National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- (-) Adverse Drug Events (ADE) (42)
- Adverse Events (41)
- Antibiotics (7)
- Antimicrobial Stewardship (3)
- Behavioral Health (3)
- Blood Clots (1)
- Blood Thinners (7)
- Brain Injury (1)
- Cardiovascular Conditions (2)
- Case Study (1)
- Children/Adolescents (7)
- Chronic Conditions (2)
- Clinician-Patient Communication (1)
- Colonoscopy (1)
- Communication (1)
- Comparative Effectiveness (1)
- COVID-19 (1)
- Critical Care (3)
- Dementia (1)
- Dental and Oral Health (1)
- Depression (2)
- Diagnostic Safety and Quality (2)
- Digestive Disease and Health (2)
- Elderly (5)
- Electronic Health Records (EHRs) (2)
- Emergency Department (2)
- Evidence-Based Practice (4)
- Genetics (1)
- Guidelines (3)
- Health Information Technology (HIT) (2)
- Health Literacy (1)
- Hospital Discharge (1)
- Hospitalization (2)
- Implementation (1)
- Injuries and Wounds (1)
- Intensive Care Unit (ICU) (3)
- Kidney Disease and Health (3)
- Labor and Delivery (1)
- Long-Term Care (1)
- Medicaid (2)
- Medical Errors (7)
- Medication (38)
- Medication: Safety (24)
- Neurological Disorders (3)
- Newborns/Infants (1)
- Nursing Homes (1)
- Opioids (3)
- Outcomes (4)
- Patient-Centered Outcomes Research (5)
- Patient Safety (24)
- Policy (1)
- Practice Patterns (1)
- Pregnancy (1)
- Prevention (2)
- Provider (1)
- Provider: Physician (1)
- Provider Performance (1)
- Public Health (1)
- Quality of Care (1)
- Registries (1)
- Respiratory Conditions (1)
- Risk (6)
- Screening (1)
- Sepsis (1)
- Shared Decision Making (1)
- Substance Abuse (1)
- Surgery (6)
- Treatments (3)
- Women (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 25 of 42 Research Studies DisplayedLoi MV, Lee JH, Huh JW
Ketamine use in the intubation of critically ill children with neurological indications: a multicenter retrospective analysis.
This study examined use of ketamine in children undergoing tubal intubation (TI) for a primary neurological indication. The authors conducted a retrospective observational cohort study of critically ill children undergoing TI for neurological indications in 53 international pediatric intensive care units and emergency departments. They screened all intubations from 2014 to 2020 entered into the multicenter National Emergency Airway Registry for Children (NEAR4KIDS) registry database. Of 21,562 TIs, 2,073 were performed for a primary neurological indication, including 190 for traumatic brain injury/trauma. Patients received ketamine in 495 TIs (23.9%), which increased from 10% in 2014 to 41% in 2020. Criteria for ketamine use includes a coindication of respiratory failure, difficult airway history, and use of vagolytic agents, apneic oxygenation, and video laryngoscopy. Composite adverse outcomes were reported in 289 (13.9%) TIs and were more common in the ketamine group (17.0% vs. 13.0%). After adjusting for location, patient age and co-diagnoses, the presence of respiratory failure and shock, difficult airway history, provider demographics, intubating device, and the use of apneic oxygenation, vagolytic agents, and neuromuscular blockade, ketamine use was not significantly associated with increased composite adverse outcomes. This paucity of association remained even when only neurotrauma intubations were considered (10.6% vs. 7.7%).
AHRQ-funded; HS022464, HS024511.
Citation: Loi MV, Lee JH, Huh JW .
Ketamine use in the intubation of critically ill children with neurological indications: a multicenter retrospective analysis.
Neurocrit Care 2024 Feb; 40(1):205-14. doi: 10.1007/s12028-023-01734-0.
Keywords: Children/Adolescents, Critical Care, Adverse Drug Events (ADE), Adverse Events, Patient Safety
Ramanathan S, Evans CT, Hershow RC
Guideline concordance and antibiotic-associated adverse events between Veterans administration and non-Veterans administration dental settings: a retrospective cohort study.
The study aimed to evaluate antibiotic prophylaxis adherence and associated adverse drug events (ADEs) in dental settings. A retrospective cohort study of adults with cardiac conditions or prosthetic joints from 2015 to 2017 was conducted. Of 61,124 patients receiving antibiotic prophylaxis, 62 (0.1%) experienced ADEs. Guideline concordance was not linked to ADEs (adjusted OR: 0.78, 95% CI: 0.25-2.46), and this was consistent across different dental settings.
AHRQ-funded; HS025177.
Citation: Ramanathan S, Evans CT, Hershow RC .
Guideline concordance and antibiotic-associated adverse events between Veterans administration and non-Veterans administration dental settings: a retrospective cohort study.
Front Pharmacol 2024 Jan 16; 15:1249531. doi: 10.3389/fphar.2024.1249531.
Keywords: Antibiotics, Medication, Adverse Drug Events (ADE), Guidelines, Dental and Oral Health, Practice Patterns
Carroll AR, Johnson JA, Stassun JC
Health literacy-informed communication to reduce discharge medication errors in hospitalized children: a randomized clinical trial.
This study’s objective was to test a health literacy-informed communication intervention to decrease liquid medication dosing errors compared with standard counseling in hospitalized children. This parallel, randomized clinical trial was conducted from June 22, 2021, to August 20, 2022, at a tertiary care, US children's hospital. English- and Spanish-speaking caregivers of hospitalized children 6 years or younger prescribed a new, scheduled liquid medication at discharge were included in the analysis. Observed dosing errors were the main outcome measured, and secondary outcomes included caregiver-reported medication knowledge. Among 198 randomized caregivers (mean age 31.4 years; 186 women [93.9%]; 36 [18.2%] Hispanic or Latino and 158 [79.8%] White), the primary outcome was available for 151 (76.3%). The observed mean (SD) percentage dosing error was 1.0% (2.2 percentage points) among the intervention group and 3.3% (5.1 percentage points) among the standard counseling group (absolute difference, 2.3 percentage points). Twenty-four of 79 caregivers in the intervention group (30.4%) measured an incorrect dose compared with 39 of 72 (54.2%) in the standard counseling group. The intervention enhanced caregiver-reported medication knowledge compared with the standard counseling group for medication dose (71 of 76 [93.4%] vs 55 of 69 [79.7%]), duration of administration (65 of 76 [85.5%] vs 49 of 69 [71.0%], and correct reporting of 2 or more medication adverse effects (60 of 76 [78.9%] vs 13 of 69 [18.8%]).
AHRQ-funded; HS026122.
Citation: Carroll AR, Johnson JA, Stassun JC .
Health literacy-informed communication to reduce discharge medication errors in hospitalized children: a randomized clinical trial.
JAMA Netw Open 2024 Jan 2; 7(1):e2350969. doi: 10.1001/jamanetworkopen.2023.50969..
Keywords: Children/Adolescents, Health Literacy, Communication, Medication, Adverse Drug Events (ADE), Adverse Events, Medical Errors, Clinician-Patient Communication, Hospital Discharge, Medication: Safety
Cohen TN, Berdahl CT, Coleman BL
Medication safety event reporting: Factors that contribute to safety events during times of organizational stress.
This study’s objective was to understand the insights conveyed in hospital incident reports about how work system factors affected medication safety during a coronavirus disease-2019 (COVID-19) surge. The authors randomly selected 100 medication safety incident reports from an academic medical center (December 2020 to January 2021), identified near misses and errors, and classified contributing work system factors using the Human Factors Analysis and Classification System-Healthcare. Results showed that among 35 near misses/errors, incident reports described contributing factors (mean 1.3/report) involving skill-based errors (n = 20), communication (n = 8), and tools/technology (n = 4). Seven of these events were linked to COVID-19.
AHRQ-funded; HS027455.
Citation: Cohen TN, Berdahl CT, Coleman BL .
Medication safety event reporting: Factors that contribute to safety events during times of organizational stress.
J Nurs Care Qual 2024 Jan-Mar; 39(1):51-57. doi: 10.1097/ncq.0000000000000720..
Keywords: Medication: Safety, Medication, Patient Safety, COVID-19, Adverse Drug Events (ADE), Adverse Events, Medical Errors
Kyler KE, Hall M, Antoon JW
Major drug-drug interaction exposure among Medicaid-insured children in the outpatient setting.
This study’s objective was to determine the prevalence of major drug-drug interactions (DDI) exposure and factors associated with higher DDI exposure rates among children in an outpatient setting. The authors performed a cross-sectional study of children aged 0 to 18 years with ≥1 ambulatory encounter, and ≥2 dispensed outpatient prescriptions using the 2019 Marketscan Medicaid database. Primary outcomes were the prevalence and rate of major DDI exposure. Out of 781,019 children with ≥2 medication exposures, 21.4% experienced ≥1 major DDI exposure. The odds of exposure increased with age and with medical and mental health complexity. Frequently mentioned drugs included Clonidine, psychiatric medications, and asthma medications. The highest adverse physiologic effect exposure rate per 100 children included: increased drug concentrations (14.6), central nervous system depression (13.6), and heart rate-corrected QT interval prolongation (9.9).
AHRQ-funded; HS028979.
Citation: Kyler KE, Hall M, Antoon JW .
Major drug-drug interaction exposure among Medicaid-insured children in the outpatient setting.
Pediatrics 2024 Jan; 153(2):e2023063506. doi: 10.1542/peds.2023-063506.
Keywords: Children/Adolescents, Adverse Drug Events (ADE), Adverse Events, Medicaid, Medication: Safety
Barnes GD
Combining antiplatelet and anticoagulant therapy in cardiovascular disease.
The author describes results of a number of randomized clinical trials that have explored different combinations of anticoagulation plus antiplatelet agents aimed at minimizing bleeding risk while preserving low thrombotic event rates. Findings include shorter courses with fewer antithrombotic agents as being effective, particularly when direct oral anticoagulants are combined with clopidogrel. Combined use of very low-dose rivaroxaban plus aspirin also demonstrated benefit in atherosclerotic diseases, including coronary and peripheral artery disease. Use of proton pump inhibitor therapy while patients were taking multiple antithrombotic agents had the potential to further reduce upper gastrointestinal bleeding risk in select populations. The author recommends that applying this evidence to patients with multiple thrombotic conditions will help to avoid costly and life-threatening adverse medication events.
AHRQ-funded; HS026874; HS026322.
Citation: Barnes GD .
Combining antiplatelet and anticoagulant therapy in cardiovascular disease.
Hematology Am Soc Hematol Educ Program 2020 Dec 4;2020(1):642-48. doi: 10.1182/hematology.2020000151..
Keywords: Blood Thinners, Medication, Medication: Safety, Adverse Drug Events (ADE), Adverse Events, Patient Safety, Cardiovascular Conditions
Daniel VT, Francalancia S, Amir NS
Upper gastrointestinal perforations: a possible danger of antibiotic overuse.
Investigators conducted a retrospective case-control study to examine the relationship between antibiotic exposure and upper gastrointestinal (UGI) perforations in a national sample. A 5% random sample of Medicare were queried to identify patients at least 65 years old who were hospitalized with stomach or small intestine UGI perforations using International Classification of Diseases diagnosis codes; Cases with UGI perforations were matched with 4 controls based on age and sex. The investigators concluded that recent outpatient antibiotic use, in particular in the preceding 30 days, is associated with UGI perforation among Medicare beneficiaries. They recommended minimizing exposure to antibiotics in the outpatient setting.
AHRQ-funded; HS022694.
Citation: Daniel VT, Francalancia S, Amir NS .
Upper gastrointestinal perforations: a possible danger of antibiotic overuse.
J Gastrointest Surg 2020 Dec;24(12):2730-36. doi: 10.1007/s11605-019-04473-w..
Keywords: Digestive Disease and Health, Antimicrobial Stewardship, Antibiotics, Medication, Adverse Drug Events (ADE), Adverse Events
Salmasian H, Blanchfield BB, Joyce K
Association of display of patient photographs in the electronic health record with wrong-patient order entry errors.
Wrong-patient order entry (WPOE) errors have a high potential for harm; these errors are particularly frequent wherever workflows are complex and multitasking and interruptions are common, such as in the emergency department (ED). The purpose of this study was to evaluate whether the use of noninterruptive display of patient photographs in the banner of the electronic health record (EHR) is associated with a decreased rate of WPOE errors.
AHRQ-funded; HS024713.
Citation: Salmasian H, Blanchfield BB, Joyce K .
Association of display of patient photographs in the electronic health record with wrong-patient order entry errors.
AMA Netw Open 2020 Nov 2;3(11):e2019652. doi: 10.1001/jamanetworkopen.2020.19652..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Medical Errors, Adverse Drug Events (ADE), Adverse Events, Medication, Medication: Safety, Patient Safety, Diagnostic Safety and Quality
Mohr NM, Pape SG, Runde D
Etomidate use is associated with less hypotension than ketamine for emergency department sepsis intubations: a NEAR cohort study.
The objectives of this study were to describe the current use of etomidate and other induction agents in patients with sepsis and to compare adverse events between etomidate and ketamine in sepsis. Using the National Emergency Airway Registry data set, findings showed that etomidate is used less frequently in sepsis patients than in non-sepsis patients, with ketamine being the most frequently used alternative. Further, ketamine was associated with more postprocedural hypotension than etomidate. Recommendations included future clinical trials to determine the optimal induction agent in patients with sepsis.
AHRQ-funded; HS025753.
Citation: Mohr NM, Pape SG, Runde D .
Etomidate use is associated with less hypotension than ketamine for emergency department sepsis intubations: a NEAR cohort study.
Acad Emerg Med 2020 Nov;27(11):1140-49. doi: 10.1111/acem.14070..
Keywords: Medication, Sepsis, Emergency Department, Registries, Adverse Drug Events (ADE), Adverse Events
Guglielminotti J, Li G
Exposure to general anesthesia for cesarean delivery and odds of severe postpartum depression requiring hospitalization.
This retrospective cohort study evaluated the risk of general anesthesia use in cesarean delivery versus neuraxial anesthesia on maternal mental health. Cesarean deliveries performed in New York State hospitals between 2006 and 2013 were included. Exclusion criteria included having more than 1 cesarean delivery during the study period, residing outside of New York State, and having a general anesthetic for other surgery or delivery in the year before or after the index case. The primary outcome looked at was severe postpartum depression (PPD), and secondary outcomes were suicidal ideation, anxiety disorders, and posttraumatic stress disorder (PTSD). The majority of cesareans used neuraxial anesthesia and only 8% (34,356) had general anesthesia. Severe PPD requiring hospitalization occurred in 1158 women with 60% identified during readmission. General anesthesia was found to be associated with a 54% increased odds of PPD, and a 91% increased odds of suicidal ideation or self-inflicted injury. There was insufficient evidence for increased risk of anxiety orders.
AHRQ-funded; HS025787.
Citation: Guglielminotti J, Li G .
Exposure to general anesthesia for cesarean delivery and odds of severe postpartum depression requiring hospitalization.
Anesth Analg 2020 Nov;131(5):1421-29. doi: 10.1213/ane.0000000000004663..
Keywords: Labor and Delivery, Pregnancy, Women, Depression, Behavioral Health, Surgery, Risk, Hospitalization, Medication, Adverse Drug Events (ADE), Adverse Events
Toce MS, Michelson K, Hudgins J
Association of state-level opioid-reduction policies with pediatric opioid poisoning.
Opioid-reduction policies have been enacted by US states to address the opioid epidemic. Evidence of an association between policy implementation and decreased rates of pediatric opioid poisoning provides further justification for expanded implementation of these policies. The purpose of this study was to examine the association of 3 state-level opioid-reduction policies with the rate of opioid poisoning in children and adolescents.
AHRQ-funded; HS026503.
Citation: Toce MS, Michelson K, Hudgins J .
Association of state-level opioid-reduction policies with pediatric opioid poisoning.
JAMA Pediatr 2020 Oct;174(10):961-68. doi: 10.1001/jamapediatrics.2020.1980..
Keywords: Children/Adolescents, Opioids, Medication: Safety, Medication, Adverse Drug Events (ADE), Adverse Events, Patient Safety, Policy
Feldman AG, Parsons JA, Dutmer CM
Subacute liver failure following gene replacement therapy for spinal muscular atrophy type 1.
This paper reports on two cases of transient, drug-induced liver failure after gene replacement therapy using an adeno-associated virus vector containing the survival motor neuron 1 gene.
AHRQ-funded; HS026510.
Citation: Feldman AG, Parsons JA, Dutmer CM .
Subacute liver failure following gene replacement therapy for spinal muscular atrophy type 1.
J Pediatr 2020 Oct;225:252-58.e1. doi: 10.1016/j.jpeds.2020.05.044..
Keywords: Newborns/Infants, Neurological Disorders, Genetics, Treatments, Adverse Drug Events (ADE), Adverse Events, Medication, Medication: Safety, Patient Safety, Case Study
Barnes GD, Sippola E, Dorsch M
Applying population health approaches to improve safe anticoagulant use in the outpatient setting: the DOAC Dashboard multi-cohort implementation evaluation study protocol.
This paper discusses the study protocol that is being used in the ongoing multi-cohort implementation evaluation study on applying population health approaches to improve safe use of direct oral anticoagulants (DOAC) for treatment of atrial fibrillation and venous thromboembolism. It is hoped that these approaches will help prevent incorrect dosing which is common and puts patients at risk of adverse events. Population health tools, including interactive dashboards built into the electronic health record (EHR), are being evaluated as a way to improve safe prescribing. A three-phase project is being conducted at the Veterans Health Administration (VHA) using both quantitative and qualitative methods. The DOAC Dashboard will be implemented in four new health systems. Quantitative evaluation of the implementation will follow the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework. Stakeholders will be interviewed as part of the qualitative evaluation using the Consolidated Framework for Implementation Research and Technology Acceptance Models. The goals of the study are to evaluate the implementation of the EHR-based population health tool, guide the adoption in four new health systems, and evaluate the multi-center implementation effort.
AHRQ-funded; HS026874.
Citation: Barnes GD, Sippola E, Dorsch M .
Applying population health approaches to improve safe anticoagulant use in the outpatient setting: the DOAC Dashboard multi-cohort implementation evaluation study protocol.
Implement Sci 2020 Sep 21;15(1):83. doi: 10.1186/s13012-020-01044-5.
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Keywords: Blood Thinners, Medication, Patient Safety, Implementation, Adverse Drug Events (ADE), Adverse Events, Medical Errors
Ing C, Ma X, Sun M
Exposure to surgery and anesthesia in early childhood and subsequent use of attention deficit hyperactivity disorder medications.
This study examines the association between higher rates of attention deficit hyperactivity disorder (ADHD) diagnosis and exposure to surgery and anesthesia before the age of 5. Longitudinal pharmacy data for children enrolled in Texas and New York Medicaid from 1999 to 2010 were used. They examined the association between a single exposure to anesthesia before age 5 years for 1 of 4 common pediatric surgical procedures: pyloromytomy, inguinal hernia repair, circumcisions outside the perinatal period, and tonsillectomy and/or adenectomy; and persistent ADHD medication use. A total of 213,435 children were included in the study. Children with a single exposure to anesthesia were 37% more likely than unexposed children to persistently use ADHD medication.
AHRQ-funded; HS022941.
Citation: Ing C, Ma X, Sun M .
Exposure to surgery and anesthesia in early childhood and subsequent use of attention deficit hyperactivity disorder medications.
Anesth Analg 2020 Sep;131(3):723-33. doi: 10.1213/ane.0000000000004619..
Keywords: Children/Adolescents, Behavioral Health, Medication, Surgery, Adverse Drug Events (ADE), Adverse Events
Bacon O, Hoffman L
System-level patient safety practices that aim to reduce medication errors associated with infusion pumps: an evidence review.
This literature review looked at studies that discuss 2 system-level patient safety practices (PSPs) that aim to reduce medication errors associated with infusion pumps. The first practice focuses on implementing structured process changes and redesigning workflows to improve efficiencies with pump use; and the other focuses on investing in initial and ongoing staff training on the correct use, maintenance, and monitoring of infusion pumps. Two databases were searched, with only four studies reporting medication administration errors, procedural errors, or deviations from hospital policy. Mixed results were found on examining process outcomes related to pump handling. Two studies found an increase in nurses’ adherence to using the medication safety software library because of education, with a resulting decrease in medication errors and adverse safety events.
AHRQ-funded; HHSP233201500013I.
Citation: Bacon O, Hoffman L .
System-level patient safety practices that aim to reduce medication errors associated with infusion pumps: an evidence review.
J Patient Saf 2020 Sep;16(3S Suppl 1):S42-s47. doi: 10.1097/pts.0000000000000722..
Keywords: Adverse Drug Events (ADE), Adverse Events, Patient Safety, Medication: Safety, Medication
Earl TR, Katapodis ND, Schneiderman SR
Using deprescribing practices and the screening tool of older persons' potentially inappropriate prescriptions criteria to reduce harm and preventable adverse drug events in older adults.
This paper is a systematic review of the literature published between 2008 to 2018 that studies the effect of interventions to reduce preventable adverse drug effects (ADEs) for adults who are prescribed multiple medications. Two safety practices were examined: 1) deprescribing interventions to reduce polypharmacy; and 2) use of the Screening Tool of Older Persons’ Potentially Inappropriate Prescriptions (STOPP) to reduce potentially inappropriate medications (PIMS). A total of 26 studies and 1 systematic review were included (14 for deprescribing and 12 for STOPP). Deprescribing interventions included decision support tools, educational interventions, and medication reviews. The STOPP tool most reported changes in PIMS, as well as some economic outcomes. Both methods were found to be effective.
AHRQ-funded; HHSP233201500013I.
Citation: Earl TR, Katapodis ND, Schneiderman SR .
Using deprescribing practices and the screening tool of older persons' potentially inappropriate prescriptions criteria to reduce harm and preventable adverse drug events in older adults.
J Patient Saf 2020 Sep;16(3S Suppl 1):S23-s35. doi: 10.1097/pts.0000000000000747..
Keywords: Elderly, Medication: Safety, Medication, Adverse Drug Events (ADE), Adverse Events, Patient Safety, Screening, Prevention
Samost-Williams A, Nanji KC
A systems theoretic process analysis of the medication use process in the operating room.
While 4 to 10% of medications administered in the operating room may involve an error, few investigations have prospectively modeled how these errors might occur. Systems theoretic process analysis is a prospective risk analysis technique that uses systems theory to identify hazards. The purpose of this study was to demonstrate the use of systems theoretic process analysis in a healthcare organization to prospectively identify causal factors for medication errors in the operating room.
AHRQ-funded; HS024764.
Citation: Samost-Williams A, Nanji KC .
A systems theoretic process analysis of the medication use process in the operating room.
Anesthesiology 2020 Aug;133(2):332-41. doi: 10.1097/aln.0000000000003376..
Keywords: Medication, Surgery, Medical Errors, Adverse Drug Events (ADE), Adverse Events
Abraham NS, Yang EH, Noseworthy PA
Fewer gastrointestinal bleeds with ticagrelor and prasugrel compared with clopidogrel in patients with acute coronary syndrome following percutaneous coronary intervention.
The goal of this study was to compare gastrointestinal bleeding (GIB) rates associated with clopidogrel, prasugrel, and ticagrelor using national medical and pharmacy claims data from privately insured and Medicare Advantage enrollees. Findings showed that, in the first year following percutaneous coronary intervention for acute coronary syndrome, ticagrelor and prasugrel were associated with fewer GIB events compared with clopidogrel.
AHRQ-funded; HS025402.
Citation: Abraham NS, Yang EH, Noseworthy PA .
Fewer gastrointestinal bleeds with ticagrelor and prasugrel compared with clopidogrel in patients with acute coronary syndrome following percutaneous coronary intervention.
Aliment Pharmacol Ther 2020 Aug;52(4):646-54. doi: 10.1111/apt.15790..
Keywords: Medication: Safety, Medication, Blood Thinners, Adverse Drug Events (ADE), Adverse Events, Patient Safety, Cardiovascular Conditions, Surgery
Assimon MM, Wang L, Pun PH
Use of QT prolonging medications by hemodialysis patients and individuals without end-stage kidney disease.
Investigators characterized the extent and patterns of QT-interval prolonging medication use by adult hemodialysis patients and individuals without end-stage kidney disease annually from 2012 to 2016. They found that hemodialysis patients used QT prolonging medications with known torsades de pointes risk more extensively than individuals without end-stage kidney disease. They recommended future studies evaluating the cardiac safety of these drugs in the hemodialysis population.
AHRQ-funded; HS026801.
Citation: Assimon MM, Wang L, Pun PH .
Use of QT prolonging medications by hemodialysis patients and individuals without end-stage kidney disease.
J Am Heart Assoc 2020 Jul 7;9(13):e015969. doi: 10.1161/jaha.120.015969..
Keywords: Medication, Medication: Safety, Adverse Drug Events (ADE), Adverse Events, Kidney Disease and Health, Risk
Villa Zapata L, Hansten PD, Horn JR
Evidence of clinically meaningful drug-drug interaction with concomitant use of colchicine and clarithromycin.
Colchicine is currently approved for the treatment of gout and familial Mediterranean fever, among other conditions. Clarithromycin, a strong inhibitor of CYP3A4 and P-glycoprotein, dramatically increases colchicine's half-life, augmenting the risk of a life-threatening adverse reaction when used inadvertently with colchicine. The aim of this study was to examine the evidence and clinical implications of concomitant use of colchicine and clarithromycin.
AHRQ-funded; HS025984.
Citation: Villa Zapata L, Hansten PD, Horn JR .
Evidence of clinically meaningful drug-drug interaction with concomitant use of colchicine and clarithromycin.
Drug Saf 2020 Jul;43(7):661-68. doi: 10.1007/s40264-020-00930-7..
Keywords: Medication, Medication: Safety, Adverse Drug Events (ADE), Adverse Events, Patient Safety
Liberman JS, Slagle JM, Whitney G
Incidence and classification of nonroutine events during anesthesia care.
A nonroutine event is any aspect of clinical care perceived by clinicians or trained observers as a deviation from optimal care based on the context of the clinical situation. The authors sought to delineate the incidence and nature of intraoperative nonroutine events during anesthesia care. The investigators concluded that nonroutine event-containing cases were commonly associated with patient impact and injury. They indicated that nonroutine event monitoring in conjunction with traditional error reporting may enhance understanding of potential intraoperative failure modes to guide prospective safety interventions.
AHRQ-funded; HS011375.
Citation: Liberman JS, Slagle JM, Whitney G .
Incidence and classification of nonroutine events during anesthesia care.
Anesthesiology 2020 Jul;133(1):41-52. doi: 10.1097/aln.0000000000003336..
Keywords: Medication: Safety, Medication, Patient Safety, Adverse Drug Events (ADE), Adverse Events, Surgery
Villa Zapata L, Hansten PD, Panic J
Risk of bleeding with exposure to warfarin and nonsteroidal anti-inflammatory drugs: a systematic review and meta-analysis.
Warfarin use can trigger the occurrence of bleeding independently or as a result of a drug-drug interaction when used in combination with nonsteroidal anti-inflammatory drugs (NSAIDs). This article examines the risk of bleeding in individuals exposed to concomitant warfarin and NSAID compared with those taking warfarin alone. The investigators concluded that risk of bleeding was significantly increased among persons taking warfarin and a NSAID or COX-2 inhibitor together as compared with taking warfarin alone.
AHRQ-funded; HS025984.
Citation: Villa Zapata L, Hansten PD, Panic J .
Risk of bleeding with exposure to warfarin and nonsteroidal anti-inflammatory drugs: a systematic review and meta-analysis.
Thromb Haemost 2020 Jul;120(7):1066-74. doi: 10.1055/s-0040-1710592..
Keywords: Blood Thinners, Medication, Medication: Safety, Risk, Adverse Drug Events (ADE), Adverse Events, Patient Safety, Evidence-Based Practice, Patient-Centered Outcomes Research, Outcomes
Nanji KC, Merry AF, Shaikh SD KC, Merry AF, Shaikh SD
Global PRoMiSe (Perioperative Recommendations for Medication Safety): protocol for a mixed-methods study.
Medication errors (MEs), which occur commonly in the perioperative period, have the potential to cause patient harm or death. Many published recommendations exist for preventing perioperative MEs; however, many of these recommendations conflict and are often not applicable to middle-income and low-income countries. The goal of this study was to develop and disseminate consensus-based recommendations for perioperative medication safety that were tailored to country income level.
AHRQ-funded; HS024764.
Citation: Nanji KC, Merry AF, Shaikh SD KC, Merry AF, Shaikh SD .
Global PRoMiSe (Perioperative Recommendations for Medication Safety): protocol for a mixed-methods study.
BMJ Open 2020 Jun 30;10(6):e038313. doi: 10.1136/bmjopen-2020-038313..
Keywords: Medication, Medication: Safety, Patient Safety, Adverse Drug Events (ADE), Adverse Events, Medical Errors
Stone CA, Stollings JL, Lindsell CJ
Risk-stratified management to remove low-risk penicillin allergy labels in the ICU.
Patients admitted to a medical ICU (MICU) often have chronic illnesses or altered immunity, increasing their need for immediate antibiotic use. In this study, the investigators sought to determine whether MICU patients with low-risk penicillin allergy history could be challenged directly with amoxicillin to have their allergy label safely removed during an acute inpatient stay.
Citation: Stone CA, Stollings JL, Lindsell CJ .
Risk-stratified management to remove low-risk penicillin allergy labels in the ICU.
Am J Respir Crit Care Med 2020 Jun 15;201(12):1572-75. doi: 10.1164/rccm.202001-0089LE..
Keywords: Intensive Care Unit (ICU), Antibiotics, Medication, Medication: Safety, Adverse Drug Events (ADE), Adverse Events, Risk, Diagnostic Safety and Quality
Vyles D, Antoon JW, Norton A
Children with reported penicillin allergy: public health impact and safety of delabeling.
The objectives of this study were to: 1.) Review the relevant literature related to children with reported penicillin allergy 2.) Highlight the different ways in which children could be delabeled and 3.) Evaluate the public health impact that a penicillin allergy has for children. The investigators concluded that penicillin allergy was overdiagnosed, often incorrectly, and the label was frequently first applied during childhood.
AHRQ-funded; HS026395.
Citation: Vyles D, Antoon JW, Norton A .
Children with reported penicillin allergy: public health impact and safety of delabeling.
Ann Allergy Asthma Immunol 2020 Jun;124(6):558-65. doi: 10.1016/j.anai.2020.03.012..
Keywords: Children/Adolescents, Medication, Medication: Safety, Patient Safety, Adverse Drug Events (ADE), Adverse Events, Public Health