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 205 Research Studies DisplayedAmick HR, Gartlehner G, Gaynes BN
Comparative benefits and harms of second generation antidepressants and cognitive behavioral therapies in initial treatment of major depressive disorder: systematic review and meta-analysis.
This systematic review sought to identify the benefits and harms of second generation antidepressants and cognitive behavioral therapies (CBTs) in the initial treatment of a current episode of major depressive disorder in adults. It concluded that the available evidence suggests no difference in treatment effects of second generation antidepressants and CBT, either alone or in combination, although small numbers may preclude detection of small but clinically meaningful differences.
AHRQ-funded; 290-2012-00008I
Citation: Amick HR, Gartlehner G, Gaynes BN .
Comparative benefits and harms of second generation antidepressants and cognitive behavioral therapies in initial treatment of major depressive disorder: systematic review and meta-analysis.
BMJ 2015 Dec 8;351:h6019. doi: 10.1136/bmj.h6019..
Keywords: Medication, Behavioral Health, Comparative Effectiveness, Depression
McCoy RG, Van Houten HK, Ross JS
HbA1c overtesting and overtreatment among US adults with controlled type 2 diabetes, 2001-13: observational population based study.
The researchers sought to determine the extent and effect of excessive testing for glycated hemoglobin (HbA1c) among adults with controlled type 2 diabetes. They found that in a US cohort of adults with stable and controlled type 2 diabetes, more than 60% received too many HbA1c tests, a practice associated with potential overtreatment with hypoglycemic drugs.
AHRQ-funded; HS018339.
Citation: McCoy RG, Van Houten HK, Ross JS .
HbA1c overtesting and overtreatment among US adults with controlled type 2 diabetes, 2001-13: observational population based study.
BMJ 2015 Dec 8;351:h6138. doi: 10.1136/bmj.h6138..
Keywords: Chronic Conditions, Diabetes, Healthcare Utilization, Medication, Patient-Centered Outcomes Research
Stockmann C, Ampofo K, Pavia AT
Comparative effectiveness of oral versus outpatient parenteral antibiotic therapy for empyema.
This study compared outcomes between oral therapy and (outpatient parenteral antibiotic therapy (OPAT) for pediatric parapneumonic empyema (PPE) . The frequency of complications was similar with oral therapy and OPAT for children with PPE. Oral antibiotics may be considered safe and effective for children with PPE who will be discharged to complete therapy in the outpatient setting.
AHRQ-funded; HS023320.
Citation: Stockmann C, Ampofo K, Pavia AT .
Comparative effectiveness of oral versus outpatient parenteral antibiotic therapy for empyema.
Hosp Pediatr 2015 Dec;5(12):605-12. doi: 10.1542/hpeds.2015-0100.
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Keywords: Comparative Effectiveness, Patient-Centered Outcomes Research, Medication, Hospitalization, Children/Adolescents
Johnson SL, Palta M, Bartels CM
Examining systemic steroid use in older inflammatory bowel disease patients using hurdle models: a cohort study.
In order to evaluate the relationship between patient characteristics and the frequency and duration of incident steroid use, the researchers applied a 2-part hurdle model to Medicare data. Their study identified differences in predictors of frequency and duration of medication use and suggests the utility of two-part models to examine drug utilization patterns.
AHRQ-funded; HS022786.
Citation: Johnson SL, Palta M, Bartels CM .
Examining systemic steroid use in older inflammatory bowel disease patients using hurdle models: a cohort study.
BMC Pharmacol Toxicol 2015 Dec 8;16:34. doi: 10.1186/s40360-015-0034-9..
Keywords: Elderly, Medicare, Medication
Ahuja V, Sohn MW, Birge JR
Geographic variation in rosiglitazone use surrounding FDA warnings in the Department of Veterans Affairs.
The purpose of this study was to document variation in the use of rosiglitazone and other glucose- lowering drugs across 21 Veterans Integrated Service Networks. It found that aggregate rosiglitazone use increased monotonically from 7.7 percent, in the quarter it was added to the VA formulary, to a peak of 15.3 percent in the quarter when the FDA issued the safety alert.
AHRQ-funded; HS018542.
Citation: Ahuja V, Sohn MW, Birge JR .
Geographic variation in rosiglitazone use surrounding FDA warnings in the Department of Veterans Affairs.
J Manag Care Spec Pharm 2015 Dec;21(12):1214-34. doi: 10.18553/jmcp.2015.21.12.1214.
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Keywords: Adverse Drug Events (ADE), Medication: Safety, Medication, Practice Patterns
Eaton EF, Kulczycki A, Saag M
Immunization costs and programmatic barriers at an urban HIV clinic.
This study estimated costs of providing Gardasil, Prevnar, and Zostavax to eligible patients at a US Ryan White Part C academically affiliated HIV clinic in 2013. Its cost analysis of 3 vaccines showed great variation in insurance coverage, with potential losses of almost $100 000 for one HIV clinic if eligible patients received vaccinations in one calendar year.
AHRQ-funded; HS013852.
Citation: Eaton EF, Kulczycki A, Saag M .
Immunization costs and programmatic barriers at an urban HIV clinic.
Clin Infect Dis 2015 Dec;61(11):1726-31. doi: 10.1093/cid/civ637.
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Keywords: Human Immunodeficiency Virus (HIV), Healthcare Costs, Medication, Vaccination
Darger B, Gonzales N, Banuelos RC
Outcomes of patients requiring blood pressure control before thrombolysis with tPA for acute ischemic stroke.
The purpose of this study was to assess safety and efficacy of thrombolysis in the setting of aggressive blood pressure (BP) control as it compares to standard BP control or no BP control prior to thrombolysis. The researchers observed no association between BP control and adverse outcomes in ischemic stroke patients undergoing thrombolysis.
AHRQ-funded; HS017586.
Citation: Darger B, Gonzales N, Banuelos RC .
Outcomes of patients requiring blood pressure control before thrombolysis with tPA for acute ischemic stroke.
West J Emerg Med 2015 Dec;16(7):1002-6. doi: 10.5811/westjem.2015.8.27859.
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Keywords: Blood Pressure, Stroke, Medication, Outcomes
Du XL, Parikh RC, Lairson DR
Racial and geographic disparities in the patterns of care and costs at the end of life for patients with lung cancer in 2007-2010 after the 2006 introduction of bevacizumab.
The authors examined racial/ethnic and geographical disparities in cancer care and costs during the last 6 months of life for lung cancer decedents after the FDA's approval of bevacizumab. They found that there were substantial racial/ethnic and geographic disparities in the types of cancer care and costs in the last 6 months of life among lung cancer decedents, regardless of the length of survival times and hospice care status.
AHRQ-funded; HS018956.
Citation: Du XL, Parikh RC, Lairson DR .
Racial and geographic disparities in the patterns of care and costs at the end of life for patients with lung cancer in 2007-2010 after the 2006 introduction of bevacizumab.
Lung Cancer 2015 Dec;90(3):442-50. doi: 10.1016/j.lungcan.2015.09.017.
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Keywords: Cancer, Cancer: Lung Cancer, Disparities, Healthcare Costs, Medication, Palliative Care, Patient-Centered Outcomes Research, Practice Patterns, Racial and Ethnic Minorities
Lo Re V, 3rd, Haynes K, Forde KA
Risk of acute liver failure in patients with drug-induced liver injury: evaluation of Hy's Law and a new prognostic model.
The researchers aimed to develop a highly sensitive model to identify drug-induced liver injury (DILI) patients at increased risk of acute liver failure (ALF). negative predictive value (0.99), but low level of sensitivity (0.68) and positive predictive value (0.02). Their model, comprising data on platelet count and total bilirubin level, identified patients with ALF with a C statistic of 0.87 and enabled calculation of a risk score (Drug-Induced Liver Toxicity ALF Score).
AHRQ-funded; HS018372.
Citation: Lo Re V, 3rd, Haynes K, Forde KA .
Risk of acute liver failure in patients with drug-induced liver injury: evaluation of Hy's Law and a new prognostic model.
Clin Gastroenterol Hepatol 2015 Dec;13(13):2360-8. doi: 10.1016/j.cgh.2015.06.020.
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Keywords: Antimicrobial Stewardship, Medication, Chronic Conditions, Adverse Drug Events (ADE), Clinical Decision Support (CDS)
Bali V, Chatterjee S, Carnahan RM
Risk of dementia among elderly nursing home patients using paroxetine and other selective serotonin reuptake inhibitors.
This study evaluated the comparative risk of dementia associated with use of paroxetine and other selective serotonin reuptake inhibitors (SSRIs) among elderly nursing home patients. It found that compared with use of other SSRIs, use of paroxetine was not associated with higher risk of dementia among elderly nursing home patients with depression.
AHRQ-funded; HS021264.
Citation: Bali V, Chatterjee S, Carnahan RM .
Risk of dementia among elderly nursing home patients using paroxetine and other selective serotonin reuptake inhibitors.
Psychiatr Serv 2015 Dec;66(12):1333-40. doi: 10.1176/appi.ps.201500011.
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Keywords: Adverse Drug Events (ADE), Dementia, Elderly, Nursing Homes, Medication
Slagle JM, Anders S, Porterfield E
Significant physiological disturbances associated with non-routine event containing and routine anesthesia cases.
The researchers sought to compare anesthesia providers' reporting of non-routine events (NREs) with the incidence of significant physiological disturbances (SPDs) detected via retrospective videotape review. They concluded that SPDs occur more often in NRE-containing cases. The incidence of approximately one NRE-independent SPD per case was similar in NRE-containing and routine case.
AHRQ-funded; HS011375.
Citation: Slagle JM, Anders S, Porterfield E .
Significant physiological disturbances associated with non-routine event containing and routine anesthesia cases.
J Patient Saf 2015 Dec;11(4):198-203. doi: 10.1097/pts.0000000000000081.
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Keywords: Patient Safety, Adverse Events, Adverse Drug Events (ADE), Medication
Strope SA, Vetter J, Elliott S
Use of medical therapy and success of laser surgery and transurethral resection of the prostate for benign prostatic hyperplasia.
To assess the impact of surgery for benign prostatic hyperplasia (BPH) on use of medication (5-alpha reductase inhibitors, alpha blockers, antispasmodics), the researchers assessed preoperative and postoperative medication utilization among surgically treated men. They found that most patients experience durable improvement after surgical intervention for BPH. However, their results show a need for effective patient counseling about continued or new use of medical therapy after laser and TURP procedures.
AHRQ-funded; HS019455.
Citation: Strope SA, Vetter J, Elliott S .
Use of medical therapy and success of laser surgery and transurethral resection of the prostate for benign prostatic hyperplasia.
Urology 2015 Dec;86(6):1115-22. doi: 10.1016/j.urology.2015.07.019..
Keywords: Surgery, Medication, Patient-Centered Outcomes Research, Men's Health
Miligkos M, Bannuru RR, Alkofide H
Leukotriene-receptor antagonists versus placebo in the treatment of asthma in adults and adolescents: a systematic review and meta-analysis.
The purpose of this study was to determine the benefits and harms of leukotriene-receptor antagonists (LTRAs) as monotherapy or in combination with inhaled corticosteroids compared with placebo in adults and adolescents with asthma. It found that leukotriene-receptor antagonists as monotherapy improved asthma control compared with placebo, but which patients are most likely to respond to treatment with LTRAs remains unclear.
AHRQ-funded; HS021396.
Citation: Miligkos M, Bannuru RR, Alkofide H .
Leukotriene-receptor antagonists versus placebo in the treatment of asthma in adults and adolescents: a systematic review and meta-analysis.
Ann Intern Med 2015 Nov 17;163(10):756-67. doi: 10.7326/m15-1059.
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Keywords: Asthma, Children/Adolescents, Medication, Comparative Effectiveness
Curtis JR, Sarsour K, Napalkov P
Incidence and complications of interstitial lung disease in users of tocilizumab, rituximab, abatacept and anti-tumor necrosis factor alpha agents, a retrospective cohort study.
Interstitial lung disease (ILD) is a common extra-articular condition in rheumatoid arthritis (RA), but few studies have systematically investigated its incidence and risk factors in patients receiving anti-tumor necrosis factor-alpha (anti-TNFα) agents or alternate mechanisms of action (MOAs). After examining 13,795 episodes of biologic exposure in 11,219 patients, researchers found no significant differences in the risk of ILD and its related complications between RA patients receiving anti-TNFα agents and those receiving alternate MOA agents.
AHRQ-funded; HS018517.
Citation: Curtis JR, Sarsour K, Napalkov P .
Incidence and complications of interstitial lung disease in users of tocilizumab, rituximab, abatacept and anti-tumor necrosis factor alpha agents, a retrospective cohort study.
Arthritis Res Ther 2015 Nov 11;17:319. doi: 10.1186/s13075-015-0835-7..
Keywords: Arthritis, Comparative Effectiveness, Medication, Respiratory Conditions, Risk
Zhang R, Manohar N, Arsoniadis E
Evaluating term coverage of herbal and dietary supplements in electronic health records.
Some supplements can interact with prescription medications, potentially leading to clinically important and potentially preventable adverse reactions. Clinical notes and corresponding medication lists from an integrated healthcare system were extracted and compared with online databases. The authors found that, overall, about 40% of listed medications are supplements, most of which are included in medication lists as nutritional or miscellaneous products. They found gaps between supplement and standard medication terminologies and identified supplements which were not mentioned in the medication lists.
AHRQ-funded; HS022085.
Citation: Zhang R, Manohar N, Arsoniadis E .
Evaluating term coverage of herbal and dietary supplements in electronic health records.
AMIA Annu Symp Proc 2015 Nov 5;2015:1361-70.
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Keywords: Adverse Drug Events (ADE), Data, Electronic Health Records (EHRs), Medication, Vitamins and Supplements
Cutting EM, Overby CL, Banchero M
Using workflow modeling to identify areas to improve genetic test processes in the University of Maryland Translational Pharmacogenomics Project.
The researchers used information gained from focus groups in order to illustrate the current process of delivering genetic test results to clinicians. They proposed a business process model and notation (BPMN) representation of this process for a Translational Pharmacogenomics Project being implemented at the University of Maryland Medical Center. They found that the current process could be improved to reduce input errors, better inform and notify clinicians about the implications of certain genetic tests, and make results more easily understood. They demonstrated theiruse of BPMN to improve this important clinical process for CYP2C19 genetic testing.
AHRQ-funded; HS023390.
Citation: Cutting EM, Overby CL, Banchero M .
Using workflow modeling to identify areas to improve genetic test processes in the University of Maryland Translational Pharmacogenomics Project.
AMIA Annu Symp Proc 2015 Nov 5;2015:466-74.
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Keywords: Genetics, Diagnostic Safety and Quality, Medication, Workflow, Quality Improvement, Quality of Care, Organizational Change
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
Goyal A, de Lemos JA, Peng SA
Association of patient enrollment in Medicare Part D with outcomes after acute myocardial infarction.
The researchers investigated whether enrollment versus nonenrollment in Medicare's prescription drug plan (Part D) is associated with better outcomes after acute myocardial infarction (AMI). They found that only half of Medicare-insured patients with AMI were enrolled in Part D by hospital discharge, and their 30-day and 1-year adjusted outcomes did not differ substantially from nonenrollees.
AHRQ-funded; HS021092.
Citation: Goyal A, de Lemos JA, Peng SA .
Association of patient enrollment in Medicare Part D with outcomes after acute myocardial infarction.
Circ Cardiovasc Qual Outcomes 2015 Nov;8(6):567-75. doi: 10.1161/circoutcomes.115.001650.
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Keywords: Heart Disease and Health, Medicare, Patient-Centered Outcomes Research, Medication, Patient Adherence/Compliance
Turner JA, Comstock BA, Standaert CJ
Can patient characteristics predict benefit from epidural corticosteroid injections for lumbar spinal stenosis symptoms?
The study’s aim was to identify patient characteristics associated with benefits from epidural injections of corticosteroid with lidocaine versus epidural injections of lidocaine only for lumbar spinal stenosis symptoms. It found that among 21 baseline patient characteristics examined, none, including clinician rated spinal stenosis severity, were consistent predictors of benefit from epidural injections of lidocain corticosteroid versus lidocaine only.
AHRQ-funded; HS019222; HS022972.
Citation: Turner JA, Comstock BA, Standaert CJ .
Can patient characteristics predict benefit from epidural corticosteroid injections for lumbar spinal stenosis symptoms?
Spine J 2015 Nov;15(11):2319-31. doi: 10.1016/j.spinee.2015.06.050..
Keywords: Patient-Centered Outcomes Research, Decision Making, Medication, Back Health and Pain, Chronic Conditions
Stuart BC, Davidoff AJ, Erten MZ
AHRQ Author: Davidoff AJ
Changes in medication management after a diagnosis of cancer among Medicare beneficiaries with diabetes.
The researchers sought to determine whether a new cancer diagnosis is associated with changes in medication adherence among Medicare beneficiaries with diabetes. They concluded that cancer diagnosis among patients with diabetes reduced adherence with evidence-based medications, particularly if patients’ life expectancy was short.
Citation: Stuart BC, Davidoff AJ, Erten MZ .
Changes in medication management after a diagnosis of cancer among Medicare beneficiaries with diabetes.
J Oncol Pract 2015 Nov;11(6):429-34. doi: 10.1200/jop.2014.003046..
Keywords: Medication, Medicare, Cancer, Diabetes, Patient Adherence/Compliance
Stevens AD, Hernandez C, Jones S
Color-coded prefilled medication syringes decrease time to delivery and dosing errors in simulated prehospital pediatric resuscitations: a randomized crossover trial.
The study’s goal was to evaluate novel, prefilled medication syringes labeled with color-coded volumes corresponding to the weight-based dosing of the Broselow Tape, compared to conventional medication administration, in simulated prehospital pediatric resuscitation scenarios. It found that the novel syringes decreased time to medication administration and significantly reduced critical dosing errors by paramedics during simulated prehospital pediatric resuscitations.
AHRQ-funded; HS017526.
Citation: Stevens AD, Hernandez C, Jones S .
Color-coded prefilled medication syringes decrease time to delivery and dosing errors in simulated prehospital pediatric resuscitations: a randomized crossover trial.
Resuscitation 2015 Nov;96:85-91. doi: 10.1016/j.resuscitation.2015.07.035..
Keywords: Medication, Emergency Medical Services (EMS), Children/Adolescents, Medical Errors, Comparative Effectiveness
Gagne JJ, Kesselheim AS, Choudhry NK
Comparative effectiveness of generic versus brand-name antiepileptic medications.
The objective of this study was to compare treatment persistence and rates of seizure-related events in patients who initiate antiepileptic drug (AED) therapy with a generic versus a brand-name product. It concluded that patients who initiated generic AEDs had fewer adverse seizure-related clinical outcomes and longer continuous treatment periods before experiencing a gap than those who initiated brand-name versions.
AHRQ-funded; HS018465.
Citation: Gagne JJ, Kesselheim AS, Choudhry NK .
Comparative effectiveness of generic versus brand-name antiepileptic medications.
Epilepsy Behav 2015 Nov;52(Pt A):14-8. doi: 10.1016/j.yebeh.2015.08.014.
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Keywords: Adverse Drug Events (ADE), Adverse Events, Comparative Effectiveness, Medication, Medication: Safety, Neurological Disorders, Patient Safety
Poonawalla IB, Parikh RC, Du XL
Cost effectiveness of chemotherapeutic agents and targeted biologics in ovarian cancer: a systematic review.
The authors evaluated the cost-effectiveness of various chemotherapeutic and targeted therapy alternatives for ovarian cancer. They found that standard platinum-taxane combination chemotherapy for first-line treatment was most cost-effective.
AHRQ-funded; HS018956.
Citation: Poonawalla IB, Parikh RC, Du XL .
Cost effectiveness of chemotherapeutic agents and targeted biologics in ovarian cancer: a systematic review.
Pharmacoeconomics 2015 Nov;33(11):1155-85. doi: 10.1007/s40273-015-0304-9.
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Keywords: Treatments, Healthcare Costs, Medication, Cancer: Ovarian Cancer
Miller GE, Sarpong EM, Hill SC
AHRQ Author: Miller GE, Sarpong EM, Hill SC
Does increased adherence to medications change health care financial burdens for adults with diabetes?
The aim of the present study was to investigate increased out-of-pocket drug costs and financial burdens of achieving adherence to oral antidiabetic medications and medications for prevalent comorbidities. The researchers found that the mean simulated additional out-of-pocket drug costs of achieving adherence were $310 for uninsured adults treated for diabetes. These additional drug costs would increase the percentage of uninsured adults with financial burden.
AHRQ-authored.
Citation: Miller GE, Sarpong EM, Hill SC .
Does increased adherence to medications change health care financial burdens for adults with diabetes?
J Diabetes 2015 Nov;7(6):872-80. doi: 10.1111/1753-0407.12292..
Keywords: Medical Expenditure Panel Survey (MEPS), Healthcare Costs, Diabetes, Patient Adherence/Compliance, Medication
Liu H, Mattke S, Predmore ZS
Medicare coverage of anesthesia services during screening colonoscopies for patients at low risk of sedation-related complications.
The authors examined the costs and potential benefit of the Medicare rule change that waived patient cost sharing for anesthesia services during screening colonoscopies. Their results cast doubt on the value associated with Medicare coverage of anesthesia services during screening colonoscopies for patients at low risk of sedation-related complications. They recommended that payers create payment bundles for endoscopy procedures that include anesthesia services in a fixed fee.
AHRQ-funded; HS000029.
Citation: Liu H, Mattke S, Predmore ZS .
Medicare coverage of anesthesia services during screening colonoscopies for patients at low risk of sedation-related complications.
JAMA Intern Med 2015 Nov;175(11):1848-50. doi: 10.1001/jamainternmed.2015.4585.
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Keywords: Adverse Drug Events (ADE), Cancer: Colorectal Cancer, Colonoscopy, Medicare, Medication