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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
10976 to 11000 of 12139 Research Studies DisplayedEncinosa WE, Bae J
AHRQ Author: Encinosa WE
Meaningful use IT reduces hospital-caused adverse drug events even at challenged hospitals.
The researchers examined the impact of the 5 core meaningful use (MU) medication elements on hospital-caused adverse drug events (ADEs). They found that adopting all 5 core MU elements was associated with a reduction in ADEs. Hospitals reporting costs as the main barrier to MU reduced their ADE rates by 35%; low quality hospitals reduced ADEs by 29 percent, compared to 27 percent at high quality hospitals.
Citation: Encinosa WE, Bae J .
Meaningful use IT reduces hospital-caused adverse drug events even at challenged hospitals.
Healthc 2015 Mar;3(1):12-7. doi: 10.1016/j.hjdsi.2014.07.001..
Keywords: Healthcare Cost and Utilization Project (HCUP), Patient Safety, Hospitals, Medication
Sylvia LG, Shelton RC, Kemp DE
Medical burden in bipolar disorder: findings from the Clinical and Health Outcomes Initiative in Comparative Effectiveness for Bipolar Disorder study (Bipolar CHOICE).
The present study examined common predictors of medical comorbidity for Individuals with bipolar disorder. It found that predictors of medical comorbidities in bipolar disorder included older age, early age of onset, more time spent depressed, less time spent manic/hypomanic, and longer duration of illness.
AHRQ-funded; HS019371.
Citation: Sylvia LG, Shelton RC, Kemp DE .
Medical burden in bipolar disorder: findings from the Clinical and Health Outcomes Initiative in Comparative Effectiveness for Bipolar Disorder study (Bipolar CHOICE).
Bipolar Disord 2015 Mar;17(2):212-23. doi: 10.1111/bdi.12243..
Keywords: Behavioral Health, Comparative Effectiveness, Patient-Centered Outcomes Research
Rashid N, Coburn BW, Wu YL
Modifiable factors associated with allopurinol adherence and outcomes among patients with gout in an integrated healthcare system.
The investigators identified modifiable patient and provider factors associated with allopurinol adherence and the achievement of a serum urate acid (SUA) goal in gout. They found that among patients with gout initiating allopurinol in their study, 68% did not reach the SUA goal and 57% were nonadherent. They concluded that modifiable factors, including allopurinol dose escalation, treatment adherence, rheumatology referral, and concomitant medication use, could be important factors to consider in efforts aimed at optimizing gout treatment outcomes.
AHRQ-funded; HS018517.
Citation: Rashid N, Coburn BW, Wu YL .
Modifiable factors associated with allopurinol adherence and outcomes among patients with gout in an integrated healthcare system.
J Rheumatol 2015 Mar;42(3):504-12. doi: 10.3899/jrheum.140588.
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Keywords: Healthcare Delivery, Healthcare Utilization, Medication, Patient Adherence/Compliance, Patient-Centered Outcomes Research
Meyer BM, Chopra V
Moving the needle forward: the imperative for collaboration in vascular access.
The authors discussed vascular access patterns of use, complications, and outcomes. They recognized a need to create a better intersection between research evidence and clinical practice. They concluded that bedside and vascular access nurses, nurse researchers, and physician-scientists must partner in a way that generates shared questions, promotes transparency of the research process, and generates mutually beneficial products.
AHRQ-funded; HS022835.
Citation: Meyer BM, Chopra V .
Moving the needle forward: the imperative for collaboration in vascular access.
J Infus Nurs 2015 Mar-Apr;38(2):100-2. doi: 10.1097/nan.0000000000000091.
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Keywords: Evidence-Based Practice, Nursing, Implementation
Dresden SM, O'Connor LM, Pearce CG
National trends in the use of postcardiac arrest therapeutic hypothermia and hospital factors influencing its use.
The goal of this study is to use population-based national hospital discharge data to examine trends in the use of therapeutic hypothermia (TH) in both in- and out-of-hospital cardiac arrest patients after implementation of the 2005 American Heart Association guidelines. Its findings demonstrate that while TH use is increasing, the overall utilization of TH relative to all cardiac arrests remains very low.
AHRQ-funded; HS000078.
Citation: Dresden SM, O'Connor LM, Pearce CG .
National trends in the use of postcardiac arrest therapeutic hypothermia and hospital factors influencing its use.
Ther Hypothermia Temp Manag 2015 Mar;5(1):48-54. doi: 10.1089/ther.2014.0023..
Keywords: Healthcare Cost and Utilization Project (HCUP), Hospitals, Cardiovascular Conditions, Healthcare Utilization
Hakkarainen TW, Steele SR, Bastaworous A
Nonsteroidal anti-inflammatory drugs and the risk for anastomotic failure: a report from Washington State's Surgical Care and Outcomes Assessment Program (SCOAP).
This study evaluated the association between the administration of postoperative non-steroidal anti-inflammatory drugs (NSAIDs) and anastomotic complication rates using a large cohort of patients in a statewide collaborative study. It found that postoperative NSAIDs were associated with a significantly increased risk for anastomotic complications among patients undergoing nonelective colorectal resection.
AHRQ-funded; HS020025
Citation: Hakkarainen TW, Steele SR, Bastaworous A .
Nonsteroidal anti-inflammatory drugs and the risk for anastomotic failure: a report from Washington State's Surgical Care and Outcomes Assessment Program (SCOAP).
JAMA Surg. 2015 Mar;150(3):223-8. doi: 10.1001/jamasurg.2014.2239..
Keywords: Medication, Surgery, Outcomes, Adverse Events
Tannenbaum D, Doctor JN, Persell SD
Nudging physician prescription decisions by partitioning the order set: results of a vignette-based study.
The purpose of this study was to examine whether the grouping of menu items systematically affects prescribing practices among primary care providers. It found that provider treatment choice appears to be influenced by the grouping of menu options, suggesting that the layout of EHR order sets is not an arbitrary exercise.
AHRQ-funded; RC4 AG039115 (NIA/AHRQ).
Citation: Tannenbaum D, Doctor JN, Persell SD .
Nudging physician prescription decisions by partitioning the order set: results of a vignette-based study.
J Gen Intern Med 2015 Mar;30(3):298-304. doi: 10.1007/s11606-014-3051-2..
Keywords: Electronic Health Records (EHRs), Primary Care, Clinical Decision Support (CDS), Health Information Technology (HIT), Medication
Davidoff AJ, Hendrick FB, Zeidan AM
AHRQ Author: Davidoff AJ
Patient cost sharing and receipt of erythropoiesis-stimulating agents through Medicare part D.
This study examined use of erythropoiesis-stimulating agents (ESAs) to manage anemia in patients with myelodysplastic syndromes (MDS). It found that few patients with MDS received ESAs through Part D. OOP payments required under Part D were substantially higher than under Part B. Cost sharing, as reflected by low-income subsidy receipt, likely affected decisions to prescribe ESAs outside of the physician office.
AHRQ-authored.
Citation: Davidoff AJ, Hendrick FB, Zeidan AM .
Patient cost sharing and receipt of erythropoiesis-stimulating agents through Medicare part D.
J Oncol Pract 2015 Mar;11(2):e190-8. doi: 10.1200/jop.2014.001527..
Keywords: Elderly, Healthcare Costs, Medicare, Medication
Panattoni L, Stone A, Chung S
Patients report better satisfaction with part-time primary care physicians, despite less continuity of care and access.
The researchers examined the relationships between a physicians’ clinical full-time equivalent (FTE), continuity of care, access to care, and patient satisfaction with the physician. Their results suggest that PCPs who choose to work fewer clinical hours may have worse continuity and access, but they may provide a better patient experience.
AHRQ-funded; HS019815; HS019167.
Citation: Panattoni L, Stone A, Chung S .
Patients report better satisfaction with part-time primary care physicians, despite less continuity of care and access.
J Gen Intern Med 2015 Mar;30(3):327-33. doi: 10.1007/s11606-014-3104-6..
Keywords: Patient Experience, Primary Care, Access to Care
Fertel BS, Hart KW, Lindsell CJ
Patients who use multiple EDs: quantifying the degree of overlap between ED populations.
The researchers estimated the proportion of emergency department (ED) patients who seek care from more than one ED by using a sample of three EDs in a region with a total of 18 EDs and one dedicated pediatric ED. They found that most repeat encounters occur within a single ED rather than among multiple EDs. Nonetheless, nearly one of every four ED encounters were by patients who also visited another ED during the study period.
AHRQ-funded; HS021749.
Citation: Fertel BS, Hart KW, Lindsell CJ .
Patients who use multiple EDs: quantifying the degree of overlap between ED populations.
West J Emerg Med 2015 Mar;16(2):229-33. doi: 10.5811/westjem.2015.1.22838..
Keywords: Emergency Department, Emergency Medical Services (EMS), Healthcare Utilization
Ragsdale L, Zhong W, Morrison W
Pediatric exposure to opioid and sedation medications during terminal hospitalizations in the United States, 2007-2011.
The researchers conducted a retrospective study in which they examined the prescribing patterns of opioid and sedation medications among 37,459 children who died in 430 hospitals in the US 2007-2011. Their study reveals an overall high prevalence of exposure to opioid and sedation medications among pediatric terminal hospitalizations, yet with slightly less than one-half of patients receiving both opioids and sedatives daily near the end of life.
AHRQ-funded; HS018425.
Citation: Ragsdale L, Zhong W, Morrison W .
Pediatric exposure to opioid and sedation medications during terminal hospitalizations in the United States, 2007-2011.
J Pediatr 2015 Mar;166(3):587-93.e1. doi: 10.1016/j.jpeds.2014.10.017..
Keywords: Children/Adolescents, Hospitalization, Medication, Opioids, Pain, Palliative Care
Hendrix KS, Downs SM, Carroll AE
Pediatricians' responses to printed clinical reminders: does highlighting prompts improve responsiveness?
The authors tested whether selectively highlighting clinical decision support prompts in yellow would improve physicians' responsiveness. They found that highlighting reminder prompts did not increase physicians' responsiveness. They suggested possible explanations and offer alternative strategies to increasing physician responsiveness to prompts.
AHRQ-funded; HS020640; HS018453; HS017939.
Citation: Hendrix KS, Downs SM, Carroll AE .
Pediatricians' responses to printed clinical reminders: does highlighting prompts improve responsiveness?
Acad Pediatr 2015 Mar-Apr;15(2):158-64. doi: 10.1016/j.acap.2014.10.009.
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Keywords: Clinical Decision Support (CDS), Children/Adolescents, Primary Care, Practice Patterns, Quality Improvement
Olenik NL, Gonzalvo JD, Snyder ME
Perceptions of Spanish-speaking clientele of patient care services in a community pharmacy.
This study aimed to identify perceptions of Spanish-speaking patients living in the U.S. with a focus on the care provided in community pharmacies, as well as to determine their satisfaction with community pharmacies. Based on 12 interviews, it found that primary themes included lack of insurance coupled with high medical care costs serving as a barrier for acquisition of health care and difficulty accessing timely and convenient primary care.
AHRQ-funded; HS022119.
Citation: Olenik NL, Gonzalvo JD, Snyder ME .
Perceptions of Spanish-speaking clientele of patient care services in a community pharmacy.
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Keywords: Access to Care, Community-Based Practice, Provider: Pharmacist, Racial and Ethnic Minorities
Alcantara C, Muntner P, Edmondson D
Perfect storm: concurrent stress and depressive symptoms increase risk of myocardial infarction or death.
A recently offered psychosocial perfect storm conceptual model hypothesizes amplified risk will occur in those with concurrent stress and depressive symptoms. The authors tested this hypothesis in a large sample of US adults with coronary heart disease. They found that those with low stress and high depressive symptoms or high stress and low depressive symptoms were not at increased risk, while participants with concurrent high stress and high depressive symptoms had increased risk for myocardial infarction or death relative to those with low stress and low depressive symptoms. They concluded that their results provide initial support for a psychosocial perfect storm conceptual model.
AHRQ-funded; HS023009.
Citation: Alcantara C, Muntner P, Edmondson D .
Perfect storm: concurrent stress and depressive symptoms increase risk of myocardial infarction or death.
Circ Cardiovasc Qual Outcomes 2015 Mar;8(2):146-54. doi: 10.1161/circoutcomes.114.001180.
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Keywords: Depression, Heart Disease and Health, Mortality, Risk, Stress
Wellman BR, Frail CK, Zillich AJ
Pharmacists' experiences with a telephonic medication therapy management program for home health care patients.
This qualitative study involved interviewing four pharmacists on their experiences with a telephone medication therapy management (MTM) program. Several themes emerged from the analysis, including: communication and relationships, coordinating care and patient self-management, logistics, professional fulfillment, service delivery and content, and training opportunities. The researchers concluded that their study provides possible strategies to overcome barriers and facilitate service provision for future telephonic MTM services.
AHRQ-funded; HS022119.
Citation: Wellman BR, Frail CK, Zillich AJ .
Pharmacists' experiences with a telephonic medication therapy management program for home health care patients.
Consult Pharm 2015 Mar;30(3):163-74. doi: 10.4140/TCP.n.2015.163..
Keywords: Home Healthcare, Medication, Provider: Pharmacist, Patient Self-Management
Chung JW, Ju MH, Kinnier CV
Postoperative venous thromboembolism outcomes measure: analytic exploration of potential misclassification of hospital quality due to surveillance bias.
The authors discuss problems associated with AHRQ’s Patient Safety Indicator (PS112), Postoperative Venous Thromboembolism such as identifying truly poor-quality hospitals from those that only seem to be poor-quality because of hospital-to-hospital variations in imaging rates for venous thromboembolism (VTE). They call for the development of administrative codes that enable reliable identification and exclusion of sub-clinical VTE from the measure numerator.
AHRQ-funded; HS021857
Citation: Chung JW, Ju MH, Kinnier CV .
Postoperative venous thromboembolism outcomes measure: analytic exploration of potential misclassification of hospital quality due to surveillance bias.
Ann Surg. 2015 Mar;261(3):443-4. doi: 10.1097/sla.0000000000000850..
Keywords: Quality Indicators (QIs), Blood Clots, Quality of Care, Adverse Events
Rust G, Zhang S, McRoy L
Potential savings from increasing adherence to inhaled corticosteroid therapy in Medicaid-enrolled children.
This study simulated the cost impact of achieving various levels of increase in inhaled corticosteroid therapy (ICS-Rx) adherence levels among elementary school–aged children (5-12 years) initially receiving a new ICS-Rx for asthma. It found that increasing the proportion of children who maintain higher adherence to 40 percent would generate savings of $95 per child per year.
AHRQ-funded; HS022444.
Citation: Rust G, Zhang S, McRoy L .
Potential savings from increasing adherence to inhaled corticosteroid therapy in Medicaid-enrolled children.
Am J Manag Care 2015 Mar;21(3):173-80..
Keywords: Children/Adolescents, Asthma, Patient Adherence/Compliance, Healthcare Costs, Medicaid
Hansen RA, Voils CI, Farley JF
Prescriber continuity and medication adherence for complex patients.
The purpose of this study was to examine the relationship between number of prescribers, number of conditions, and refill adherence to oral medications among 7,933 veterans who were identified with 1 to 4 cardiometabolic conditions: diabetes, hypertension, dyslipidemia, and/or heart failure. It found that for veterans taking antihypertensive or lipid-lowering medications, having more prescribers involved in care modestly decreased the likelihood of being adherent.
AHRQ-funded; HS019445.
Citation: Hansen RA, Voils CI, Farley JF .
Prescriber continuity and medication adherence for complex patients.
Ann Pharmacother 2015 Mar;49(3):293-302. doi: 10.1177/1060028014563266..
Keywords: Patient Adherence/Compliance, Medication, Chronic Conditions
Davidoff AJ, Miller GE, Sarpong EM
AHRQ Author: Miller GE, Sarpong EM
Prevalence of potentially inappropriate medication use in older adults using the 2012 Beers criteria.
The purpose of this study was to use the most recently available population-based data to estimate potentially inappropriate medication (PIM) prevalence under the 2012 update of the Beers list of PIMs and to provide a benchmark from which to measure future changes. It found that despite the overall high use of PIMs, there has been a decline observed in recent years.
AHRQ-authored.
Citation: Davidoff AJ, Miller GE, Sarpong EM .
Prevalence of potentially inappropriate medication use in older adults using the 2012 Beers criteria.
J Am Geriatr Soc 2015 Mar;63(3):486-500. doi: 10.1111/jgs.13320..
Keywords: Medical Expenditure Panel Survey (MEPS), Medication, Elderly
Dauw CA, Alruwaily AF, Bierlein MJ
Provider variation in the quality of metabolic stone management.
The researchers quantified the degree of variation in repeat 24-hour urine testing attributable to providers and assessed differences in repeat testing rates between specialist and primary care physicians. They found, that, while most variation in follow-up testing was attributable to the patient, the provider contribution was nontrivial (18 percent). The specialty of the ordering provider was also important.
AHRQ-funded; HS020927.
Citation: Dauw CA, Alruwaily AF, Bierlein MJ .
Provider variation in the quality of metabolic stone management.
J Urol 2015 Mar;193(3):885-90. doi: 10.1016/j.juro.2014.09.111..
Keywords: Care Management, Chronic Conditions, Practice Patterns
Garfield LD, Brown DS, Allaire BT
Psychotropic drug use among preschool children in the Medicaid program from 36 states.
The researchers examined utilization of the most commonly used psychotropic medications among children aged 4 years and younger. They determined the prevalence of and indications for psychotropic medication among preschool children in Medicaid. Their study found that preschoolers are receiving psychotropic medications despite limited evidence supporting safety or efficacy. Medications for attention-deficit disorder/attention-deficit hyperactivity disorder treatment were most common.
AHRQ-funded; HS020269.
Citation: Garfield LD, Brown DS, Allaire BT .
Psychotropic drug use among preschool children in the Medicaid program from 36 states.
Am J Public Health 2015 Mar;105(3):524-9. doi: 10.2105/ajph.2014.302258..
Keywords: Children/Adolescents, Medication, Medicaid, Behavioral Health
Lee BY, Bartsch SM, Brown ST
Quantifying the economic value and quality of life impact of earlier influenza vaccination.
This study quantifies the potential benefits and cost-savings of vaccinating against influenza earlier than current practice. It found that, depending on the timing of the influenza season peak, influenza transmissibility, and preexisting immunity, vaccinating those who typically receive the vaccine later by the end of September could avert up to $3.7 million in direct costs, and $10.7 million in productivity losses.
AHRQ-funded; HS023317.
Citation: Lee BY, Bartsch SM, Brown ST .
Quantifying the economic value and quality of life impact of earlier influenza vaccination.
Med Care 2015 Mar;53(3):218-29. doi: 10.1097/mlr.0000000000000302..
Keywords: Vaccination, Influenza, Healthcare Costs
Govindarajan P, Friedman BT, Delgadillo JQ
Race and sex disparities in prehospital recognition of acute stroke.
The investigators examined prehospital provider recognition of stroke by race and sex. They found that correct prehospital recognition of stroke was lower among Hispanic patients, Asians, and others, when compared with non-Hispanic whites, and also in women compared with men. They concluded that significant disparities exist in prehospital stroke recognition.
AHRQ-funded; HS017965.
Citation: Govindarajan P, Friedman BT, Delgadillo JQ .
Race and sex disparities in prehospital recognition of acute stroke.
Acad Emerg Med 2015 Mar;22(3):264-72. doi: 10.1111/acem.12595.
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Keywords: Diagnostic Safety and Quality, Disparities, Racial and Ethnic Minorities, Sex Factors, Stroke
Meagher AD, Beadles CA, Doorey J
Racial and ethnic disparities in discharge to rehabilitation following traumatic brain injury.
The authors investigate racial disparities in discharge destination (inpatient rehabilitation vs skilled nursing facility vs home health vs home) following traumatic brain injury. They found that Hispanic and black patients were significantly less likely to be discharged to a higher level of rehabilitation than similarly matched non-Hispanic white patients. This disparity persisted in the subgroup examination of older adults with uniform Medicare coverage.
AHRQ-funded; HS000032.
Citation: Meagher AD, Beadles CA, Doorey J .
Racial and ethnic disparities in discharge to rehabilitation following traumatic brain injury.
J Neurosurg 2015 Mar;122(3):595-601. doi: 10.3171/2014.10.jns14187..
Keywords: Disparities, Racial and Ethnic Minorities, Brain Injury
Robinson JC, Brown T, Whaley C
Reference-based benefit design changes consumers' choices and employers' payments for ambulatory surgery.
The researchers analyzed the impact of reference-based benefit (RBB) designs on cataract surgery patients choice of less-expensive ambulatory surgery centers over more expensive hospital outpatient departments. Examining two groups of patients, one in plans incorporating RBB and the other in non-RBB plans, they found that the shift to RBB led to an 8.6 percent increase in ambulatory surgery centers as well as a 19.7 percent decrease in payments per procedure.
AHRQ-funded; HS022098
Citation: Robinson JC, Brown T, Whaley C .
Reference-based benefit design changes consumers' choices and employers' payments for ambulatory surgery.
Health Aff. 2015 Mar;34(3):415-22. doi: 10.1377/hlthaff.2014.1198..
Keywords: Ambulatory Care and Surgery, Eye Disease and Health, Health Insurance, Healthcare Costs, Health Insurance