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
1 to 25 of 251 Research Studies DisplayedChou R, Korthuis PT, McCarty D
Management of suspected opioid overdose with naloxone in out-of-hospital settings: a systematic review.
This review synthesized evidence on 1) the effects of naloxone route of administration and dosing for suspected opioid overdose in out-of-hospital settings on mortality, reversal of overdose, and harms, and 2) the need for transport to a health care facility. It concluded that higher-concentration intranasal naloxone (2 mg/mL) seems to have efficacy similar to that of intramuscular naloxone for reversal of opioid overdose, with no difference in adverse events.
AHRQ-funded; 290201500009I.
Citation: Chou R, Korthuis PT, McCarty D .
Management of suspected opioid overdose with naloxone in out-of-hospital settings: a systematic review.
Ann Intern Med 2017 Dec 19;167(12):867-75. doi: 10.7326/m17-2224.
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Keywords: Emergency Medical Services (EMS), Evidence-Based Practice, Medication, Opioids, Patient-Centered Outcomes Research
Ngo-Metzger Q, Gottfredson R
AHRQ Author: Ngo-Metzger Q
Statin use for the primary prevention of cardiovascular disease in adults.
This case study concerns a 66-year-old generally healthy white man, who presents for his annual physical. He has no history of cardiovascular disease (CVD); he has had consistent systolic blood pressure measurements of 140 mm Hg. You calculate his 10-year risk of a CVD event to be 16.7 percent. The case study poses three multiple choice questions together with the U.S. Preventive Services Task Force recommendations and related background information.
AHRQ-authored.
Citation: Ngo-Metzger Q, Gottfredson R .
Statin use for the primary prevention of cardiovascular disease in adults.
Am Fam Physician 2017 Dec 15;96(12):805-06.
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Keywords: Cardiovascular Conditions, Case Study, Medication, Prevention, U.S. Preventive Services Task Force (USPSTF)
Cox ED, Hansen K, Rajamanickam VP
Are parents who feel the need to watch over their children's care better patient safety partners?
In this study, the investigators assessed whether needing to watch over care predicted parent performance of recommended safety behaviors to reduce medication errors and health care-associated infections. The researchers concluded that parents who reported the need to watch over care were more likely to perform behaviors specific to safe medication use (but not hand hygiene) compared with those not reporting this need.
AHRQ-funded; HS018680.
Citation: Cox ED, Hansen K, Rajamanickam VP .
Are parents who feel the need to watch over their children's care better patient safety partners?
Hosp Pediatr 2017 Dec;7(12):716-22. doi: 10.1542/hpeds.2017-0036..
Keywords: Adverse Drug Events (ADE), Adverse Events, Caregiving, Children/Adolescents, Healthcare-Associated Infections (HAIs), Medical Errors, Medication, Patient Safety
Carson NJ, Progovac AM, Wang Y
A decline in depression treatment following FDA antidepressant warnings largely explains racial/ethnic disparities in prescription fills.
The Food and Drug Administration's 2004 antidepressant warning was followed by decreases in antidepressant prescribing for youth. Little is known about how antidepressant prescribing patterns varied by race/ethnicity. This study analyzed Medicaid claims data from four U.S. states (2002-2009) for youth ages 5-17. The authors found that antidepressant prescription fills declined most post-warning for White youth, suggesting that risk information may have diffused less rapidly to prescribers or caregivers of minorities.
AHRQ-funded; HS021486.
Citation: Carson NJ, Progovac AM, Wang Y .
A decline in depression treatment following FDA antidepressant warnings largely explains racial/ethnic disparities in prescription fills.
Depress Anxiety 2017 Dec;34(12):1147-56. doi: 10.1002/da.22681..
Keywords: Medication, Children/Adolescents, Depression, Guidelines, Racial and Ethnic Minorities
Niznik J, Zhao X, Jiang T
Anticholinergic prescribing in Medicare Part D beneficiaries residing in nursing homes: results from a retrospective cross-sectional analysis of Medicare data.
The primary objective of this study was to identify factors associated with low- and high-level anticholinergic burden in nursing home residents. Overall, 29.6 percent of subjects had a high anticholinergic burden and 35.2 percent had a low burden. High burden was most often (72 percent) due to one highly anticholinergic medication rather than a cumulative effect.
AHRQ-funded; HS023779.
Citation: Niznik J, Zhao X, Jiang T .
Anticholinergic prescribing in Medicare Part D beneficiaries residing in nursing homes: results from a retrospective cross-sectional analysis of Medicare data.
Drugs Aging 2017 Dec;34(12):925-39. doi: 10.1007/s40266-017-0502-6.
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Keywords: Elderly, Medicare, Medication, Nursing
Turan B, Rogers AJ, Rice WS
Association between perceived discrimination in healthcare settings and HIV medication adherence: mediating psychosocial mechanisms.
There is insufficient research on the impact of perceived discrimination in healthcare settings on adherence to antiretroviral therapy (ART), particularly among women living with HIV, and even less is known about psychosocial mechanisms that may mediate this association. Cross-sectional analyses were conducted in a sample of diverse women living with HIV enrolled in the Women's Interagency HIV Study (WIHS), a multi-center cohort study to investigate these issues.
AHRQ-funded; HS013852.
Citation: Turan B, Rogers AJ, Rice WS .
Association between perceived discrimination in healthcare settings and HIV medication adherence: mediating psychosocial mechanisms.
AIDS Behav 2017 Dec;21(12):3431-39. doi: 10.1007/s10461-017-1957-5..
Keywords: Human Immunodeficiency Virus (HIV), Medication, Patient Adherence/Compliance, Social Stigma
Badawy SM, Morrone K, Thompson A
Computer and mobile technology interventions to promote medication adherence and disease management in people with thalassemia.
This study aims to identify and assess the effects of computer and mobile technology interventions designed to facilitate medication adherence and disease management in individuals with thalassemia.
AHRQ-funded; HS023011.
Citation: Badawy SM, Morrone K, Thompson A .
Computer and mobile technology interventions to promote medication adherence and disease management in people with thalassemia.
Cochrane Database Syst Rev 2017 Dec;2017(12)..
Keywords: Health Information Technology (HIT), Medication, Patient Adherence/Compliance, Patient-Centered Healthcare, Patient Self-Management
Cosgrove L, Krimsky S, Wheeler EE
Conflict of interest policies and industry relationships of guideline development group members: A cross-sectional study of clinical practice guidelines for depression.
The purpose of the present study was to assess a) the disclosure requirements of guideline development groups in a cross-section of guidelines for major depression; and, b) the extent and type of conflicts of panel members. It found that most of the guidelines were developed by panels that had members with industry financial ties to drug companies that manufacture antidepressant medication.
AHRQ-funded; HS022940.
Citation: Cosgrove L, Krimsky S, Wheeler EE .
Conflict of interest policies and industry relationships of guideline development group members: A cross-sectional study of clinical practice guidelines for depression.
Account Res 2017;24(2):99-115. doi: 10.1080/08989621.2016.1251319.
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Keywords: Medication, Depression, Guidelines, Behavioral Health, Research Methodologies
Fan Y, Adam TJ, McEwan R
Detecting signals of interactions between warfarin and dietary supplements in electronic health records.
This study detected signals of interactions between warfarin and seven dietary supplements, viz., alfalfa, garlic, ginger, ginkgo, ginseng, St. John's Wort, and Vitamin E by analyzing structured clinical data and unstructured clinical notes from the University of Minnesota Clinical Data Repository. There was a statistically significant association of warfarin concurrently used with supplements which can potentially increase the risk of adverse events, such as gastrointestinal bleeding.
AHRQ-funded; HS022085.
Citation: Fan Y, Adam TJ, McEwan R .
Detecting signals of interactions between warfarin and dietary supplements in electronic health records.
Stud Health Technol Inform 2017;245:370-74.
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Keywords: Adverse Drug Events (ADE), Blood Thinners, Electronic Health Records (EHRs), Medication, Health Information Technology (HIT)
Adams AS, Madden JM, Zhang F
Effects of transitioning to Medicare Part D on access to drugs for medical conditions among dual enrollees with cancer.
This study evaluated the impact of transitioning from Medicaid to Medicare Part D drug coverage on the use of noncancer treatments among dual enrollees with cancer. Its findings suggest that the removal of drug caps under Part D had a modest impact on the treatment of hypercholesterolemia overall and may have reduced white-black gaps in the use of lipid-lowering and antidepressant therapies.
AHRQ-funded; HS018577.
Citation: Adams AS, Madden JM, Zhang F .
Effects of transitioning to Medicare Part D on access to drugs for medical conditions among dual enrollees with cancer.
Value Health 2017 Dec;20(10):1345-54. doi: 10.1016/j.jval.2017.05.023.
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Keywords: Access to Care, Cancer, Medicare, Medication, Racial and Ethnic Minorities
Taira DA, Seto BK, Davis JW
Examining factors associated with nonadherence and identifying providers caring for nonadherent subgroups.
This study examined racial/ethnic and regional differences in medication adherence in patients with diabetes taking oral anti-diabetic, anti-hypertensive, and cholesterol lowering medications and to identify the pharmacies and prescribers who serve these communities. After adjustment for other factors, Filipinos, Native Hawaiians, and people of other race were significantly less adherent to anti-diabetic and anti-hypertensive medications than Japanese.
AHRQ-funded; HS023185.
Citation: Taira DA, Seto BK, Davis JW .
Examining factors associated with nonadherence and identifying providers caring for nonadherent subgroups.
J Pharm Health Serv Res 2017 Dec;8(4):247-53. doi: 10.1111/jphs.12193.
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Keywords: Diabetes, Medication, Patient Adherence/Compliance, Patient-Centered Healthcare, Racial and Ethnic Minorities
Slota C, Davis SA, Blalock SJ
Patient-physician communication on medication cost during glaucoma visits.
The aim of this secondary analysis was to describe the frequency and nature of patient-physician communication regarding medication cost during glaucoma office visits. Most participants did not discuss medication cost during their glaucoma office visit. The majority of the subjects who discussed cost had mild disease severity (51 percent), took one glaucoma medication (63 percent), and had Medicare (49 percent) as well as a form of prescription insurance (78 percent).
AHRQ-funded; HS023054.
Citation: Slota C, Davis SA, Blalock SJ .
Patient-physician communication on medication cost during glaucoma visits.
Optom Vis Sci 2017 Dec;94(12):1095-101. doi: 10.1097/opx.0000000000001139.
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Keywords: Eye Disease and Health, Healthcare Costs, Medication, Patient and Family Engagement, Clinician-Patient Communication
George MD, Baker JF, Hsu JY
Perioperative timing of infliximab and the risk of serious infection after elective hip and knee arthroplasty.
The purpose of this retrospective cohort study was to evaluate the association between infliximab timing and serious infection after elective hip or knee arthroplasty. The investigators concluded that administering infliximab within 4 weeks of elective knee or hip arthroplasty was not associated with a higher risk of short- or long-term serious infection compared to withholding infliximab for longer time periods. They also concluded that glucocorticoid use, especially >10 mg/day, was associated with an increased infection risk.
AHRQ-funded; HS018517.
Citation: George MD, Baker JF, Hsu JY .
Perioperative timing of infliximab and the risk of serious infection after elective hip and knee arthroplasty.
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Keywords: Adverse Drug Events (ADE), Adverse Events, Medication, Medication: Safety, Orthopedics, Patient Safety, Surgery
van den Bogert CA, Miller MJ, Cobaugh DJ
Screening questions for nonsteroidal anti-inflammatory drug risk knowledge.
The aim of this study was to evaluate screening questions for estimating nonsteroidal anti-inflammatory drug (NSAID) risk knowledge. It concluded that screening questions for subjective NSAID risk awareness and health literacy are predictive of objectively tested NSAID knowledge and can be used to triage patients as well as subsequently initiate and direct a conversation about NSAID risk.
AHRQ-funded; HS016956.
Citation: van den Bogert CA, Miller MJ, Cobaugh DJ .
Screening questions for nonsteroidal anti-inflammatory drug risk knowledge.
J Patient Saf 2017 Dec;13(4):217-22. doi: 10.1097/pts.0000000000000143.
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Keywords: Adverse Drug Events (ADE), Health Literacy, Medication, Risk
Kohler-Forsberg O, Madsen T, Behrendt-Moller I
Trajectories of suicidal ideation over 6 months among 482 outpatients with bipolar disorder.
The researchers aimed to investigate 6-months trajectories of suicidal ideation among adults with bipolar disorder. Using data from the Bipolar CHOICE study, they identified four distinct trajectories and found that more than one in ten adult outpatients with bipolar disorder had moderately increased suicidal ideation throughout 6 months of pharmacotherapy. They recommended that the identified predictors may help clinicians to identify those with additional need for treatment against suicidal thoughts, and future studies need to investigate whether targeted treatment may improve the course of persistent suicidal ideation.
AHRQ-funded; HS019371.
Citation: Kohler-Forsberg O, Madsen T, Behrendt-Moller I .
Trajectories of suicidal ideation over 6 months among 482 outpatients with bipolar disorder.
J Affect Disord 2017 Dec 1;223:146-52. doi: 10.1016/j.jad.2017.07.038.
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Keywords: Behavioral Health, Medication, Ambulatory Care and Surgery, Patient-Centered Healthcare
Prochaska MT, Hohmann SF, Modes M
Trends in troponin-only testing for AMI in academic teaching hospitals and the impact of Choosing Wisely(R).
This study examined the variation in cardiac biomarker testing and the effect of the Choosing Wisely(R) troponin-only recommendation for the diagnosis of acute myocardial infarction (AMI). It concluded that in institutions with low rates of troponin-only testing prior to the Choosing Wisely(R) recommendation, the recommendation was associated with a significant increase in the rate of troponin-only testing.
AHRQ-funded; HS023007.
Citation: Prochaska MT, Hohmann SF, Modes M .
Trends in troponin-only testing for AMI in academic teaching hospitals and the impact of Choosing Wisely(R).
J Hosp Med 2017 Dec;12(12):957-62. doi: 10.12788/jhm.2846.
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Keywords: Cardiovascular Conditions, Medication, Heart Disease and Health, Patient-Centered Outcomes Research
Taira DA, Shen C, King M
Access to medications for Medicare enrollees related to race/ethnicity: results from the 2013 Medicare Current Beneficiary Survey.
Prescription medications are taken by millions of Americans to manage chronic conditions and treat acute conditions. These medications, however, are not equally accessible to all. The purpose of this study was to examine medication access by race/ethnicity among Medicare beneficiaries. The authors found that possible interventions for non-Hispanic blacks might include assisting them in finding the best drug plan to meeting their needs, connecting them to medication assistance programs, and discussing convenience of pharmacy with patients.
AHRQ-funded; HS023185.
Citation: Taira DA, Shen C, King M .
Access to medications for Medicare enrollees related to race/ethnicity: results from the 2013 Medicare Current Beneficiary Survey.
Res Social Adm Pharm 2017 Nov;13(6):1208-13. doi: 10.1016/j.sapharm.2016.10.021..
Keywords: Access to Care, Medicare, Medication, Racial and Ethnic Minorities, Social Determinants of Health
Wang Z, Whiteside SPH, Sim L
Comparative effectiveness and safety of cognitive behavioral therapy and pharmacotherapy for childhood anxiety disorders: a systematic review and meta-analysis.
This review evaluated the comparative effectiveness and adverse events of cognitive behavioral therapy (CBT) and pharmacotherapy for childhood anxiety disorders. Evidence supports the effectiveness of CBT and selective serotonin reuptake inhibitors (SSRIs) for reducing childhood anxiety symptoms. Serotonin-norepinephrine reuptake inhibitors also appear to be effective based on less consistent evidence.
AHRQ-funded; 290201500013I.
Citation: Wang Z, Whiteside SPH, Sim L .
Comparative effectiveness and safety of cognitive behavioral therapy and pharmacotherapy for childhood anxiety disorders: a systematic review and meta-analysis.
JAMA Pediatr 2017 Nov;171(11):1049-56. doi: 10.1001/jamapediatrics.2017.3036.
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Keywords: Anxiety, Behavioral Health, Children/Adolescents, Comparative Effectiveness, Medication
Zullo AR, Sharmin S, Lee Y
Secondary prevention medication use after myocardial infarction in U.S. nursing home residents.
This study evaluated new use of secondary prevention medications after acute myocardial infarction (AMI) in NH residents who were previously nonusers and to evaluate what factors were associated with use. More than one-third of older NH residents in the United States do not have any secondary prevention medications initiated after AMI, with fewer medications initiated in older residents; women; and those with, DNR orders, poor physical function, and cognitive impairment.
AHRQ-funded; HS022998.
Citation: Zullo AR, Sharmin S, Lee Y .
Secondary prevention medication use after myocardial infarction in U.S. nursing home residents.
J Am Geriatr Soc 2017 Nov;65(11):2397-404. doi: 10.1111/jgs.15144.
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Keywords: Elderly, Medication, Heart Disease and Health, Nursing Homes, Prevention
Zhou M, Wang SV, Leonard CE
Sentinel modular program for propensity score-matched cohort analyses: application to glyburide, glipizide, and serious hypoglycemia.
Sentinel is a program sponsored by the US Food and Drug Administration to monitor the safety of medical products. This cohort assessment was conducted to evaluate the ability of the Sentinel Propensity Score Matching Tool to reproduce, in an expedited fashion, the known association between glyburide (vs. glipizide) and serious hypoglycemia. The study’s findings were consistent with the literature, and demonstrated the ability of the tool to reproduce this known association in an expedited.
AHRQ-funded; HS022193.
Citation: Zhou M, Wang SV, Leonard CE .
Sentinel modular program for propensity score-matched cohort analyses: application to glyburide, glipizide, and serious hypoglycemia.
Epidemiology 2017 Nov;28(6):838-46. doi: 10.1097/ede.0000000000000709..
Keywords: Adverse Drug Events (ADE), Diabetes, Medication: Safety, Medication, Patient Safety
Werner NE, Malkana S, Gurses AP
Toward a process-level view of distributed healthcare tasks: medication management as a case study.
Researchers aimed to highlight the importance of using a process-level view in analyzing distributed healthcare tasks through a case study analysis of medication management (MM). Their findings identified key cross-system characteristics not observable at the task-level: (1) identification of emergent properties (e.g., role ambiguity, loosely-coupled teams performing MM) and associated barriers; and (2) examination of barrier propagation across system boundaries.
AHRQ-funded; HS022916.
Citation: Werner NE, Malkana S, Gurses AP .
Toward a process-level view of distributed healthcare tasks: medication management as a case study.
Appl Ergon 2017 Nov;65:255-68. doi: 10.1016/j.apergo.2017.06.020.
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Keywords: Care Management, Elderly, Home Healthcare, Medication, Transitions of Care
Sadasivaiah S, Smith DE, Goldman S
Improving best possible medication history with vulnerable patients at an urban safety net academic hospital using pharmacy technicians.
A multidisciplinary team designed an EHR-facilitated medication reconciliation program by which pharmacy technicians engaged newly admitted patients and their caregivers at the bedside to develop and electronically document the best possible medication history (BPMH). They found that, by optimizing not only the health information technology platform but also the operational processes, the program achieved a nearly 80 percent generation of BPMH completed by a highly trained pharmacy technician.
AHRQ-funded; HS022561; HS023558.
Citation: Sadasivaiah S, Smith DE, Goldman S .
Improving best possible medication history with vulnerable patients at an urban safety net academic hospital using pharmacy technicians.
BMJ Open Qual 2017 Oct 21;6(2):e000102. doi: 10.1136/bmjoq-2017-000102.
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Keywords: Electronic Health Records (EHRs), Medication, Patient Safety, Urban Health, Vulnerable Populations
Tedesco D, Gori D, Desai KR
Drug-free interventions to reduce pain or opioid consumption after total knee arthroplasty: a systematic review and meta-analysis.
The authors systematically reviewed and meta-analyzed evidence of nonpharmacological interventions for postoperative pain management after total knee arthroplasty. The most commonly performed interventions included in the review were continuous passive motion, preoperative exercise, cryotherapy, electrotherapy, and acupuncture. In the meta-analysis, electrotherapy and acupuncture after total knee arthroplasty were associated with reduced and delayed opioid consumption.
AHRQ-funded; HS024096.
Citation: Tedesco D, Gori D, Desai KR .
Drug-free interventions to reduce pain or opioid consumption after total knee arthroplasty: a systematic review and meta-analysis.
JAMA Surg 2017 Oct 18;152(10):e172872. doi: 10.1001/jamasurg.2017.2872.
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Keywords: Care Management, Medication, Opioids, Orthopedics, Pain, Surgery
Elysee G, Herrin J, Horwitz LI
An observational study of the relationship between meaningful use-based electronic health information exchange, interoperability, and medication reconciliation capabilities.
Stagnation in hospitals' adoption of data integration functionalities coupled with reduction in the number of operational health information exchanges could become a significant impediment to hospitals' adoption of 3 critical capabilities: electronic health information exchange, interoperability, and medication reconciliation, in which electronic systems are used to assist with resolving medication discrepancies and improving patient safety. This observational study examines the relationship between meaningful use-based electronic health information exchange, interoperability, and medication reconciliation capabilities.
AHRQ-funded; HS022882.
Citation: Elysee G, Herrin J, Horwitz LI .
An observational study of the relationship between meaningful use-based electronic health information exchange, interoperability, and medication reconciliation capabilities.
Medicine 2017 Oct;96(41):e8274. doi: 10.1097/MD.0000000000008274..
Keywords: Electronic Health Records (EHRs), Health Information Exchange (HIE), Health Information Technology (HIT), Hospitals, Medication
Yabroff KR, Kirby J, Zodet M
AHRQ Author: Kirby J, Zodet M
Association of insurance gains and losses with access to prescription drugs.
The researchers used longitudinal data to assess the effects of insurance gains and losses on prescription drug access. Their findings that unmet need for prescription drugs declined among initially uninsured adults who gained coverage and doubled among initially insured adults who lost coverage provide longitudinal evidence that having and maintaining health insurance is a key protection against unmet need for prescription drugs in a nationally representative sample.
AHRQ-authored.
Citation: Yabroff KR, Kirby J, Zodet M .
Association of insurance gains and losses with access to prescription drugs.
JAMA Intern Med 2017 Oct;177(10):1531-32. doi: 10.1001/jamainternmed.2017.4011.
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Keywords: Access to Care, Health Insurance, Medication, Medical Expenditure Panel Survey (MEPS), Uninsured