National Healthcare Quality and Disparities Report
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Topics
- Access to Care (2)
- Adverse Drug Events (ADE) (13)
- Adverse Events (8)
- Alcohol Use (3)
- Ambulatory Care and Surgery (2)
- Antibiotics (3)
- Antimicrobial Stewardship (3)
- Arthritis (3)
- Asthma (4)
- Behavioral Health (8)
- Blood Pressure (3)
- Blood Thinners (2)
- Cancer (4)
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- Cardiovascular Conditions (4)
- Care Management (3)
- Children/Adolescents (13)
- Chronic Conditions (5)
- Clinical Decision Support (CDS) (3)
- Clinician-Patient Communication (1)
- Communication (2)
- Community-Based Practice (1)
- Comparative Effectiveness (17)
- Complementary and Alternative Medicine (1)
- Critical Care (1)
- Decision Making (2)
- Dementia (1)
- Depression (1)
- Diabetes (6)
- Education: Patient and Caregiver (1)
- Elderly (8)
- Electronic Health Records (EHRs) (4)
- Electronic Prescribing (E-Prescribing) (1)
- Emergency Department (1)
- Emergency Medical Services (EMS) (3)
- Evidence-Based Practice (6)
- Genetics (3)
- Guidelines (3)
- Healthcare-Associated Infections (HAIs) (1)
- Healthcare Costs (8)
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- Health Information Technology (HIT) (13)
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- Health Services Research (HSR) (1)
- Heart Disease and Health (6)
- Hepatitis (1)
- Hospital Discharge (1)
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- Human Immunodeficiency Virus (HIV) (1)
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- Long-Term Care (1)
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- Medicaid (10)
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- Medical Expenditure Panel Survey (MEPS) (1)
- Medicare (3)
- (-) Medication (99)
- Medication: Safety (7)
- Methicillin-Resistant Staphylococcus aureus (MRSA) (1)
- Nursing Homes (4)
- Obesity (2)
- Opioids (6)
- Outcomes (5)
- Pain (3)
- Patient-Centered Healthcare (2)
- Patient-Centered Outcomes Research (7)
- Patient Adherence/Compliance (10)
- Patient Safety (17)
- Patient Self-Management (1)
- Policy (4)
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- Pregnancy (4)
- Prevention (4)
- Primary Care (1)
- Provider: Pharmacist (3)
- Public Reporting (1)
- Quality Measures (1)
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- Quality of Life (1)
- Racial and Ethnic Minorities (5)
- Registries (2)
- Research Methodologies (1)
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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
76 to 99 of 99 Research Studies DisplayedDesai RJ, Hernandez-Diaz S, Bateman BT
Increase in prescription opioid use during pregnancy among Medicaid-enrolled women.
The researchers reported the prevalence of prescription opioid use and evaluated the trends in a large cohort of Medicaid-enrolled pregnant women. They observed high and increasing number of filled prescriptions for opioids during pregnancy among Medicaid-enrolled women and recommended further safety evaluations of these drugs and their effects on the developing fetus.
AHRQ-funded; HS018533.
Citation: Desai RJ, Hernandez-Diaz S, Bateman BT .
Increase in prescription opioid use during pregnancy among Medicaid-enrolled women.
Obstet Gynecol 2014 May;123(5):997-1002. doi: 10.1097/aog.0000000000000208.
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Keywords: Healthcare Utilization, Medicaid, Medication, Opioids, Pregnancy
Armstrong EP, Wang SM, Hines LE
Prescriber perceptions of a near real-time fax alert program for potential drug-drug interactions.
The purpose of this study was to determine whether prescribers thought that near real-time fax alerts for potential drug-drug interactions (PDDIs) were a good way to communicate with them. The researchers found that physician perceptions of the value of the fax alerts were dependent on which combination of drugs was involved.
AHRQ-funded; HS017001
Citation: Armstrong EP, Wang SM, Hines LE .
Prescriber perceptions of a near real-time fax alert program for potential drug-drug interactions.
J Manag Care Spec Pharm. 2014 May;20(5):494-500a..
Keywords: Adverse Drug Events (ADE), Health Information Technology (HIT), Medication, Patient Safety, Practice Patterns
Kirkendall ES, Spires WL, Mottes TA
Development and performance of electronic acute kidney injury triggers to identify pediatric patients at risk for nephrotoxic medication-associated harm.
The authors described an approach and provided a technical framework for the creation of risk-stratifying acute kidney injury (AKI) triggers and the development of an application to manage the AKI trigger data. Their report summarizes the construction of a trigger-based application, the performance of the triggers, and the challenges uncovered during the design, build, and implementation of the system.
AHRQ-funded; HS021114.
Citation: Kirkendall ES, Spires WL, Mottes TA .
Development and performance of electronic acute kidney injury triggers to identify pediatric patients at risk for nephrotoxic medication-associated harm.
Appl Clin Inform 2014 Apr 2;5(2):313-33. doi: 10.4338/aci-2013-12-ra-0102.
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Keywords: Adverse Drug Events (ADE), Children/Adolescents, Medication, Health Information Technology (HIT), Electronic Health Records (EHRs)
Bressler B, Siegel CA
Beware of the swinging pendulum: anti-tumor necrosis factor monotherapy vs combination therapy for inflammatory bowel disease.
An editorial commenting on a study in the same issue by Osterman, et al. in the context of related studies concludes that it is more reasonable to consider slightly modifying the approach to anti-tumor necrosis factor combination therapy as opposed to a full pendulum swing back to monotherapy.
AHRQ-funded; HS021747
Citation: Bressler B, Siegel CA .
Beware of the swinging pendulum: anti-tumor necrosis factor monotherapy vs combination therapy for inflammatory bowel disease.
Gastroenterolog.y 2014 Apr;146(4):884-7. doi: 10.1053/j.gastro.2014.02.018..
Keywords: Comparative Effectiveness, Outcomes, Patient-Centered Outcomes Research, Medication, Chronic Conditions
O'Brien EC, Holmes DN, Ansell JE
Physician practices regarding contraindications to oral anticoagulation in atrial fibrillation: findings from the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF) registry.
This study describes the frequencies of and factors associated with oral anticoagulation (OAC) contraindications in clinical practice for patients with atrial fibrillation (AF). Contraindications to OAC therapy among patients with AF are common but subjective. Many patients with reported contraindications were receiving OAC, suggesting that the perceived benefits outweighed the potential harm posed by the relative contraindication.
AHRQ-funded; HS021092
Citation: O'Brien EC, Holmes DN, Ansell JE .
Physician practices regarding contraindications to oral anticoagulation in atrial fibrillation: findings from the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF) registry.
Am Heart J. 2014 Apr;167(4):601-609.e1. doi: 10.1016/j.ahj.2013.12.014..
Keywords: Heart Disease and Health, Blood Thinners, Medication, Registries, Cardiovascular Conditions, Patient-Centered Outcomes Research, Evidence-Based Practice, Practice Patterns
Singh JA
Facilitators and barriers to adherence to urate-lowering therapy in African-Americans with gout: a qualitative study.
The study aim was to assess the facilitators and barriers to adherence to urate-lowering therapy (ULT) in African-Americans with gout. It found that facilitators to ULT adherence included recognition of the need to take ULT regularly to prevent gout flares and the desire to have less dietary restriction. Barriers to optimal ULT adherence included doubts about effectiveness of ULT and concerns about cost and side effects.
AHRQ-funded; HS021110.
Citation: Singh JA .
Facilitators and barriers to adherence to urate-lowering therapy in African-Americans with gout: a qualitative study.
Arthritis Res Ther 2014 Mar 29;16(2):R82. doi: 10.1186/ar4524..
Keywords: Patient Adherence/Compliance, Medication, Racial and Ethnic Minorities
Eapen ZJ, Grau-Sepulveda MV, Fonarow GC
Prescribing warfarin at discharge for heart failure patients: findings from the Get With The Guidelines-Heart Failure Registry
The researchers used data from a heart failure (HF) registry to determine the prevalence and variation, as well as patient characteristics, in warfarin prescription among real-world HF population. They found that warfarin was prescribed at discharge for more than 1 out of 10 patients hospitalized for HF without evident indications or contraindications for anticoagulation.
AHRQ-funded; HS021092
Citation: Eapen ZJ, Grau-Sepulveda MV, Fonarow GC .
Prescribing warfarin at discharge for heart failure patients: findings from the Get With The Guidelines-Heart Failure Registry
Int J Cardiol. 2014 Mar 15;172(2):e322-3. doi: 10.1016/j.ijcard.2013.12.161..
Keywords: Heart Disease and Health, Registries, Comparative Effectiveness, Blood Thinners, Medication
Li L, Vollmer WM, Butler MG
A comparison of confounding adjustment methods for assessment of asthma controller medication effectiveness.
Using three confounding adjustment procedures—covariate-adjusted regression, propensity score regression, and high-dimemsional propensity score regression—on a population of 24,680 children with asthma, researchers found that patients treated with leukotriene antagonists were no more likely than those treated with inhaled corticosteroids to experience adverse outcomes.
AHRQ-funded; HS019669
Citation: Li L, Vollmer WM, Butler MG .
A comparison of confounding adjustment methods for assessment of asthma controller medication effectiveness.
Am J Epidemiol. 2014 Mar 1;179(5):648-59. doi: 10.1093/aje/kwt323..
Keywords: Comparative Effectiveness, Outcomes, Children/Adolescents, Asthma, Medication
Kim DH, Lin Y, Goytizolo EA
Adductor canal block versus femoral nerve block for total knee arthroplasty: a prospective, randomized, controlled trial.
In a study of pain relief for patients recovering from a total knee arthroplasty, researchers found that adductor canal block (ACB) results in less motor impairment for quadriceps muscles after surgery than femoral nerve block (FNB) and it provides a comparable level of pain relief. The prospective, randomized, controlled study included 46 patients receiving ACB and 47 receiving FNB.
AHRQ-funded; HS021734
Citation: Kim DH, Lin Y, Goytizolo EA .
Adductor canal block versus femoral nerve block for total knee arthroplasty: a prospective, randomized, controlled trial.
Anesthesiology. 2014 Mar;120(3):540-50. doi: 10.1097/ALN.0000000000000119..
Keywords: Medication, Opioids, Outcomes, Pain, Surgery
Gellad WF, Choi P, Mizah M
Assessing the chiral switch: approval and use of single-enantiomer drugs, 2001 to 2011.
The researchers studied the prevalence of chiral switching in the United States over the past decade, including trends in use of, and expenditures on these products in Medicaid. They found that recently approved single-enantiomer drugs showed no evidence of superior efficacy over the older racemic precursors in the pivotal trials leading to their approval.
AHRQ-funded; HS018465.
Citation: Gellad WF, Choi P, Mizah M .
Assessing the chiral switch: approval and use of single-enantiomer drugs, 2001 to 2011.
Am J Manag Care 2014 Mar;20(3):e90-7..
Keywords: Medicaid, Medication
Yehia BR, French B, Fleishman JA
AHRQ Author: Fleishman JA
Retention in care is more strongly associated with viral suppression in HIV-infected patients with lower versus higher CD4 counts.
The investigators evaluated whether the association between retention in care and viral suppression differed by HIV disease severity. They found that retention in care is more strongly associated with viral suppression in patients with lower CD4 counts. They concluded that their results have important implications for improving the health of patients with advanced HIV disease and for test and treat approaches to HIV prevention.
AHRQ-authored; AHRQ-funded; 290201100007C.
Citation: Yehia BR, French B, Fleishman JA .
Retention in care is more strongly associated with viral suppression in HIV-infected patients with lower versus higher CD4 counts.
J Acquir Immune Defic Syndr 2014 Mar;65(3):333-9. doi: 10.1097/qai.0000000000000023.
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Keywords: Human Immunodeficiency Virus (HIV), Medication, Patient Adherence/Compliance
Konetzka RT, Brauner DJ, Shega J
The effects of public reporting on physical restraints and antipsychotic use in nursing home residents with severe cognitive impairment.
The purpose of this paper was to assess whether reductions in physical restraint use associated with quality reporting may have had the unintended consequence of increasing antipsychotic use in nursing home (NH) residents with severe cognitive impairment. Physical restraint use declined significantly from 1999 to 2008 in NH residents with severe cognitive impairment. Correspondingly, antipsychotic use in the same residents increased more in NHs that were subject to public reporting. This analysis suggests that public reporting of physical restraint use had the unintended consequence of increasing use of antipsychotics in NH residents with severe cognitive impairment.
AHRQ-funded; HS018718.
Citation: Konetzka RT, Brauner DJ, Shega J .
The effects of public reporting on physical restraints and antipsychotic use in nursing home residents with severe cognitive impairment.
J Am Geriatr Soc 2014 Mar;62(3):454-61. doi: 10.1111/jgs.12711.
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Keywords: Dementia, Elderly, Medication, Nursing Homes, Public Reporting
Stroup TS, Gerhard T, Crystal S
Geographic and clinical variation in clozapine use in the United States.
This nationwide study examined predictors of clozapine use to help identify ways to optimize its use. It found that the clozapine initiation rate was low compared with the expected proportion of patients who warrant a clozapine trial and was strongly affected by local treatment.
AHRQ-funded; HS016097
Citation: Stroup TS, Gerhard T, Crystal S .
Geographic and clinical variation in clozapine use in the United States.
Psychiatr Serv. 2014 Feb;65(2):186-92. doi: 10.1176/appi.ps.201300180.
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Keywords: Comparative Effectiveness, Medication, Behavioral Health
Hwang TJ, Avorn J, Carpenter D
Quantifying the Food And Drug Administration's rulemaking delays highlights the need for transparency.
In order to better understand the FDA’s rulemaking process, the authors examined the evolution of significant rules that the agency published during 2000–12 for drugs, devices, and other medical products. They found that the rules’ median time to finalization was 7.3 years. Longer review times were significantly associated with a reduction in the stringency of final rules, compared to the originally proposed versions.
AHRQ-funded; HS018465.
Citation: Hwang TJ, Avorn J, Carpenter D .
Quantifying the Food And Drug Administration's rulemaking delays highlights the need for transparency.
Health Aff 2014 Feb;33(2):309-15. doi: 10.1377/hlthaff.2013.0564..
Keywords: Patient Safety, Policy, Decision Making, Medication
Ezaz G, Long JB, Gross CP
Risk prediction model for heart failure and cardiomyopathy after adjuvant trastuzumab therapy for breast cancer.
The investigators sought to develop a clinical risk score that identifies older women with breast cancer who are at higher risk of heart failure or cardiomyopathy after trastuzumab. That found that a 7-factor risk score was able to stratify 3-year risk of heart failure/cardiomyopathy after trastuzumab between the lowest and highest risk groups by more than 2-fold in a Medicare population.
AHRQ-funded; HS018781.
Citation: Ezaz G, Long JB, Gross CP .
Risk prediction model for heart failure and cardiomyopathy after adjuvant trastuzumab therapy for breast cancer.
J Am Heart Assoc 2014 Feb;3(1):e000472. doi: 10.1161/jaha.113.000472.
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Keywords: Cancer: Breast Cancer, Heart Disease and Health, Medication, Patient Safety, Risk
Nuckols TK, Anderson L, Popescu I
Opioid prescribing: a systematic review and critical appraisal of guidelines for chronic pain.
This review evaluated the quality and content of guidelines on the use of opioids for chronic pain. Despite limited evidence and variable development methods, it concluded that recent guidelines on chronic pain agree on several opioid risk mitigation strategies, including upper dosing thresholds; cautions with certain medications; attention to drug–drug and drug–disease interactions; and use of risk assessment tools, treatment agreements, and urine drug testing.
AHRQ-funded; HS017954.
Citation: Nuckols TK, Anderson L, Popescu I .
Opioid prescribing: a systematic review and critical appraisal of guidelines for chronic pain.
Ann Intern Med 2014 Jan 7;160(1):38-47. doi: 10.7326/0003-4819-160-1-201401070-00732..
Keywords: Opioids, Pain, Guidelines, Medication, Evidence-Based Practice, Chronic Conditions
Barnett ML, Linder JA
Antibiotic prescribing to adults with sore throat in the United States, 1997-2010.
In only about 10 percent of cases of sore throat (those related to A Streptococcus infection) are antibiotics indicated. However, a new study, combined with an earlier study, finds that despite efforts to reduce overprescribing, antibiotic use dropped from roughly 80 to 70 percent around 1993 and then to around 60 percent by 2000 where it has remained as of 2010.
AHRQ-funded; HS018419
Citation: Barnett ML, Linder JA .
Antibiotic prescribing to adults with sore throat in the United States, 1997-2010.
JAMA Intern Med. 2014 Jan;174(1):138-40. doi: 10.1001/jamainternmed.2013.11673..
Keywords: Antibiotics, Antimicrobial Stewardship, Medication, Healthcare Utilization
Donnelly JP, Baddley JW, Wang HE
Antibiotic utilization for acute respiratory tract infections in U.S. emergency departments.
Using national surveillance data for acute respiratory tract infections (ARTIs), this study characterized patterns of antibiotic usage in U.S. emergency departments between 2001 and 2010. It found significant progress toward reductions on inappropriate antibiotic use among children; however, adults with ARTI continued to receive inappropriately high amounts of antibiotics.
AHRQ-funded; HS013852
Citation: Donnelly JP, Baddley JW, Wang HE .
Antibiotic utilization for acute respiratory tract infections in U.S. emergency departments.
Antimicrob Agents Chemother. 2014 Mar;58(3):1451-7. doi: 10.1128/AAC.02039-13..
Keywords: Antimicrobial Stewardship, Emergency Medical Services (EMS), Medication, Critical Care
Hartung DM, Zerzan J, Yamashita T
Characteristics and trends of low-dose quetiapine use in two western state Medicaid programs.
This study characterized longitudinal trends in low-dose second-generation antipsychotic medications, and, in particular, quetiapine in two western State Medicaid programs over a 5-year period. The researchers found that when one State suspended off-label promotional activities, there was a significant decline in the initiation of low-dose quetiapine use.
AHRQ-funded; HS019456; HS019464.
Citation: Hartung DM, Zerzan J, Yamashita T .
Characteristics and trends of low-dose quetiapine use in two western state Medicaid programs.
Pharmacoepidemiol Drug Saf. 2014 Jan;23(1):87-94. doi: 10.1002/pds.3538..
Keywords: Medication, Medicaid, Behavioral Health
Goldberger ZD, Alexander GC
Digitalis use in contemporary clinical practice: refitting the foxglove.
The researchers hypothesized that digoxin use for systolic heart failure (HF) has decreased during the past 15 years, despite clinical guidelines supporting its use. They fund that there has been a marked reduction in ambulatory digoxin use in the United States since 1997, with the largest declines in use observed from 1997 through 2001, and especially for patients with HF.
AHRQ-funded; HS018960.
Citation: Goldberger ZD, Alexander GC .
Digitalis use in contemporary clinical practice: refitting the foxglove.
JAMA Intern Med 2014 Jan;174(1):151-4. doi: 10.1001/jamainternmed.2013.10432..
Keywords: Heart Disease and Health, Medication, Ambulatory Care and Surgery, Practice Patterns
Pevnick JM, Li N, Asch SM
Effect of electronic prescribing with formulary decision support on medication tier, copayments, and adherence.
The researchers evaluated whether formulary decision support (FDS) could reduce patient medication costs, and thereby improve adherence. In the studied population, interruptive FDS shifted prescribing toward preferred tier medications, but these medications were only minimally less expensive for patients. Thus, FDS did not significantly increase adherence.
AHRQ-funded; HS016391.
Citation: Pevnick JM, Li N, Asch SM .
Effect of electronic prescribing with formulary decision support on medication tier, copayments, and adherence.
BMC Med Inform Decis Mak 2014;14:79. doi: 10.1186/1472-6947-14-79..
Keywords: Electronic Prescribing (E-Prescribing), Medication, Patient Adherence/Compliance, Clinical Decision Support (CDS), Health Information Technology (HIT)
Schoenthaler A, Montague E, Baier Manwell L
Patient-physician racial/ethnic concordance and blood pressure control: the role of trust and medication adherence.
The researchers examined the associations between racial/ethnic concordance and blood pressure (BP) control to determine whether patient trust and medication adherence mediate these associations. They found that higher levels of trust were associated with better medication adherence and a tendency toward better BP control, irrespective of patient–physician racial/ethnic concordance.
AHRQ-funded; HS011955.
Citation: Schoenthaler A, Montague E, Baier Manwell L .
Patient-physician racial/ethnic concordance and blood pressure control: the role of trust and medication adherence.
Ethn Health 2014;19(5):565-78. doi: 10.1080/13557858.2013.857764..
Keywords: Blood Pressure, Racial and Ethnic Minorities, Medication, Patient Adherence/Compliance
Zhang Y, McCoy RG, Mason JE
Second-line agents for glycemic control for type 2 diabetes: are newer agents better?
The researchers aimed to assess the benefits and harms of four commonly used antihyperglycemia treatment regimens considering clinical effectiveness, quality of life, and cost. According to the model used by the researchers, all regimens resulted in similar life years and quality-adjusted life years (QALYs) regardless of glycemic control goal, but the regimen with sulfonylurea incurred significantly lower cost per QALY.
AHRQ-funded; HS017628.
Citation: Zhang Y, McCoy RG, Mason JE .
Second-line agents for glycemic control for type 2 diabetes: are newer agents better?
Diabetes Care 2014;37(5):1338-45. doi: 10.2337/dc13-1901..
Keywords: Diabetes, Comparative Effectiveness, Quality of Life, Medication
Erten MZ, Davidoff AJ, Zuckerman IH
AHRQ Author: Davidoff AJ
The effect of supplemental medical and prescription drug coverage on health care spending for Medicare beneficiaries with cancer.
The researchers examined whether patients with newly diagnosed cancer respond differently to supplemental coverage than the general Medicare population. They concluded that Medicare beneficiaries with cancer are less responsive to the presence and type of supplemental insurance than are beneficiaries without cancer. They recommended that policymakers consider welfare effects associated with coverage restrictions.
AHRQ-authored.
Citation: Erten MZ, Davidoff AJ, Zuckerman IH .
The effect of supplemental medical and prescription drug coverage on health care spending for Medicare beneficiaries with cancer.
Value Health 2014 Jan-Feb;17(1):15-21. doi: 10.1016/j.jval.2013.11.003.
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Keywords: Cancer, Health Insurance, Medicare, Medication