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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.
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1 to 4 of 4 Research Studies DisplayedWilson AS, Pham T, Mbusa D
Pharmacist-led, checklist intervention did not improve adherence in ambulatory patients starting/resuming DOACs.
This study’s aim was to determine whether checklist-driven care from a clinical pharmacist improved adherence in ambulatory patients starting a direct-acting anticoagulant (DOAC) or resuming it after a setback (thromboembolic event or bleeding) in an ambulatory setting. Clinical pharmacists using the DOAC checklist verified DOAC appropriateness, instructed dose de-escalation, educated through 3 tele-visits, fielded hotline calls, and handed off to a continuity provider after 3 months. Coupons and help with completing manufacturer-based medication assistance applicants were made available to intervention and control patients. Using pharmacy dispense records, the authors measured medication possession ratio (MPR) at 90 days (primary outcome) and proportion of days covered (PDC) at 90 days and MPR and PDC at 180 and 365 days (secondary outcomes). Of the 561 patients randomized, only 427 had sufficient records to analyze. Adherence was high with only 41 patients having MPR less than 80% at 90 days. There was no difference in adherence between intervention and control patients for primary outcome (odds ratio 0.94)) or secondary outcomes. The authors felt that given the already high levels of adherence in both study groups, reassessing the DOAC checklist outside of a traditional trial may be more fruitful.
AHRQ-funded; HS02592401.
Citation: Wilson AS, Pham T, Mbusa D .
Pharmacist-led, checklist intervention did not improve adherence in ambulatory patients starting/resuming DOACs.
J Am Pharm Assoc 2023 May-Jun; 63(3):878-84.e3. doi: 10.1016/j.japh.2023.02.019..
Keywords: Provider: Pharmacist, Patient Adherence/Compliance, Blood Thinners, Medication
Yang AD, Hewitt DB, Blay E
Multi-institution evaluation of adherence to comprehensive postoperative VTE chemoprophylaxis.
The aims of this study were to: (1) measure the rate of failure to provide defect-free postoperative venous thromboembolism (VTE) chemoprophylaxis, (2) identify reasons for failure to provide defect-free VTE chemoprophylaxis, and (3) examine patient- and hospital-level factors associated with failure. The investigators concluded that in contrast to SCIP-VTE-2, their novel quality measure unmasked VTE chemoprophylaxis failures in 18% of colectomies. They found that most failures were due to patient refusals or ordering errors.
AHRQ-funded; HS024516.
Citation: Yang AD, Hewitt DB, Blay E .
Multi-institution evaluation of adherence to comprehensive postoperative VTE chemoprophylaxis.
Ann Surg 2020 Jun;271(6):1072-79. doi: 10.1097/sla.0000000000003124..
Keywords: Patient Adherence/Compliance, Guidelines, Blood Clots, Blood Thinners, Medication, Medication: Safety, Patient Safety, Adverse Events
Lau BD, Streiff MB, Kraus PS
Missed doses of venous thromboembolism (VTE) prophylaxis at community hospitals: cause for alarm.
This study examined the rate of missed doses of venous thromboembolism (VTE) prophylaxis at community hospitals in the Washington, DC and greater Baltimore metropolitan areas. This retrospective study included four hospitals within the Johns Hopkins Health System. Non-administration of VTE prophylaxis was found 10.9% to 15.0% of the time among the three community hospitals. About 43.6% of patients missed at least one dose in all four hospitals. The investigators weren’t able to categorize patients by specialty, however it has been reported that more doses are missed with medically ill patients than other hospitalized patients.
AHRQ-funded; HS024547.
Citation: Lau BD, Streiff MB, Kraus PS .
Missed doses of venous thromboembolism (VTE) prophylaxis at community hospitals: cause for alarm.
J Gen Intern Med 2018 Jan;33(1):19-20. doi: 10.1007/s11606-017-4203-y..
Keywords: Blood Clots, Prevention, Blood Thinners, Patient Adherence/Compliance, Medication, Hospitals
Zhou M, Chang HY, Segal JB
Adherence to a novel oral anticoagulant among patients with atrial fibrillation.
The researchers examined adherence and persistence to dabigatran among adults with atrial fibrillation. Among those using dabigatran alone (n = 2,713), 41 percent were nonadherent with therapy, and 32 percent had gaps of 60 days or greater. Among those observed for 9 months who used dabigatran alone, rates of nonadherence were 47 percent, whereas 48 percent discontinued therapy during follow-up.
AHRQ-funded; HS018960.
Citation: Zhou M, Chang HY, Segal JB .
Adherence to a novel oral anticoagulant among patients with atrial fibrillation.
J Manag Care Spec Pharm 2015 Nov;21(11):1054-62. doi: 10.18553/jmcp.2015.21.11.1054.
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Keywords: Blood Thinners, Patient Adherence/Compliance, Heart Disease and Health, Cardiovascular Conditions, Medication