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AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (3)
- (-) Adverse Events (7)
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- (-) Elderly (7)
- Emergency Department (1)
- Healthcare Cost and Utilization Project (HCUP) (1)
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- Medication: Safety (3)
- Nursing Homes (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
1 to 7 of 7 Research Studies DisplayedField TS, Fouayzi H, Crawfo TS, Fouayzi H, Crawford S
The association of nursing home characteristics and quality with adverse events after a hospitalization.
This prospective cohort analysis measured the association of long-stay nursing home residents returning to the facility after a hospitalization and adverse events (AEs). Thirty-two nursing homes in New England states participated with a total of 555 long-stay residents contributing 762 returns from hospitalizations. The authors measured the association between AEs developing in the 45 days following discharge back to long-term care and characteristics of the nursing homes including bed size, ownership, 5-star quality ratings, registered nurse and nursing assistant hours, and the individual Centers for Medicare & Medicaid Services (CMS) quality indicators. They found no association of AEs with most nursing home characteristics. Several individual quality indicators were associated with AEs. The highest tertile of residents with depression had a hazard ratio (HR) of 1.65 and the highest tertile of the percentage taking antipsychotic medications had an HR of 1.58. Residents needing increased assistance with activities of daily living was statistically significant, but not monotonic.
AHRQ-funded; HS024422.
Citation: Field TS, Fouayzi H, Crawfo TS, Fouayzi H, Crawford S .
The association of nursing home characteristics and quality with adverse events after a hospitalization.
J Am Med Dir Assoc 2021 Oct;22(10):2196-200. doi: 10.1016/j.jamda.2021.02.027..
Keywords: Elderly, Nursing Homes, Adverse Events, Hospitalization
Herzig SJ, Anderson TS, Jung Y
Relative risks of adverse events among older adults receiving opioids versus NSAIDs after hospital discharge: a nationwide cohort study.
This retrospective cohort study’s objective was to determine the incidence and risk of post-discharge adverse events among opioid claims in the week after hospital discharge, compared to those with nonsteroidal anti-inflammatory drugs (NSAIDs) claims alone. A national sample of Medicare beneficiaries age 65 and older who were hospitalized in the United States in 2016 was used. Beneficiaries who were admitted from or discharged to a facility were excluded. The authors used 3:1 propensity matching to match beneficiaries with an opioid claim in the week after discharge (13,385) with beneficiaries with NSAID claim alone (4,677). Beneficiaries receiving opioids had a higher incidence of death, healthcare utilization, and any potential adverse effect compared to those with an NSAID claim only. Specific adverse effects included higher relative risk of fall/fracture, nausea/vomiting, and slowed colonic motility.
AHRQ-funded; HS026215.
Citation: Herzig SJ, Anderson TS, Jung Y .
Relative risks of adverse events among older adults receiving opioids versus NSAIDs after hospital discharge: a nationwide cohort study.
PLoS Med 2021 Sep 27;18(9):e1003804. doi: 10.1371/journal.pmed.1003804..
Keywords: Elderly, Opioids, Medication, Medication: Safety, Adverse Drug Events (ADE), Adverse Events, Patient Safety, Risk, Hospital Discharge
Harben AL, Kashy DA, Esfahanian S
Using change detection to objectively evaluate whether novel over-the-counter drug labels can increase attention to critical health information among older adults.
Over-the-counter (OTC) drugs have many benefits but also carry risks, such as adverse drug reactions, which are more prevalent in older adults. Because these products do not require the oversight of a physician or pharmacist, labeling plays a key role in communicating information required for their safe and effective use. In two experiments, the investigators used a change detection task to objectively evaluate how novel label designs that employ highlighting and a warning label placed on the package's front impact attention to critical information among older participants (65 and older).
AHRQ-funded; HS025386.
Citation: Harben AL, Kashy DA, Esfahanian S .
Using change detection to objectively evaluate whether novel over-the-counter drug labels can increase attention to critical health information among older adults.
Cogn Res Princ Implic 2021 May 26;6(1):40. doi: 10.1186/s41235-021-00307-z..
Keywords: Elderly, Medication: Safety, Medication, Adverse Drug Events (ADE), Adverse Events, Patient Safety
Gurwitz JH, Kapoor A, Garber L
Effect of a multifaceted clinical pharmacist intervention on medication safety after hospitalization in persons prescribed high-risk medications: a randomized clinical trial.
The purpose of this study was to determine whether a multifaceted clinical pharmacist intervention improves medication safety for patients who are discharged from the hospital and prescribed medications within 1 or more of these high-risk drug classes: anticoagulants, diabetes agents, and opioids. The randomized clinical trial was conducted at a large multidisciplinary group practice in Massachusetts and included patients 50 years or older. Findings showed that there was not an observed lower rate of adverse drug-related incidents or clinically important medication errors during the posthospitalization period that was associated with a clinical pharmacist intervention.
AHRQ-funded; HS023774.
Citation: Gurwitz JH, Kapoor A, Garber L .
Effect of a multifaceted clinical pharmacist intervention on medication safety after hospitalization in persons prescribed high-risk medications: a randomized clinical trial.
JAMA Intern Med 2021 May;181(5):610-18. doi: 10.1001/jamainternmed.2020.9285..
Keywords: Elderly, Medication: Safety, Medication, Patient Safety, Adverse Drug Events (ADE), Adverse Events, Provider: Pharmacist, Provider
Griffey RT, Schneider RM, Adler L
Post-acute and long-term care patients account for a disproportionately high number of adverse events in the emergency department.
This retrospective observation study compares emergency department (ED) rates for adverse events (AEs) between post-acute and long-term care settings (PA/LTC) residents and non-PA/LTC residents. The authors describe all-cause harm among patients from PA/LTC setting seen in the ED. The study used the ED Trigger Tool, with dual independent nurse reviews of 5582 ED records with triggers. Data was captured for all adult patients at an urban, academic ED over a 13-month period. PA/LTC patients tended to be older (median 69 vs 50 years old). They accounted for 21% of all AEs (26% present on arrival, 13% in ED). Present on arrival AEs from a PA/LTC setting were most commonly patient-care related (39%), medication (34%) and infections (16%). The analysis showed that a disproportionate number of ED visits from PA/LTC are for AEs, which is an admission rate double that for non-PA/LTC patients.
AHRQ-funded; R18 HS025052.
Citation: Griffey RT, Schneider RM, Adler L .
Post-acute and long-term care patients account for a disproportionately high number of adverse events in the emergency department.
J Am Med Dir Assoc 2021 Apr;22(4):907-12.e1. doi: 10.1016/j.jamda.2020.06.043..
Keywords: Elderly, Long-Term Care, Emergency Department, Adverse Events
Dworsky JQ, Shellito AD, Childers CP
Association of geriatric events with perioperative outcomes after elective inpatient surgery.
Researchers investigated the prevalence and association of geriatric events (GEs) with clinical outcomes after elective surgery. Using National Inpatient Sample data, they found that, compared to admissions with no GEs, one or more GEs were associated with higher probability of worse outcomes including mortality, postoperative complications, prolonged length of stay, and discharge to a skilled nursing facility. They recommended efforts focusing on mutable factors responsible for GEs in order to optimize surgical care for older adults.
AHRQ-funded; HS000046.
Citation: Dworsky JQ, Shellito AD, Childers CP .
Association of geriatric events with perioperative outcomes after elective inpatient surgery.
J Surg Res 2021 Mar;259:192-99. doi: 10.1016/j.jss.2020.11.011..
Keywords: Healthcare Cost and Utilization Project (HCUP), Elderly, Surgery, Adverse Events, Outcomes
Osterman CK, Deal AM, McCloskey H
Impairment and longitudinal recovery of older adults treated with radical cystectomy for muscle invasive bladder cancer.
Treatment for muscle invasive bladder cancer includes radical cystectomy, a major surgery that can be associated with significant toxicity. Limited data exist related to changes in patient global health status and recovery following radical cystectomy. In this study, the investigators used geriatric assessment to longitudinally compare health related impairments in older and younger patients with muscle invasive bladder cancer who undergo radical cystectomy.
AHRQ-funded; HS024134.
Citation: Osterman CK, Deal AM, McCloskey H .
Impairment and longitudinal recovery of older adults treated with radical cystectomy for muscle invasive bladder cancer.
J Urol 2021 Jan;205(1):94-99. doi: 10.1097/ju.0000000000001323..
Keywords: Elderly, Cancer, Surgery, Adverse Events, Quality of Life