HS023011.
Citation: Andereck JW, Reuter QR, Allen KC .
A quality improvement initiative featuring peer-comparison prescribing feedback reduces emergency department opioid prescribing.
Jt Comm J Qual Patient Saf 2019 Oct;45(10):669-79. doi: 10.1016/j.jcjq.2019.07.008..
Keywords: Emergency Department, Opioids, Medication, Practice Patterns, Quality Improvement, Quality of Care
Springer R, Marino M,, Bailey SR
Prescription opioid use patterns, use disorder diagnoses and addiction treatment receipt after the 2014 Medicaid expansion in Oregon.
This study compared the prevalence of receipt of opioid prescriptions and opioid use disorder (OUD), along with time from OUD diagnosis to medication-assisted treatment (MAT) receipt between Oregon residents who had been continuously insured by Medicaid, were newly insured after Medicaid expansion in 2014 or returned to Medicaid coverage after expansion.
AHRQ-funded; HS024270.
Citation: Springer R, Marino M,, Bailey SR .
Prescription opioid use patterns, use disorder diagnoses and addiction treatment receipt after the 2014 Medicaid expansion in Oregon.
Addiction 2019 Oct;114(10):1775-84. doi: 10.1111/add.14667..
Keywords: Opioids, Medication, Substance Abuse, Medicaid, Practice Patterns, Health Insurance, Access to Care, Policy
Bach P, Hartung D
Leveraging the role of community pharmacists in the prevention, surveillance, and treatment of opioid use disorders.
This narrative review explores the literature describing novel programs designed to capitalize on the role of the community pharmacist in helping to reduce opioid-related harms, as well as evaluations of existing practices already in place in the US and elsewhere around the world. Specific approaches examined include strategies to facilitate pharmacist monitoring for problematic opioid use, to increase pharmacy-based harm reduction efforts (including naloxone distribution and needle exchange programs), and to involve community pharmacists in the dispensation of opioid agonist therapy.
AHRQ-funded; HS024227; 2902015000091.
Citation: Bach P, Hartung D .
Leveraging the role of community pharmacists in the prevention, surveillance, and treatment of opioid use disorders.
Addict Sci Clin Pract 2019 Sep 2;14(1):30. doi: 10.1186/s13722-019-0158-0..
Keywords: Medication, Opioids, Provider, Provider: Pharmacist, Substance Abuse
McCarthy DM, Russell AM , Effler MR
Implementation fidelity of patient-centered prescription label to promote opioid safe use.
The authors assessed implementation of a patient-centered "PRN" (as needed) label entitled "Take-Wait-Stop" (TWS) with three deconstructed steps replacing traditional wording. They found that exact intervention adherence was not achieved in the majority of cases, limiting impact, but that community pharmacies were responsive to new instructions, with higher implementation reliability requiring additional supports.
AHRQ-funded; HS023459.
Citation: McCarthy DM, Russell AM , Effler MR .
Implementation fidelity of patient-centered prescription label to promote opioid safe use.
Pharmacoepidemiol Drug Saf 2019 Sep;28(9):1251-57. doi: 10.1002/pds.4795..
Keywords: Opioids, Patient Safety, Health Literacy, Medication, Provider: Pharmacist, Provider
Ike B, Baldwin LM, Sutton S
Staff and clinician work-life perceptions after implementing systems-based improvements to opioid management.
The authors assessed the impact of implementing the Six Building Blocks on the work-life of primary care providers and staff. Six rural and rural-serving primary care organizations implemented the Six Building Blocks, with assistance from practice facilitators, clinical experts, and informatics specialists. The authors found that clinicians and staff reported improvement in their work-life after implementing the Six Building Blocks Program to improve opioid medication management and recommended further research on patient experiences specific to practice redesign programs.
AHRQ-funded; HS023750.
Citation: Ike B, Baldwin LM, Sutton S .
Staff and clinician work-life perceptions after implementing systems-based improvements to opioid management.
J Am Board Fam Med 2019 Sep-Oct;32(5):715-23. doi: 10.3122/jabfm.2019.05.190027.
.
.
Keywords: Opioids, Pain, Chronic Conditions, Primary Care: Models of Care, Primary Care, Care Management, Ambulatory Care and Surgery, Quality Improvement, Medication, Provider, Clinician-Patient Communication
Smith ME, Lee JS, Bonham A
Effect of new persistent opioid use on physiologic and psychologic outcomes following bariatric surgery.
In this study, the investigators sought to determine the relationship between new persistent opioid use and 1-year postoperative outcomes for patients undergoing bariatric surgery. The investigators concluded that new persistent opioid use is common following bariatric surgery and associated with significantly worse physiologic and psychologic outcomes. More effective screening and postoperative surveillance tools are needed to identify these patients, who likely require more aggressive counseling and treatment to maximize the benefits of bariatric surgery.
AHRQ-funded; HS024403.
Citation: Smith ME, Lee JS, Bonham A .
Effect of new persistent opioid use on physiologic and psychologic outcomes following bariatric surgery.
Surg Endosc 2019 Aug;33(8):2649-56. doi: 10.1007/s00464-018-6542-0..
Keywords: Opioids, Surgery, Medication, Obesity: Weight Management, Obesity, Obesity: Weight Management, Pain, Outcomes
Dy CJ, Peacock K, Olsen MA
Frequency and risk factors for prolonged opioid prescriptions after surgery for brachial plexus injury.
This study examined risk of prolonged opioid prescription use after surgery for brachial plexus injury (BPI). A cohort of BPI surgery patients was compared to a control group of non-BPI patients, matching for age, sex, and year. Pharmacy claims for prescriptions filled for opioids and neuropathic pain methods were examined 1 year before surgery to 180 days after surgery. The primary outcome studied was prolonged opioid prescription, which is defined as receiving a prescription 90 to 180 days after the surgery or randomly selected date of service for controls. Among BPI patients, a subgroup analysis was also performed on opioid-naïve patients between 30 days to 1 year before surgery. Among BPI surgery patients, 27.7% had prolonged opioid prescriptions, but only 10.8% of opioid-naïve patients had prolonged opioid prescriptions. The rate for controls was 0.11%. The rates of prolonged opioid prescriptions for BPI patients was higher than previous estimates among other surgical patients.
AHRQ-funded; HS019455.
Citation: Dy CJ, Peacock K, Olsen MA .
Frequency and risk factors for prolonged opioid prescriptions after surgery for brachial plexus injury.
J Hand Surg Am 2019 Aug;44(8):662-68.e1. doi: 10.1016/j.jhsa.2019.04.001..
Keywords: Opioids, Medication, Surgery, Pain, Practice Patterns, Risk, Chronic Conditions
Jeffery MM, Hooten WM, Jena AB
Rates of physician coprescribing of opioids and benzodiazepines after the release of the Centers for Disease Control and Prevention guidelines in 2016.
Researchers sought to determine whether the release of the CDC guidelines was associated with changes in co-prescription of opioids and benzodiazepines. Their study showed a reduction in the extent, but not the intensity, of co-prescribing of benzodiazepines for patients with long-term opioid use.
AHRQ-funded; HS025164.
Citation: Jeffery MM, Hooten WM, Jena AB .
Rates of physician coprescribing of opioids and benzodiazepines after the release of the Centers for Disease Control and Prevention guidelines in 2016.
JAMA Netw Open 2019 Aug 2;2(8):e198325. doi: 10.1001/jamanetworkopen.2019.8325..
Keywords: Opioids, Medication, Practice Patterns, Pain, Evidence-Based Practice, Guidelines
Cochran G, Cole ES, Warwick J
Rural access to MAT in Pennsylvania (RAMP): a hybrid implementation study protocol for medication assisted treatment adoption among rural primary care providers.
This paper reports the design and protocol of an implementation study seeking to advance availability of medication-assisted treatment (MAT) for opioid use disorder (OUD) in rural Pennsylvania counties for patients insured by Medicaid in primary care settings. Results showed an urgent need in the US to expand access to high quality, evidence-based OUD treatment, particularly in rural areas where capacity is limited for service delivery, in order to improve patient health and protect lives. Further, results of this study will provide needed evidence in the field for appropriate methods for implementing MAT among a large number of rural primary care providers.
AHRQ-funded; HS025072.
Citation: Cochran G, Cole ES, Warwick J .
Rural access to MAT in Pennsylvania (RAMP): a hybrid implementation study protocol for medication assisted treatment adoption among rural primary care providers.
Addict Sci Clin Pract 2019 Aug 1;14(1):25. doi: 10.1186/s13722-019-0154-4..
Keywords: Opioids, Substance Abuse, Rural Health, Medication, Access to Care, Implementation, Primary Care, Healthcare Delivery, Medicaid
Kim HS, Kaplan SH, McCarthy DM
A comparison of analgesic prescribing among ED back and neck pain visits receiving physical therapy versus usual care.
Researchers used a retrospective cohort study to examine whether physical therapy (PT) is associated with lower analgesic prescribing in the emergency department (ED) setting. They found that, in this single center study, ED back and neck pain visits receiving PT were no less likely to receive an opioid prescription and were more likely to receive a benzodiazepine than visits receiving usual care. They conclude that, although prior studies demonstrated that PT may reduce opioid utilization in the subsequent year, these results indicated that analgesic prescribing is not reduced at the initial ED encounter.
AHRQ-funded; HS023011.
Citation: Kim HS, Kaplan SH, McCarthy DM .
A comparison of analgesic prescribing among ED back and neck pain visits receiving physical therapy versus usual care.
Am J Emerg Med 2019 Jul;37(7):1322-26. doi: 10.1016/j.ajem.2018.10.009..
Keywords: Opioids, Medication, Practice Patterns, Emergency Department, Patient-Centered Outcomes Research, Pain, Back Health and Pain, Outcomes, Evidence-Based Practice
Kim SC, Jin Y, Lee YC
Association of preoperative opioid use with mortality and short-term safety outcomes after total knee replacement.
The purpose of this study was to determine the association of preoperative opioid use among patients 65 years and older with mortality and other complications at 30 days post-total knee replacement (TKR). Findings show that continuous opioid users had a higher risk of revision operations, vertebral fractures, and opioid overdose at 30 days post-TKR but not of in-hospital or 30-day mortality, compared with opioid-naive patients. Highlights include the need for better understanding of patient characteristics associated with chronic opioid use to optimize preoperative assessment of overall risk after TKR.
AHRQ-funded; HS018910.
Citation: Kim SC, Jin Y, Lee YC .
Association of preoperative opioid use with mortality and short-term safety outcomes after total knee replacement.
JAMA Netw Open 2019 Jul 3;2(7):e198061. doi: 10.1001/jamanetworkopen.2019.8061..
Keywords: Opioids, Medication, Surgery, Orthopedics, Elderly, Patient-Centered Outcomes Research, Mortality, Outcomes, Arthritis, Evidence-Based Practice