National Healthcare Quality and Disparities Report
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Topics
- Access to Care (5)
- Adverse Drug Events (ADE) (9)
- Adverse Events (7)
- Antibiotics (3)
- (-) Cancer (67)
- Cancer: Breast Cancer (6)
- Cancer: Cervical Cancer (1)
- Cancer: Colorectal Cancer (1)
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- Caregiving (1)
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- Falls (1)
- Guidelines (1)
- Healthcare-Associated Infections (HAIs) (2)
- Healthcare Costs (11)
- Healthcare Utilization (1)
- Health Information Technology (HIT) (3)
- Health Insurance (4)
- Human Immunodeficiency Virus (HIV) (1)
- Kidney Disease and Health (1)
- Medicaid (1)
- Medical Expenditure Panel Survey (MEPS) (1)
- Medicare (7)
- (-) Medication (67)
- Medication: Safety (2)
- Men's Health (2)
- Mortality (1)
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- Palliative Care (3)
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- Policy (1)
- Practice Patterns (5)
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- Provider: Pharmacist (2)
- Provider: Physician (1)
- Quality of Life (3)
- Racial and Ethnic Minorities (3)
- Research Methodologies (1)
- Respiratory Conditions (1)
- Risk (8)
- Screening (1)
- Shared Decision Making (2)
- Surgery (6)
- Treatments (9)
- U.S. Preventive Services Task Force (USPSTF) (2)
- Women (5)
- Young Adults (1)
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
1 to 25 of 67 Research Studies DisplayedDe Castro GC, Slatnick LR, Shannon M
Impact of time-to-antibiotic delivery in pediatric patients with cancer presenting with febrile neutropenia.
Researchers abstracted episodes of febrile neutropenia (FN) in pediatric patients with cancer occurring at Vanderbilt Children's Hospital and Colorado Children's Hospital to capture time-to-antibiotic (TTA) metrics and clinical outcomes including major complications. Results showed that only 0.6% of episodes required immediate ICU management, with a median TTA of 28 minutes; for the remaining patients, the median TTA was 56 minutes. TTA was not associated with major nor any other complications in adjusted analysis. The researchers concluded that there was no clear evidence that a reduced TTA improves clinical outcomes in pediatric oncology FN and it should not be used as a primary quality measure.
AHRQ-funded; HS025696.
Citation: De Castro GC, Slatnick LR, Shannon M .
Impact of time-to-antibiotic delivery in pediatric patients with cancer presenting with febrile neutropenia.
JCO Oncol Pract 2024 Feb; 20(2):228-38. doi: 10.1200/op.23.00583..
Keywords: Children/Adolescents, Cancer, Antibiotics, Medication
Watterson TL, Stone JA, Kleinschmidt PC
CancelRx case study: implications for clinic and community pharmacy work systems.
This study examined the impact of implementation of CancelRx, a health IT system that automatically communicates medication discontinuations from the clinic electronic health record to the community pharmacy dispensing platform, theoretically improving communication. The system was implemented across a Midwest academic health system in October 2017, using their 15 outpatient community pharmacies to test it. Interviews were conducted with 9 medical assistants, 12 community pharmacists, and 3 pharmacy administrators employed by the health system across 3-time periods between 2017 and 2018: 3-months prior to CancelRx implementation, 3-months after CancelRx implementation, and 9-months after CancelRx implementation. While CancelRx automated and streamlined how medication discontinuation messages were received and processed, it also increased workload and introduced new errors.
AHRQ-funded; HS025793.
Citation: Watterson TL, Stone JA, Kleinschmidt PC .
CancelRx case study: implications for clinic and community pharmacy work systems.
BMC Health Serv Res 2023 Dec 6; 23(1):1360. doi: 10.1186/s12913-023-10396-9..
Keywords: Cancer, Provider: Pharmacist, Medication
Hill D, Kaufman SR, Oerline MK
In-office dispensing of oral targeted agents by urology practices in men with advanced prostate cancer.
Researchers investigated the dispensing oral targeted agents for advanced prostate cancer treatment directly to patients in urologists’ offices, and whether this delivery model improves access to these agents especially for Black men who are historically undertreated. Their retrospective cohort study used national Medicare data for men with advanced prostate cancer managed by urology practices with and without in-office dispensing. They concluded that this model of delivery could improve access to this class of medications.
AHRQ-funded; HS025707.
Citation: Hill D, Kaufman SR, Oerline MK .
In-office dispensing of oral targeted agents by urology practices in men with advanced prostate cancer.
JNCI Cancer Spectr 2023 Jul 3; 7(5). doi: 10.1093/jncics/pkad062..
Keywords: Cancer: Prostate Cancer, Cancer, Men's Health, Medication
Jazowski SA, Vaidya AU, Donohue JM
Time to confirmatory study initiation after accelerated approval of cancer and noncancer drugs in the US.
The FDA requires that studies must be conducted to confirm a drug’s clinical benefit, but the accelerated approval pathway has been criticized because of delays by manufacturers in completing the studies. A possible source of delays is that the needed confirmatory studies are often not taking place at the time of accelerated approval. The aim of this study was to explore and compare the time elapsed between the accelerated approval of cancer and noncancer drugs to the commencement of confirmatory studies in the United States. The study found that for 103 cancer–indication pairs and noncancer products, 20.31% of confirmatory studies were not underway at the time of accelerated approval, and the median time from approval to study initiation was 1.41. Noncancer products had a greater proportion of confirmatory studies with initiation occurring after accelerated approval and a longer median time from approval to study initiation compared with cancer product–indication pairs. When evaluating delays in confirmatory study completion, studies underway at the time of accelerated approval were less likely to be submitted past FDA-designated deadlines relative to studies initiated after approval. Similar patterns were observed for cancer and noncancer products, but delays in confirmatory study completion were more distinct within studies commenced after approval for noncancer products than for cancer product–indication pairs.
AHRQ-funded; HS026122.
Citation: Jazowski SA, Vaidya AU, Donohue JM .
Time to confirmatory study initiation after accelerated approval of cancer and noncancer drugs in the US.
JAMA Intern Med 2023 Jul; 183(7):737-39. doi: 10.1001/jamainternmed.2023.0777..
Keywords: Cancer, Medication
Enzinger AC, Ghosh K, Keating NL
Racial and ethnic disparities in opioid access and urine drug screening among older patients with poor-prognosis cancer near the end of life.
This research characterized racial and ethnic disparities and trends in opioid access and urine drug screening (UDS) among older patients dying of cancer, and to explore potential mechanisms. Among 18,549 non-Hispanic White (White), Black, and Hispanic Medicare decedents older than 65 years with poor-prognosis cancers, the authors examined 2007-2019 trends in opioid prescription fills and potency (morphine milligram equivalents [MMEs] per day [MMEDs]) near the end of life (EOL), defined as 30 days before death or hospice enrollment. They found that between 2007 and 2019, White, Black, and Hispanic decedents experienced steady declines in EOL opioid access and rapid expansion of UDS. Compared with White patients, Black and Hispanic patients were less likely to receive any opioid (Black, -4.3 percentage points; Hispanic, -3.6 percentage points) and long-acting opioids (Black, -3.1 percentage points; Hispanic, -2.2 percentage points). They also received lower daily doses (Black, -10.5 MMED; Hispanic, -9.1 MMED) and lower total doses (Black, -210 MMEs; Hispanic, -179 MMEs). Black patients were also more likely to undergo UDS (0.5 percentage points).
AHRQ-funded; HS024072.
Citation: Enzinger AC, Ghosh K, Keating NL .
Racial and ethnic disparities in opioid access and urine drug screening among older patients with poor-prognosis cancer near the end of life.
J Clin Oncol 2023 May 10; 41(14):2511-22. doi: 10.1200/jco.22.01413..
Keywords: Elderly, Opioids, Medication, Cancer, Racial and Ethnic Minorities, Disparities, Access to Care
Vo H, Valentine KD, Barry MJ
Evaluation of the shared decision-making process scale in cancer screening and medication decisions.
The objectives of this study were to examine the reliability and validity of the Shared Decision-Making (SDM) Process scale for cancer screening and medication decisions. Researchers conducted a secondary data analysis of more than 6,000 participants who made decisions about breast, colon, or prostate cancer screening or taking medication for menopause, depression, hypertension or high cholesterol. They concluded that the SDM Process scale demonstrated construct validity and retest reliability.
AHRQ-funded; HS025718.
Citation: Vo H, Valentine KD, Barry MJ .
Evaluation of the shared decision-making process scale in cancer screening and medication decisions.
Patient Educ Couns 2023 Mar;108:107617. doi: 10.1016/j.pec.2022.107617.
Keywords: Shared Decision Making, Cancer, Medication, Screening
Warren DK, Peacock KM, Nickel KB
Postdischarge prophylactic antibiotics following mastectomy with and without breast reconstruction.
The authors investigated factors associated with post-discharge prophylactic antibiotic use after mastectomy with and without immediate reconstruction and the impact on surgical-site infection (SSI). They found that anti-methicillin-sensitive Staphylococcus aureus antibiotics were associated with decreased risk of SSI for patients who had mastectomy only and those who had mastectomy with immediate reconstruction. They concluded that the high numbers needed to treat suggest that potential benefits of post-discharge antibiotics should be weighed against potential harms associated with antibiotic overuse.
AHRQ-funded; HS019455.
Citation: Warren DK, Peacock KM, Nickel KB .
Postdischarge prophylactic antibiotics following mastectomy with and without breast reconstruction.
Infect Control Hosp Epidemiol 2022 Oct;43(10):1382-88. doi: 10.1017/ice.2021.400..
Keywords: Antibiotics, Cancer: Breast Cancer, Cancer, Medication, Surgery, Healthcare-Associated Infections (HAIs), Prevention, Women, Practice Patterns
Jiang Y, Mason M, Cho Y
Tolerance to oral anticancer agent treatment in older adults with cancer: a secondary analysis of data from electronic health records and a pilot study of patient-reported outcomes.
The purpose of this study was to explore the tolerance of capecitabine oral chemotherapy among older adults with cancer and investigate factors associated with related side effects and treatment changes. The researchers combined data from electronic health records and a pilot study of patient-reported outcomes, and found that older adults were more likely to experience fatigue and experienced more severe fatigue and hand-foot syndrome (HFS) than younger adults. The severity of fatigue and HFS were associated with the number of outpatient medications and the duration of treatment respectively. Female sex, breast cancer diagnosis, capecitabine monotherapy, and severe HFS were found to be associated with subsequent dose reductions. The study concluded that older adults were less likely to tolerate capecitabine treatment and had different co-occurring side effects compared to younger adults.
AHRQ-funded; HS027846.
Citation: Jiang Y, Mason M, Cho Y .
Tolerance to oral anticancer agent treatment in older adults with cancer: a secondary analysis of data from electronic health records and a pilot study of patient-reported outcomes.
BMC Cancer 2022 Sep 3;22(1):950. doi: 10.1186/s12885-022-10026-3..
Keywords: Elderly, Cancer, Medication, Adverse Drug Events (ADE), Adverse Events, Electronic Health Records (EHRs), Health Information Technology (HIT)
Lai LY, Oerline MK, Caram MEV
Risk of metabolic and cardiovascular adverse events with abiraterone or enzalutamide among men with advanced prostate cancer.
Investigators examined the association between the use of abiraterone or enzalutamide and the risk of metabolic or cardiovascular adverse events while on treatment for advanced prostate cancer. They found that, compared with men not receiving abiraterone, men receiving abiraterone were at increased risk of both a major composite adverse event and a minor composite adverse event. Compared with men not receiving enzalutamide, men receiving enzalutamide were at an increased risk of a major composite adverse event but not a minor composite adverse event. They recommended careful monitoring and management of men on abiraterone or enzalutamide through team-based approaches.
AHRQ-funded; HS027507.
Citation: Lai LY, Oerline MK, Caram MEV .
Risk of metabolic and cardiovascular adverse events with abiraterone or enzalutamide among men with advanced prostate cancer.
J Natl Cancer Inst 2022 Aug 8;114(8):1127-34. doi: 10.1093/jnci/djac081..
Keywords: Cardiovascular Conditions, Cancer: Prostate Cancer, Cancer, Risk, Adverse Events, Medication, Adverse Drug Events (ADE), Medication: Safety, Patient Safety
Watterson TL, Stone JA, Gilson A
Impact of CancelRx on discontinuation of controlled substance prescriptions: an interrupted time series analysis.
The purpose of this study was to assess how controlled substance medication discontinuations were communicated over time, before and after the implementation of CancelRx. Data were collected from a midwestern academic health system’s electronic health record and pharmacy platform for 12 months prior to and for 12 months post CancelRx implementation. Findings showed that, after CancelRx implementation, there was an immediate and significant increase in the number of controlled substance medications that were successfully discontinued at the pharmacy once they were discontinued in the clinic. This change was sustained in the year following CancelRx and did not revert to pre-CancelRx levels. The health IT functionality was able to complete discontinuation tasks and potentially to reduce workload for clinic staff.
AHRQ-funded; HS025793.
Citation: Watterson TL, Stone JA, Gilson A .
Impact of CancelRx on discontinuation of controlled substance prescriptions: an interrupted time series analysis.
BMC Med Inform Decis Mak 2022 Feb 25;22(1):50. doi: 10.1186/s12911-022-01779-9..
Keywords: Cancer, Medication, Health Information Technology (HIT), Provider: Pharmacist
Enzinger AC, Ghosh K, Keating NL
US trends in opioid access among patients with poor prognosis cancer near the end-of-life.
This study looked at trends in opioid prescriptions for cancer patients near the end-of-life (EOL) defined as the 30 days before death or hospice enrollment. The authors looked at Medicare part D data from 2007 to 2017 for 270,632 Medicare fee-for-service decedents with poor prognosis cancers. During that time, the proportion of decedents with poor prognosis cancers receiving 1 or greater opioid prescriptions near EOL declined 15.5% and the proportion receiving 1 or greater long-acting opioid prescriptions declined 36.5% to 18.1%. The mean daily dose fell from 24.5%, from 85.6 morphine milligram equivalents per day (MMED) to 64.6. The total amount of opioids prescribed fell from 1,075 morphine milligram equivalents per decedent to 666 morphine milligram equivalents per decedents. At the same time, the proportion of patients with pain-related ED visits increase 50.8% from 13.2% to 19.9%.
AHRQ-funded; HS024072.
Citation: Enzinger AC, Ghosh K, Keating NL .
US trends in opioid access among patients with poor prognosis cancer near the end-of-life.
J Clin Oncol 2021 Sep 10;39(26):2948-58. doi: 10.1200/jco.21.00476..
Keywords: Cancer, Opioids, Palliative Care, Pain, Access to Care, Medication, Practice Patterns
Brajcic BC, Ko CY, Liu JB
A NSQIP-based randomized clinical trial evaluating choice of prophylactic antibiotics for pancreaticoduodenectomy.
This paper describes the protocol for an upcoming multicenter randomized surgical trial to evaluate choice of prophylactic antibiotics for pancreaticoduodenectomy. The rationale and methodology of the trial evaluating piperacillin-tazobactam compared to cefoxitin for surgical site infection prevention is described. The study will utilize a clinical registry for data collection.
AHRQ-funded; HS000078.
Citation: Brajcic BC, Ko CY, Liu JB .
A NSQIP-based randomized clinical trial evaluating choice of prophylactic antibiotics for pancreaticoduodenectomy.
J Surg Oncol 2021 May;123(6):1387-94. doi: 10.1002/jso.26402..
Keywords: Cancer, Antibiotics, Medication, Prevention, Surgery, Healthcare-Associated Infections (HAIs), Comparative Effectiveness, Evidence-Based Practice
Mian HS, Fiala MA, Sanchez L
Renal failure among multiple myeloma patients utilizing carfilzomib and associated factors in the "real world."
Researchers investigated the rate of renal failure and associated risk factors in real-world populations of patients with multiple myeloma taking carfilzomib. Using Surveillance, Epidemiology, and End Results (SEER)-Medicare linked data, they found that renal failure developed in 22% of patients during the study period. The median time to development of renal failure from first carfilzomib administration was 1.6 months. Increasing age, pre-existing heart failure, and pre-existing chronic kidney disease were associated with a higher risk of developing renal failure. As their study could not determine the exact cause and mechanism of renal failure, they recommended future studies to further understand this cause among patients on carfilzomib and to devise strategies to mitigate the risk.
AHRQ-funded; HS019455.
Citation: Mian HS, Fiala MA, Sanchez L .
Renal failure among multiple myeloma patients utilizing carfilzomib and associated factors in the "real world."
Ann Hematol 2021 May;100(5):1261-66. doi: 10.1007/s00277-021-04420-3..
Keywords: Cancer, Kidney Disease and Health, Medication, Adverse Drug Events (ADE), Adverse Events, Risk
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
Heneghan MB, Hussain T, Barrera L
Access to technology and preferences for an mHealth intervention to promote medication adherence in pediatric acute lymphoblastic leukemia: approach leveraging behavior change techniques.
This study’s objectives were to examine access to mobile technology and preferences for an mHealth intervention to improve medication adherence in pediatric acute lymphoblastic leukemia (ALL). Parents of children with ALL as well as adolescents and young adults (AYAs) with ALL who received maintenance chemotherapy were given a cross-sectional survey. Findings showed that parents, adolescents, and AYAs reported ubiquitous access to mobile technology and strong interest in multiple adherence-specific mHealth app features. Parents and AYAs provided valuable insight into preferred features for a multifunctional behavioral intervention to promote medication adherence in pediatric ALL.
AHRQ-funded; HS023011.
Citation: Heneghan MB, Hussain T, Barrera L .
Access to technology and preferences for an mHealth intervention to promote medication adherence in pediatric acute lymphoblastic leukemia: approach leveraging behavior change techniques.
J Med Internet Res 2021 Feb 18;23(2):e24893. doi: 10.2196/24893..
Keywords: Children/Adolescents, Young Adults, Caregiving, Cancer, Medication, Patient Adherence/Compliance, Health Information Technology (HIT), Treatments
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
Rashdan S, Yang H, Le T
Prevalence and significance of potential pharmacokinetic drug-drug interactions among patients with lung cancer: implications for clinical trials.
The overall prevalence of potential drug-drug interactions (DDIs) among patients with lung cancer is unknown. The objective of this study was to determine the prevalence of potential DDIs and major DDIs among individuals newly diagnosed with lung cancer in a national cohort. The investigators concluded that medications with potential DDIs were prescribed to the majority of patients with lung cancer; however, only about 5% of patients were prescribed medications with major DDIs that might be prohibited in certain clinical trials.
AHRQ-funded; HS022418.
Citation: Rashdan S, Yang H, Le T .
Prevalence and significance of potential pharmacokinetic drug-drug interactions among patients with lung cancer: implications for clinical trials.
Clin Drug Investig 2021 Feb;41(2):161-67. doi: 10.1007/s40261-020-00994-4.
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Keywords: Cancer: Lung Cancer, Cancer, Adverse Drug Events (ADE), Adverse Events, Medication
Eyrich NW, Sloss KR, Howard RA
Opioid prescribing exceeds consumption following common surgical oncology procedures.
Researchers aimed to compare opioid prescribing to opioid consumption for common surgical oncology procedures. They found that the median quantity of opioid prescribed was significantly larger than consumed following breast biopsy, lumpectomy, and mastectomy or wide local excision. The majority of patients reported receiving education on taking opioids, but only 27% received instructions on proper disposal; 82% of prescriptions filled resulted in unused opioids, and only 11% of these patients safely disposed of them. They concluded that their study demonstrated that opioid prescribing exceeds consumption following common surgical oncology procedures, thus indicating the potential for reductions in prescribing.
AHRQ-funded; HS023313.
Citation: Eyrich NW, Sloss KR, Howard RA .
Opioid prescribing exceeds consumption following common surgical oncology procedures.
J Surg Oncol 2021 Jan;123(1):352-56. doi: 10.1002/jso.26272..
Keywords: Opioids, Medication, Surgery, Cancer: Breast Cancer, Cancer, Practice Patterns, Pain
Caram MEV, Oerline MK, Dusetzina S
Adherence and out-of-pocket costs among Medicare beneficiaries who are prescribed oral targeted therapies for advanced prostate cancer.
The authors investigated coping and material measures of the financial hardship of abiraterone and enzalutamide among patients with advanced prostate cancer with Medicare Part D coverage. They found substantial variations in the adherence rate and out-of-pocket payments, with sociodemographic patient and regional factors found to be associated with both aspects.
AHRQ-funded; HS025707.
Citation: Caram MEV, Oerline MK, Dusetzina S .
Adherence and out-of-pocket costs among Medicare beneficiaries who are prescribed oral targeted therapies for advanced prostate cancer.
Cancer 2020 Dec 1;126(23):5050-59. doi: 10.1002/cncr.33176..
Keywords: Patient Adherence/Compliance, Medicare, Cancer: Prostate Cancer, Cancer, Medication, Healthcare Costs
Brown TJ Keshvani, N Gupta, et al.
Rates of appropriate laxative prophylaxis for opioid-induced constipation in veterans with lung cancer: a retrospective cohort study.
This study examined trends in the use of laxatives for opioid-induced constipation (OIC) in patients prescribed opioids for cancer pain treatment. A retrospective study was conducted of lung cancer patients seen in the Veteran’s Affair system from 2003 to 2016. There were 130,990 individuals included in the analysis. The majority (87%) received no prophylaxis (75%) or received docusate alone while 5% received OIC prophylaxis with the unnecessary addition of docusate. Throughout the study period, laxative prescription significantly decreased while categories of OIC prophylaxis were unchanged. The study concluded that almost 90% received inadequate or inappropriate OIC prophylaxis.
AHRQ-funded; HS022418.
Citation: Brown TJ Keshvani, N Gupta, et al..
Rates of appropriate laxative prophylaxis for opioid-induced constipation in veterans with lung cancer: a retrospective cohort study.
Support Care Cancer 2020 Nov;28(11):5315-21. doi: 10.1007/s00520-020-05364-6..
Keywords: Cancer: Lung Cancer, Cancer, Opioids, Medication, Prevention, Pain
Osterman CK, Milowsky MI
New and emerging therapies in the management of bladder cancer.
This review’s objective was to discuss the newly approved classes of medications to treat bladder cancer and to feature promising drugs and combinations, including immune checkpoint inhibitors, targeted therapies, and antibody-drug conjugates that are in development. In the past 5 years seven new agents were approved by the FDA.
AHRQ-funded; HS000032.
Citation: Osterman CK, Milowsky MI .
New and emerging therapies in the management of bladder cancer.
F1000Res 2020 Sep 16 2020;9::F1000 Faculty Rev-146. doi: 10.12688/f1000research.26841.1..
Keywords: Cancer, Medication
Maclean JC, Halpern MT, Hill SC
AHRQ Author: Hill SC
The effect of Medicaid expansion on prescriptions for breast cancer hormonal therapy medications.
The purpose of this study was to quantify the effects of the Affordable Care Act Medicaid expansion on prescriptions for effective breast cancer hormonal therapies (tamoxifen and aromatase inhibitors) among Medicaid enrollees. Data from the Medicaid State Drug Utilization Database was used. Findings showed that Medicaid expansion may have had a meaningful impact on the ability of lower-income women to access effective hormonal therapies used to treat breast cancer.
AHRQ-authored.
Citation: Maclean JC, Halpern MT, Hill SC .
The effect of Medicaid expansion on prescriptions for breast cancer hormonal therapy medications.
Health Serv Res 2020 Jun;55(3):399-410. doi: 10.1111/1475-6773.13289..
Keywords: Medicaid, Cancer: Breast Cancer, Cancer, Medication, Policy, Women, Healthcare Utilization, Access to Care, Health Insurance
Heneghan MB, Hussain T, Barrera L
Applying the COM-B model to patient-reported barriers to medication adherence in pediatric acute lymphoblastic leukemia.
This study examined parent- and patient-reported barriers to oral chemotherapy adherence with children with pediatric acute lymphoblastic leukemia (ALL). The medicine most often used was 6-mercaptopurine (6-MP). Forty-nine parents and 15 patients were surveyed and most reported at least one adherence barrier. Most of the barriers were about meeting other patients with ALL or meeting other parents. Patients also reported difficulty in finding out what their medications are, and what 6-MP does. These barriers can lead to relapse if they are not addressed.
AHRQ-funded; HS023011.
Citation: Heneghan MB, Hussain T, Barrera L .
Applying the COM-B model to patient-reported barriers to medication adherence in pediatric acute lymphoblastic leukemia.
Pediatr Blood Cancer 2020 May;67(5):e28216. doi: 10.1002/pbc.28216..
Keywords: Children/Adolescents, Treatments, Cancer, Medication, Patient Adherence/Compliance, Patient-Centered Outcomes Research
Rosenberg SM, Petrie KJ, Stanton AL
Interventions to enhance adherence to oral antineoplastic agents: a scoping review.
As new targeted oral antineoplastic therapies have emerged in recent years, the development of effective strategies that promote optimal adherence to cancer medication regimens has become an important priority. In this study, the investigators conducted a scoping literature review to search for English language articles published through July 15, 2019, to identify studies that reported the testing and/or evaluation of interventions to improve adherence to oral antineoplastic agents.
AHRQ-funded; HS023680.
Citation: Rosenberg SM, Petrie KJ, Stanton AL .
Interventions to enhance adherence to oral antineoplastic agents: a scoping review.
J Natl Cancer Inst 2020 May;112(5):443-65. doi: 10.1093/jnci/djz244..
Keywords: Patient Adherence/Compliance, Medication, Cancer
Gibson DC, Chou LN, Raji MA
Opioid prescribing trends in women following mastectomy or breast-conserving surgery before and after the 2014 federal reclassification of hydrocodone.
This study compares changes in opioid prescribing among surgical breast cancer patients following the 2014 federal reclassification of hydrocodone. Data from 2009 to 2017 was used from a large nationally representative commercial insurance health program. Women aged 18 years and older who were diagnosed with carcinoma in-situ or malignant breast cancer and received breast-conserving surgery or a mastectomy from 2010 to 2016 were included. Patients in 2015 or 2016 who had surgery were less likely to receive a greater than 1-day supply of opioid prescriptions or 30 days or more supply than in 2013. However, only in 2016 were surgical breast cancer patients less likely to receive a 90-day supply than in 2013.
AHRQ-funded; HS026133.
Citation: Gibson DC, Chou LN, Raji MA .
Opioid prescribing trends in women following mastectomy or breast-conserving surgery before and after the 2014 federal reclassification of hydrocodone.
Oncologist 2020 Apr;25(4):281-89. doi: 10.1634/theoncologist.2019-0758..
Keywords: Opioids, Medication, Surgery, Cancer: Breast Cancer, Cancer, Women