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- Adverse Drug Events (ADE) (2)
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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 16 of 16 Research Studies DisplayedMcPheeters M, O'Connor EA, Riley S
Pharmacotherapy for alcohol use disorder: a systematic review and meta-analysis.
Researchers conducted a literature review and analysis to compare efficacy of therapies for alcohol use disorder. Their findings supported the use of oral naltrexone at 50 mg/d and acamprosate as first-line pharmacotherapies in conjunction with psychosocial interventions for treating alcohol use disorder.
AHRQ-funded; 75Q80120D00007.
Citation: McPheeters M, O'Connor EA, Riley S .
Pharmacotherapy for alcohol use disorder: a systematic review and meta-analysis.
JAMA 2023 Nov 7; 330(17):1653-65. doi: 10.1001/jama.2023.19761..
Keywords: Medication, Alcohol Use, Evidence-Based Practice, Patient-Centered Outcomes Research
Chou R, Spencer H, Bougatsos C
Preexposure prophylaxis for the prevention of HIV: updated evidence report and systematic review for the US Preventive Services Task Force.
This article updates research used in the 2019 US Preventive Services Task Force final recommendation on use of oral preexposure prophylaxis (PrEP) to prevent HIV in adults at increased risk. The summary includes newer PrEP regimens that were not available for the 2019 final recommendation. A literature review was conducted that included randomized clinical trials of PrEP vs placebo or no PrEP or newer vs older PrEP regimens and diagnostic accuracy studies of instruments for predicting incident HIV infection. Thirty-two studies were included in the review (20 randomized clinical trials [n = 36,543] and 12 studies of diagnostic accuracy [n = 5,544,500]). Eleven trials in the 2019 review found oral PrEP associated with decreased HIV infection risk vs placebo or no PrEP. One new trial (n = 5335) found oral tenofovir alafenamide/emtricitabine (TAF/FTC) to be noninferior to tenofovir disoproxil fumarate/emtricitabine (TDF/FTC) in men who have sex with men. Two new trials found long-acting injectable cabotegravir associated with decreased risk of HIV infection vs oral TDF/FTC in cisgender men who have sex with men and transgender women [n = 4490] and RR, 0.11 in cisgender women [n = 3178]). Discrimination of instruments for predicting incident HIV infection was found to be moderate in men who have sex with men (5 studies; n = 25,488) and moderate to high in general populations of persons without HIV (2 studies; n = 5,477,291).
AHRQ-funded; 75Q80120D00006.
Citation: Chou R, Spencer H, Bougatsos C .
Preexposure prophylaxis for the prevention of HIV: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2023 Aug 22; 330(8):746-63. doi: 10.1001/jama.2023.9865..
Keywords: U.S. Preventive Services Task Force (USPSTF), Human Immunodeficiency Virus (HIV), Prevention, Medication, Evidence-Based Practice
Cabral SM, Harris AD, Cosgrove SE
Adherence to antimicrobial prophylaxis guidelines for elective surgeries across 825 US hospitals, 2019-2020.
This retrospective cohort study assessed adherence to surgical antimicrobial prophylaxis guidelines for elective surgeries across 825 US hospitals from 2019 to 2020. The authors looked at adults who underwent elective craniotomy, hip replacement, knee replacement, spinal procedure, or hernia repair in 2019-2020 at hospitals in the PINC AI (Premier) Healthcare Database. They evaluated adherence of prophylaxis regimes, with respect to antimicrobial agents endorsed in the American Society of Health-System Pharmacist guidelines, accounting for patient antibiotic allergy and methicillin-resistant Staphylococcus aureus colonization status. They found that across 825 hospitals and 521,091 inpatient elective surgeries, 59% were adherent to prophylaxis guidelines. The most common reason found for nonadherence was unnecessary vancomycin use. Patients receiving cefazolin plus vancomycin had 19% higher odds of acute kidney injury (AKI) compared with patients receiving cefazolin alone.
AHRQ-funded; HS028363.
Citation: Cabral SM, Harris AD, Cosgrove SE .
Adherence to antimicrobial prophylaxis guidelines for elective surgeries across 825 US hospitals, 2019-2020.
Clin Infect Dis 2023 Jun 16; 76(12):2106-15. doi: 10.1093/cid/ciad077..
Keywords: Antimicrobial Stewardship, Antibiotics, Medication, Guidelines, Evidence-Based Practice, Surgery
Smith SN, Lanham M, Seagull FJ
Implementing pharmacist-prescriber collaboration to improve evidence-based anticoagulant use: a randomized trial.
This article described a study designed to improve existing alert systems for direct oral anticoagulant medications (DOAC) by testing novel alerts that encourage collaboration between prescribers and expert pharmacists working in anticoagulation clinics. Its goals were to determine the effect of notifications targeting existing inappropriate DOAC prescriptions, to examine the effect of alerts on newly prescribed inappropriate DOACs, and to examine changes in the magnitude of effects over time for both the new and existing prescription alerts. Prescribing healthcare providers would be randomized to different types of electronic health record medication alerts when a patient has an unsafe anticoagulant prescription; the authors identified which alerts are most effective at encouraging evidence-based prescribing.
AHRQ-funded; HS028562.
Citation: Smith SN, Lanham M, Seagull FJ .
Implementing pharmacist-prescriber collaboration to improve evidence-based anticoagulant use: a randomized trial.
Implement Sci 2023 May 15; 18(1):16. doi: 10.1186/s13012-023-01273-4..
Keywords: Provider: Pharmacist, Blood Thinners, Medication, Evidence-Based Practice
Hansten PD, Tan MS, Horn JR
Colchicine drug interaction errors and misunderstandings: recommendations for improved evidence-based management.
Colchicine serves as an effective therapy for the management and prevention of gout and various other medical conditions. As a substrate for CYP3A4 and P-glycoprotein (P-gp), its simultaneous use with CYP3A4/P-gp inhibitors can lead to critical drug-drug interactions (DDIs) that may result in pancytopenia, multiorgan dysfunction, and cardiac irregularities. Additionally, colchicine's potential for myotoxicity could elevate the risk of myopathy and rhabdomyolysis when combined with other myotoxic medications. Numerous sources of DDI information, encompassing journal articles, product labels, and online resources, contain inaccuracies or vague statements regarding colchicine's interactions with other drugs and subpar guidance on managing DDIs to minimize patient harm. Moreover, assessments of the clinical significance of specific colchicine DDIs can differ substantially between sources. The purpose of this study was to present an evidence-based analysis of drugs that are likely to interact with colchicine, as well as those that have been cited to interact but are improbable to do so. Based on these assessments, the researchers proposes strategies to mitigate the risk of severe adverse consequences from colchicine DDIs. The frequent recommendation to decrease colchicine dosage when administered with CYP3A4/P-gp inhibitors may, in some cases, lead to colchicine toxicity or therapeutic failure. An exhaustive evaluation of nearly 100 documented instances of colchicine DDIs is provided in a table within the electronic supplementary material. While colchicine is a beneficial medication, enhancements to the available information on colchicine DDIs are necessary to reduce the risk of serious adverse events.
AHRQ-funded; HS025984
Citation: Hansten PD, Tan MS, Horn JR .
Colchicine drug interaction errors and misunderstandings: recommendations for improved evidence-based management.
Drug Saf 2023 Mar;46(3):223-42. doi: 10.1007/s40264-022-01265-1.
Keywords: Medication, Adverse Drug Events (ADE), Adverse Events, Medical Errors, Evidence-Based Practice
Shmuel S, Leonard CE, Bykov K
Breaking research silos and stimulating "innovation at the edges" in epidemiology.
The authors discuss the importance of promoting an exchange of ideas across seemingly disparate epidemiologic subdisciplines. This exchange could lead to opportunities to learn from and to merge knowledge across subdisciplines, as well as promote "innovation at the edges." The authors also outline specific steps to promote such innovation at the researcher, institution, and professional society level.
AHRQ-funded; HS027623.
Citation: Shmuel S, Leonard CE, Bykov K .
Breaking research silos and stimulating "innovation at the edges" in epidemiology.
Am J Epidemiol 2023 Feb 24;192(3):323-27. doi: 10.1093/aje/kwac192.
Keywords: Evidence-Based Practice, Research Methodologies, Medication
Djulbegovic B, Hozo I, Lizarraga D
Evaluation of a fast-and-frugal clinical decision algorithm ('pathways') on clinical outcomes in hospitalised patients with COVID-19 treated with anticoagulants.
The objective of this study was to assess if delivery of anticoagulant prophylaxis according to an algorithm improved clinical outcomes in patients hospitalized with COVID-19 in comparison with anticoagulant treatment given at individual practitioners' discretion. Findings indicated that the algorithm did not reduce death, venous thromboembolism, nor major bleeding, but helped avoid longer hospital stay and admission to an intensive-care unit.
AHRQ-funded; HS024917.
Citation: Djulbegovic B, Hozo I, Lizarraga D .
Evaluation of a fast-and-frugal clinical decision algorithm ('pathways') on clinical outcomes in hospitalised patients with COVID-19 treated with anticoagulants.
J Eval Clin Pract 2023 Feb; 29(1):3-12. doi: 10.1111/jep.13780..
Keywords: COVID-19, Clinical Decision Support (CDS), Blood Thinners, Medication, Evidence-Based Practice, Health Information Technology (HIT)
Treadwell JR, Kessler SK, Wu M
Pharmacologic and dietary treatments for epilepsies in children aged 1-36 months: a systematic review.
The purpose of this systematic review study was to assess the effectiveness and harms of pharmacologic and dietary treatments for epilepsy in children aged 1-36 months without infantile spasms. The researchers searched EMBASE, MEDLINE, PubMed, and the Cochrane Library for studies published from 1/1/1999 to 8/19/21 to identify studies reporting data on children aged 1-36 months receiving pharmacologic or dietary treatments for epilepsy. Twenty-three studies met the inclusion criteria. The study found that Levetiracetam leads to seizure freedom in some infants but the data on 6 other medications (lamotrigine, phenytoin, rufinamide, stiripentol, topiramate, and vigabatrin) were too limited to allow conclusions about their effectiveness. Three medications (lamotrigine, levetiracetam, and topiramate) were rarely discontinued due to adverse effects, and severe events were also rare. In the category of diets, the ketogenic diet lead to seizure freedom in some infants and both the ketogenic diet and modified Atkins diet reduced average seizure frequency.
AHRQ-funded; 75Q80120D00002.
Citation: Treadwell JR, Kessler SK, Wu M .
Pharmacologic and dietary treatments for epilepsies in children aged 1-36 months: a systematic review.
Neurology 2023 Jan 3;100(1):e16-e27. doi: 10.1212/wnl.0000000000201026..
Keywords: Children/Adolescents, Neurological Disorders, Newborns/Infants, Medication, Nutrition, Treatments, Evidence-Based Practice
Bangalore S, Ogedegbe G, Gyamfi J
Outcomes with angiotensin-converting enzyme inhibitors vs other antihypertensive agents in hypertensive blacks.
The study’s objective was to evaluate the effectiveness of angiotensin-converting enzyme inhibitors when compared with other antihypertensive agents in hypertensive blacks. It found that in a large cohort of hypertensive blacks, angiotensin-converting enzyme inhibitors were associated with less benefit when compared with calcium channel blockers or thiazide diuretics.
AHRQ-funded; HS018589.
Citation: Bangalore S, Ogedegbe G, Gyamfi J .
Outcomes with angiotensin-converting enzyme inhibitors vs other antihypertensive agents in hypertensive blacks.
Am J Med 2015 Nov;128(11):1195-203. doi: 10.1016/j.amjmed.2015.04.034..
Keywords: Blood Pressure, Racial and Ethnic Minorities, Medication, Outcomes, Cardiovascular Conditions, Patient-Centered Outcomes Research, Evidence-Based Practice, Comparative Effectiveness
Patnode CD, Henderson JT, Thompson JH
Behavioral counseling and pharmacotherapy interventions for tobacco cessation in adults, including pregnant women: a review of reviews for the U.S. Preventive Services Task Force.
The researchers reviewed the effectiveness and safety of pharmacotherapy and behavioral interventions for tobacco cessation. They concluded that behavioral and pharmacotherapy interventions improve rates of smoking cessation among the general adult population, alone or in combination. Data on the effectiveness and safety of electronic nicotine delivery systems are limited.
AHRQ-funded; 290201200015I.
Citation: Patnode CD, Henderson JT, Thompson JH .
Behavioral counseling and pharmacotherapy interventions for tobacco cessation in adults, including pregnant women: a review of reviews for the U.S. Preventive Services Task Force.
Ann Intern Med 2015 Oct 20;163(8):608-21. doi: 10.7326/m15-0171..
Keywords: Behavioral Health, Evidence-Based Practice, Medication, Pregnancy, Prevention, Tobacco Use, U.S. Preventive Services Task Force (USPSTF), Women
Desai NR, Sabatine MS
PCSK9 inhibition in patients with hypercholesterolemia.
The authors specified that large, cardiovascular outcomes trials are underway to assess definitively the efficacy and safety of 3 monoclonal antibodies (evolocumab, alirocumab, and bococizumab), while additional non-monoclonal antibody approaches to inhibit PCSK9 continue in the early-phase development.
AHRQ-funded; HS023000.
Citation: Desai NR, Sabatine MS .
PCSK9 inhibition in patients with hypercholesterolemia.
Trends Cardiovasc Med 2015 Oct;25(7):567-74. doi: 10.1016/j.tcm.2015.01.009.
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Keywords: Adverse Drug Events (ADE), Heart Disease and Health, Evidence-Based Practice, Medication, Patient-Centered Outcomes Research
Chou R, Hashimoto R, Friedly J
Epidural corticosteroid injections for radiculopathy and spinal stenosis: a systematic review and meta-analysis.
The researchers reviewed evidence on the benefits and harms of epidural corticosteroid injections in adults with radicular low back pain or spinal stenosis of any duration. They concluded that epidural corticosteroid injections for radiculopathy were associated with immediate reductions in pain and function. However, benefits were small and not sustained, and there was no effect on long-term surgery risk.
AHRQ-funded; 290201200014I.
Citation: Chou R, Hashimoto R, Friedly J .
Epidural corticosteroid injections for radiculopathy and spinal stenosis: a systematic review and meta-analysis.
Ann Intern Med 2015 Sep 1;163(5):373-81. doi: 10.7326/m15-0934.
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Keywords: Medication, Back Health and Pain, Chronic Conditions, Comparative Effectiveness, Evidence-Based Practice
Tjia J, Field T, Mazor K
Dissemination of evidence-based antipsychotic prescribing guidelines to nursing homes: a cluster randomized trial.
This study evaluated the effectiveness of efforts to translate and disseminate evidence-based guidelines about atypical antipsychotic use to nursing homes (NHs). It found that RE-AIM indicators suggest some success in disseminating the toolkit and differences in reach, adoption, and implementation according to dissemination strategy but no measurable effect on antipsychotic prescribing trends.
AHRQ-funded; HS019351.
Citation: Tjia J, Field T, Mazor K .
Dissemination of evidence-based antipsychotic prescribing guidelines to nursing homes: a cluster randomized trial.
J Am Geriatr Soc 2015 Jul;63(7):1289-98. doi: 10.1111/jgs.13488..
Keywords: Communication, Evidence-Based Practice, Guidelines, Long-Term Care, Medication, Nursing Homes, Practice Patterns, Tools & Toolkits, Implementation
Singh JA, Akhras KS, Shiozawa A
Comparative effectiveness of urate lowering with febuxostat versus allopurinol in gout: analyses from large U.S. managed care cohort.
The researchers sought to assess the comparative effectiveness of febuxostat and allopurinol in reducing serum urate (sUA) levels in a real-world U.S. managed care setting. It concluded that febuxostat was more effective than allopurinol at the currently used doses in lowering sUA in gout patients as demonstrated by post-index mean sUA level, the likelihood of and the time to achieving sUA goals.
AHRQ-funded; HS021110.
Citation: Singh JA, Akhras KS, Shiozawa A .
Comparative effectiveness of urate lowering with febuxostat versus allopurinol in gout: analyses from large U.S. managed care cohort.
Arthritis Res Ther 2015 May 12;17(1):120. doi: 10.1186/s13075-015-0624-3..
Keywords: Comparative Effectiveness, Patient-Centered Outcomes Research, Evidence-Based Practice, Medication, Treatments
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
Viswanathan M, Kahwati LC, Golin CE
Medication therapy management interventions in outpatient settings: a systematic review and meta-analysis.
Medication therapy management (MTM) services (also called clinical pharmacy services) aim to reduce medication-related problems and their downstream outcomes. The purpose of this study was to assess the effect of MTM interventions among outpatients with chronic illnesses. The investigators graded the evidence as insufficient for most outcomes because of inconsistency and imprecision that stemmed in part from underlying heterogeneity in populations and interventions.
AHRQ-funded; 290201200008I.
Citation: Viswanathan M, Kahwati LC, Golin CE .
Medication therapy management interventions in outpatient settings: a systematic review and meta-analysis.
JAMA Intern Med 2015 Jan;175(1):76-87. doi: 10.1001/jamainternmed.2014.5841..
Keywords: Medication, Ambulatory Care and Surgery, Chronic Conditions, Evidence-Based Practice, Patient-Centered Outcomes Research, Provider: Pharmacist, Provider