National Healthcare Quality and Disparities Report
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Search All Research Studies
AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (4)
- Adverse Events (1)
- Alcohol Use (1)
- Blood Clots (2)
- (-) Blood Thinners (13)
- Cardiovascular Conditions (5)
- Care Management (1)
- Community-Based Practice (1)
- Comparative Effectiveness (2)
- Data (1)
- Diagnostic Safety and Quality (1)
- Evidence-Based Practice (2)
- Genetics (1)
- Guidelines (1)
- Heart Disease and Health (6)
- Hospitalization (2)
- Medication (8)
- Patient-Centered Outcomes Research (3)
- Patient Adherence/Compliance (1)
- Patient Safety (3)
- Prevention (1)
- Racial and Ethnic Minorities (1)
- Registries (1)
- Research Methodologies (1)
- Risk (2)
- Social Determinants of Health (1)
- Stroke (1)
- Substance Abuse (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 13 of 13 Research Studies DisplayedRaebel MA, Shetterly S, Lu CY
Methods for using clinical laboratory test results as baseline confounders in multi-site observational database studies when missing data are expected.
The purpose of this paper was to quantify missing baseline laboratory results, assess predictors of missingness, and examine performance of missing data methods. The researchers used the Mini-Sentinel Distributed Database to select three exposure-outcome scenarios with laboratory results as baseline confounders. They found that missing data methods performed similarly.
AHRQ-funded; HS023898.
Citation: Raebel MA, Shetterly S, Lu CY .
Methods for using clinical laboratory test results as baseline confounders in multi-site observational database studies when missing data are expected.
Pharmacoepidemiol Drug Saf 2016 Jul;25(7):798-814. doi: 10.1002/pds.4015.
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Keywords: Adverse Drug Events (ADE), Blood Thinners, Data, Diagnostic Safety and Quality, Medication
Wang SV, Franklin JM, Glynn RJ
Prediction of rates of thromboembolic and major bleeding outcomes with dabigatran or warfarin among patients with atrial fibrillation: new initiator cohort study.
The authors compared stratified event rates from randomized controlled trials with predicted event rates from models developed in observational data and assessed their ability to accurately capture observed rates of thromboembolism and major bleeding for patients treated with dabigatran or warfarin as part of routine care. They found that estimated rates of thromboembolism under dabigatran or warfarin treatment in randomized controlled trials were close to observed rates in routine care patients, but that rates of major bleeding were underestimated. They concluded that models developed in routine care patients can provide accurate, tailored estimates of risk and benefit under alternative treatment to enhance patient centered care.
AHRQ-funded; HS022193.
Citation: Wang SV, Franklin JM, Glynn RJ .
Prediction of rates of thromboembolic and major bleeding outcomes with dabigatran or warfarin among patients with atrial fibrillation: new initiator cohort study.
BMJ 2016 May 24;353:i2607. doi: 10.1136/bmj.i2607.
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Keywords: Blood Thinners, Adverse Drug Events (ADE), Blood Clots, Patient Safety, Medication
Metersky ML, Eldridge N, Wang Y
AHRQ Author: Eldridge N
Predictors of warfarin-associated adverse events in hospitalized patients: Opportunities to prevent patient harm.
The researchers assessed the relationship between daily versus less frequent international normalized ratio ( INR) monitoring and overanticoagulation and warfarin-related adverse events. They bconcluded that daily INR measurement and recognition of a rapidly rising INR might decrease the frequency of warfarin-associated adverse events in hospitalized patients.
AHRQ-authored; AHRQ-funded; 290201200003C.
Citation: Metersky ML, Eldridge N, Wang Y .
Predictors of warfarin-associated adverse events in hospitalized patients: Opportunities to prevent patient harm.
J Hosp Med 2016 Apr;11(4):276-82. doi: 10.1002/jhm.2528.
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Keywords: Blood Thinners, Care Management, Adverse Drug Events (ADE), Patient Safety, Hospitalization, Prevention
Baik SH, Hernandez I, Zhang Y
Evaluating the initiation of novel oral anticoagulants in Medicare beneficiaries.
This study evaluated how patient demographics, clinical characteristics, types of insurance, and patient out-of-pocket spending affect the initiation of warfarin and 2 novel oral anticoagulants (NOACs)--dabigatran and rivaroxaban. It found that race, sex, type of Part D plans, and some clinical conditions were associated with the initiation of NOACs relative to warfarin.
AHRQ-funded; HS018657.
Citation: Baik SH, Hernandez I, Zhang Y .
Evaluating the initiation of novel oral anticoagulants in Medicare beneficiaries.
J Manag Care Spec Pharm 2016 Mar;22(3):281-92. doi: 10.18553/jmcp.2016.22.3.281.
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Keywords: Blood Thinners, Medication, Heart Disease and Health, Cardiovascular Conditions, Social Determinants of Health
O'Brien EC, Simon DN, Thomas LE
The ORBIT bleeding score: a simple bedside score to assess bleeding risk in atrial fibrillation.
The researchers sought to develop and validate a novel bleeding risk score using routinely available clinical information to predict major bleeding in a large, community-based in atrial fibrillation (AF) population. They concluded that their five-element ORBIT bleeding risk score had better ability to predict major bleeding in AF patients when compared with HAS-BLED and ATRIA risk scores.
AHRQ-funded; HS021092.
Citation: O'Brien EC, Simon DN, Thomas LE .
The ORBIT bleeding score: a simple bedside score to assess bleeding risk in atrial fibrillation.
Eur Heart J 2015 Dec 7;36(46):3258-64. doi: 10.1093/eurheartj/ehv476.
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Keywords: Blood Thinners, Heart Disease and Health, Cardiovascular Conditions, Adverse Drug Events (ADE), Adverse Events, Risk, Registries, Patient-Centered Outcomes Research, Evidence-Based Practice
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
Wyss R, Ellis AR, Brookhart MA
Matching on the disease risk score in comparative effectiveness research of new treatments.
The researchers used simulations and an empirical example to evaluate the performance of disease risk score (DRS) matching compared with propensity score (PS) matching when controlling large numbers of covariates in settings involving newly introduced treatments. When PS distributions are separated, DRS matching can improve the precision of effect estimates and allow researchers to evaluate the treatment effect in a larger proportion of the treated population.
AHRQ-funded; HS017950.
Citation: Wyss R, Ellis AR, Brookhart MA .
Matching on the disease risk score in comparative effectiveness research of new treatments.
Pharmacoepidemiol Drug Saf 2015 Sep;24(9):951-61. doi: 10.1002/pds.3810.
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Keywords: Comparative Effectiveness, Research Methodologies, Blood Thinners, Medication
Duconge J, Cadilla CL, Seip RL
Why admixture matters in genetically-guided therapy: missed targets in the COAG and EU-PACT trials.
It is now well recognized that these commonly used pharmacogenetic algorithms perform poorly when applied to people with substantial African heritage. The authors of this letter conclude that the best approach for global pharmacogenetics is to guide warfarin dosing by using a pharmacogenetic-based algorithm that also accounts for the effect of admixture or ancestry proportions.
AHRQ-funded; HS022304.
Citation: Duconge J, Cadilla CL, Seip RL .
Why admixture matters in genetically-guided therapy: missed targets in the COAG and EU-PACT trials.
P R Health Sci J 2015 Sep;34(3):175-7..
Keywords: Racial and Ethnic Minorities, Genetics, Blood Thinners, Medication
Hess CN, Peterson ED, Peng SA
Use and outcomes of triple therapy among older patients with acute myocardial infarction and atrial fibrillation.
The authors sought to determine appropriate antithrombotic therapy for acute myocardial infarction (MI) patients with atrial fibrillation (AF) treated with percutaneous coronary intervention (PCI). They found that approximately 1 in 4 older AF patients undergoing PCI for MI were discharged on triple therapy. Those receiving triple therapy versus dual antiplatelet therapy had higher rates of major bleeding without a measurable difference in composite MI, death, or stroke.
AHRQ-funded; HS021092.
Citation: Hess CN, Peterson ED, Peng SA .
Use and outcomes of triple therapy among older patients with acute myocardial infarction and atrial fibrillation.
J Am Coll Cardiol 2015 Aug 11;66(6):616-27. doi: 10.1016/j.jacc.2015.05.062.
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Keywords: Blood Thinners, Heart Disease and Health, Cardiovascular Conditions, Medication
Roth JA, Bradley K, Thummel KE
Alcohol misuse, genetics, and major bleeding among warfarin therapy patients in a community setting.
The researchers conducted a case–control study to assess the association between screening positive for moderate/severe alcohol misuse and the risk of major bleeding in a community sample of patients using warfarin. They found that alcohol screening questionnaires, potentially coupled with genetic testing, could have clinical utility in selecting patients for warfarin therapy, as well as refining dosing and monitoring practices.
AHRQ-funded; HS022982.
Citation: Roth JA, Bradley K, Thummel KE .
Alcohol misuse, genetics, and major bleeding among warfarin therapy patients in a community setting.
Pharmacoepidemiol Drug Saf 2015 Jun;24(6):619-27. doi: 10.1002/pds.3769..
Keywords: Alcohol Use, Blood Thinners, Community-Based Practice, Substance Abuse
O'Brien EC, Kim S, Hess PL
Effect of the 2014 atrial fibrillation guideline revisions on the proportion of patients recommended for oral anticoagulation.
Researchers assessed the potential effect of a new guideline for atrial fibrillation (AF) by comparing the proportion of patients with AF recommended for oral anticoagulation (OAC) under the 2011 and 2014 guidelines. They found that two-thirds of patients with AF who were previously not recommended for OAC are newly recommended under the 2014 guideline. They advised future studies evaluating longitudinal changes in anticoagulation treatment patterns and outcomes among patients reclassified by the new guidelines.
AHRQ-funded; HS021092.
Citation: O'Brien EC, Kim S, Hess PL .
Effect of the 2014 atrial fibrillation guideline revisions on the proportion of patients recommended for oral anticoagulation.
JAMA Intern Med 2015 May;175(5):848-50. doi: 10.1001/jamainternmed.2015.13.
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Keywords: Heart Disease and Health, Blood Thinners, Guidelines, Medication, Cardiovascular Conditions, Evidence-Based Practice, Patient-Centered Outcomes Research
Chopra V, Fallouh N, McGuirk H
Patterns, risk factors and treatment associated with PICC-DVT in hospitalized adults: a nested case-control study.
The purpose of this study was to determine patterns, risk factors and treatment related to peripherally inserted central catheters-deep vein thrombosis (PICC-DVT) in hospitalized patients. It found that treatment for PICC-DVT varied and included heparin bridging, low molecular weight heparin only and device removal only; the average duration of treatment also varied across these groups.
AHRQ-funded; HS022835.
Citation: Chopra V, Fallouh N, McGuirk H .
Patterns, risk factors and treatment associated with PICC-DVT in hospitalized adults: a nested case-control study.
Thromb Res 2015 May;135(5):829-34. doi: 10.1016/j.thromres.2015.02.012..
Keywords: Patient Safety, Blood Clots, Blood Thinners, Risk, Hospitalization
Lauffenburger JC, Farley JF, Gehi AK
Effectiveness and safety of dabigatran and warfarin in real-world US patients with non-valvular atrial fibrillation: a retrospective cohort study.
The researchers compared the effectiveness and safety of the new oral anticoagulant, dabigatran, with warfarin in clinical practice among a large nationally representative retrospective cohort of commercially insured patients in the United States. They found that compared with warfarin, dabigatran was associated with a lower risk of ischemic stroke or systemic embolism, hemorrhagic stroke, and acute myocardial infarction.
AHRQ-funded; HS023099.
Citation: Lauffenburger JC, Farley JF, Gehi AK .
Effectiveness and safety of dabigatran and warfarin in real-world US patients with non-valvular atrial fibrillation: a retrospective cohort study.
J Am Heart Assoc 2015 Apr 10;4(4):e001798. doi: 10.1161/jaha.115.001798..
Keywords: Comparative Effectiveness, Blood Thinners, Patient-Centered Outcomes Research, Stroke, Heart Disease and Health