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Search All Research Studies
Topics
- Adverse Drug Events (ADE) (2)
- Adverse Events (3)
- Back Health and Pain (3)
- Behavioral Health (3)
- Cancer (5)
- Cancer: Breast Cancer (2)
- Cancer: Colorectal Cancer (1)
- Cancer: Lung Cancer (1)
- Cancer: Skin Cancer (1)
- Cardiovascular Conditions (1)
- Care Management (2)
- Chronic Conditions (2)
- Comparative Effectiveness (5)
- Dementia (1)
- Depression (2)
- (-) Elderly (20)
- Evidence-Based Practice (2)
- Healthcare Costs (1)
- Healthcare Utilization (1)
- Heart Disease and Health (1)
- Medicare (4)
- Medication (3)
- Mortality (2)
- Neurological Disorders (1)
- Nursing Homes (1)
- Outcomes (2)
- Pain (1)
- Palliative Care (1)
- Patient-Centered Outcomes Research (6)
- Social Determinants of Health (2)
- Surgery (3)
- (-) Treatments (20)
- 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 20 of 20 Research Studies DisplayedDi M, Keeney T, Belanger E
Functional status and therapy for older adults with diffuse large B-cell lymphoma in nursing homes: a population-based study.
The purpose of this study was to describe the prevalence of functional and cognitive impairments, and relationships between impairments and treatment in older patients with diffuse large B cell lymphoma (DLBCL) receiving nursing home (NH) care. The study found that of the eligible 649 NH patients 45% received chemoimmunotherapy; among the recipients, 47% received multi-agent, anthracycline-containing regimens. Those patients in a NH were less likely to receive chemoimmunotherapy, had higher 30-day mortality, and poorer OS compared with community-dwelling patients. NH patients with severe functional (61%) or any cognitive impairment (48%) were less likely to receive chemoimmunotherapy.
AHRQ-funded; HS000011.
Citation: Di M, Keeney T, Belanger E .
Functional status and therapy for older adults with diffuse large B-cell lymphoma in nursing homes: a population-based study.
J Am Geriatr Soc 2023 Jul; 71(7):2239-49. doi: 10.1111/jgs.18302..
Keywords: Elderly, Nursing Homes, Medicare, Cancer, Treatments
Curatolo M, Rundell SD, Gold LS
Long-term effectiveness of epidural steroid injections after new episodes of low back pain in older adults.
The purpose of this prospective study was to compare older adults undergoing epidural steroid injections (ESI) with patients not receiving ESI to test the hypotheses that those on ESI: 1) have worse outcomes before ESI, 2) have improved outcomes after ESI, and 3) have improved outcomes due to a specific ESI effect. The researchers evaluated patients 65 years of age or older from 3 United States health care systems who presented to primary care with new episodes of back pain. The three outcomes assessed were back and leg pain intensity, disability, and quality of life, all of which were evaluated at baseline, and then with 3-, 6-, 12- and 24- month follow-ups. The study found that in ESI patients, pain intensity, disability, and quality of life at baseline were significantly worse than in non-ESI patients. The study concluded that adults 65 and older who were treated with ESI have long-term improvement, but the improvement is not likely to be related to a specific effect of ESI, making epidural steroid injections unlikely to provide long-term benefits.
AHRQ-funded; HS019222; HS022972.
Citation: Curatolo M, Rundell SD, Gold LS .
Long-term effectiveness of epidural steroid injections after new episodes of low back pain in older adults.
Eur J Pain 2022 Aug;26(7):1469-80. doi: 10.1002/ejp.1975..
Keywords: Elderly, Back Health and Pain, Pain, Treatments
Rhee TG, Sint K, Olfson M
Association of ECT with risks of all-cause mortality and suicide in older Medicare patients.
This observational study examined the effects of electroconvulsive therapy (ECT) on suicide and all-cause mortality risk in Medicare psychiatric patients age 65 or older. Patients receiving ECT were exact matched to control subjects in a 1-to-3 ratio on age, gender, principal hospital diagnosis, past-year psychiatric hospitalizations, past-year suicide attempts, and Elixhauser comorbidity index. A total of 10,46 patients were in the ECT group and 31,160 in the control group. Compared with the control group, patients receiving ECT had lower all-cause mortality for up to 1 year following hospital discharge. For death by suicide, ECT was associated with short-lived effects which waned over time.
AHRQ-funded; HS023000.
Citation: Rhee TG, Sint K, Olfson M .
Association of ECT with risks of all-cause mortality and suicide in older Medicare patients.
Am J Psychiatry 2021 Dec;178(12):1089-97. doi: 10.1176/appi.ajp.2021.21040351..
Keywords: Elderly, Behavioral Health, Mortality, Treatments
Rhee TG, Olfson M, Sint K
Characterization of the quality of electroconvulsive therapy among older Medicare beneficiaries.
Electroconvulsive therapy (ECT) is an important therapy for treatment-resistant depression and is especially effective for elderly individuals with depression. This study provides the first US nationally representative description of ECT in the elderly. The investigators concluded that despite substantial evidence of efficacy, ECT use remained rare among elderly patients with depression.
AHRQ-funded; HS023000.
Citation: Rhee TG, Olfson M, Sint K .
Characterization of the quality of electroconvulsive therapy among older Medicare beneficiaries.
J Clin Psychiatry 2020 Jul 7;81(4). doi: 10.4088/JCP.19m13186.
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Keywords: Elderly, Medicare, Depression, Behavioral Health, Treatments, Patient-Centered Outcomes Research
Fink HA, Linskens EJ, MacDonald R
Benefits and harms of prescription drugs and supplements for treatment of clinical Alzheimer-type dementia
This is a systematic review and meta-analysis of the benefits and harms of prescription drugs and supplements for treatment of clinical Alzheimer-type dementia (CATD). Studies with low or medium risk of bias (ROB) were analyzed and rated. The analysis concluded there was a slight reduction in short-term cognitive decline with cholinesterase inhibitors and memantime, and cholinesterase inhibitors slightly reduced reported functional decline. There was mostly insufficient evidence on drug treatment of behavioral and psychological symptoms of dementia and on supplements for all outcomes.
AHRQ-funded; 290201500008I.
Citation: Fink HA, Linskens EJ, MacDonald R .
Benefits and harms of prescription drugs and supplements for treatment of clinical Alzheimer-type dementia
Ann Intern Med 2020 May 19;172(10):656-68. doi: 10.7326/m19-3887..
Keywords: Elderly, Dementia, Neurological Disorders, Medication, Patient-Centered Outcomes Research, Evidence-Based Practice, Outcomes, Adverse Drug Events (ADE), Adverse Events, Treatments
Ochs-Ross R, Daly EJ, Zhang Y
Efficacy and safety of esketamine nasal spray plus an oral antidepressant in elderly patients with treatment-resistant depression-TRANSFORM-3.
This phase 3 double-blind study randomized patients with treatment-resistant depression age 65 or older to flexibly-dosed esketamine nasal spray and new oral antidepressant (esketamine/antidepressant) or new oral antidepressant and placebo nasal spray (antidepressant/placebo). The primary endpoint was change in the Montgomery-Asberg Depression Rating Scale (MADRS) over 28 days from baseline. Results showed that esketamine/antidepressant did not achieve statistical significance for patients ages 75 and older; however, greater differences were seen for patients ages 65-74 and patients with earlier onset of depression younger than age 55.
AHRQ-funded; HS023000.
Citation: Ochs-Ross R, Daly EJ, Zhang Y .
Efficacy and safety of esketamine nasal spray plus an oral antidepressant in elderly patients with treatment-resistant depression-TRANSFORM-3.
Am J Geriatr Psychiatry 2020 Feb;28(2):121-41. doi: 10.1016/j.jagp.2019.10.008..
Keywords: Medication, Depression, Behavioral Health, Elderly, Comparative Effectiveness, Treatments, Evidence-Based Practice
Kundi H, Popma JJ, Reynolds MR
Frailty and related outcomes in patients undergoing transcatheter valve therapies in a nationwide cohort.
In this study, the investigators sought to identify the prevalence and related outcomes of frail individuals undergoing transcatheter mitral valve repair and transcatheter aortic valve replacement (TAVR). Patients aged 65 and older were included in the study if they had at least one procedural code for transcatheter mitral valve repair or TAVR between 1 January 2016 and 31 December 2016 in the Centers for Medicare and Medicaid Services Medicare Provider and Review database.
Citation: Kundi H, Popma JJ, Reynolds MR .
Frailty and related outcomes in patients undergoing transcatheter valve therapies in a nationwide cohort.
Eur Heart J 2019 Jul 14;40(27):2231-39. doi: 10.1093/eurheartj/ehz187.
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Keywords: Elderly, Heart Disease and Health, Cardiovascular Conditions, Surgery, Outcomes, Treatments
Ellis CT, Cole AL, Sanoff HK
Evaluating surveillance patterns after chemoradiation-only compared with conventional management for older patients with rectal cancer.
This study examined surveillance patterns for elderly patients who were treated only with chemoradiation (CR) as opposed to traditional treatment (chemoradiation and protectomy). In the cohort study, a total of 2,482 individuals met the inclusion criteria, with 21% receiving CR-only treatment, and 79% had conventional treatment. In comparison to patients who had traditional treatment, patients with CR-only treatment had far less follow-up during the first 2 years post-treatment. Adherence to guideline-recommended surveillance was poor for all Medicare patients, but especially for CR-only treated patients.
AHRQ-funded; HS000032.
Citation: Ellis CT, Cole AL, Sanoff HK .
Evaluating surveillance patterns after chemoradiation-only compared with conventional management for older patients with rectal cancer.
J Am Coll Surg 2019 May;228(5):782-91.e2. doi: 10.1016/j.jamcollsurg.2019.01.010..
Keywords: Cancer, Cancer: Colorectal Cancer, Care Management, Treatments, Elderly, Patient-Centered Outcomes Research
Fritz JM, Rundell SD, Dougherty P
Deconstructing chronic low back pain in the older adult-step by step evidence and expert-based recommendations for evaluation and treatment. Part vi: Lumbar spinal stenosis.
This article is the sixth in a series of articles designed to deconstruct chronic low back pain (CLBP) in older adults. It focuses on the evaluation and management of lumbar spinal stenosis (LSS), the most common condition for which older adults undergo spinal surgery. It concluded that lumbar spinal stenosis exists not uncommonly in older adults with CLBP and management often can be accomplished without surgery.
AHRQ-funded; HS022982.
Citation: Fritz JM, Rundell SD, Dougherty P .
Deconstructing chronic low back pain in the older adult-step by step evidence and expert-based recommendations for evaluation and treatment. Part vi: Lumbar spinal stenosis.
Pain Med 2016 Mar;17(3):501-10. doi: 10.1093/pm/pnw011..
Keywords: Back Health and Pain, Elderly, Chronic Conditions, Treatments, Surgery
Poonawalla IB, Piller LB, Lairson DR
Impact of hematopoietic growth factors on blood transfusion needs, incidence of neutropenia, and overall survival among elderly advanced ovarian cancer patients treated with chemotherapy.
The researchers sought to determine the effectiveness of erythropoietin-stimulating agent (ESA) and granulocyte colony-stimulating factor (CSF) in reducing blood transfusion needs and neutropenia incidence in community-dwelling elderly ovarian cancer patients. They found that erythropoietin-stimulating agents were effective in reducing blood transfusion need. Granulocyte colony-stimulating factors were effective in lowering neutropenia incidence and also were associated with improved survival in elderly ovarian cancer patients.
AHRQ-funded; HS018956.
Citation: Poonawalla IB, Piller LB, Lairson DR .
Impact of hematopoietic growth factors on blood transfusion needs, incidence of neutropenia, and overall survival among elderly advanced ovarian cancer patients treated with chemotherapy.
Int J Gynecol Cancer 2016 Jan;26(1):95-103. doi: 10.1097/igc.0000000000000564.
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Keywords: Cancer, Treatments, Comparative Effectiveness, Elderly, Patient-Centered Outcomes Research
Gupta A, Long JB, Chen J
Risk of vascular toxicity with platinum based chemotherapy in elderly patients with bladder cancer.
The researchers evaluated the short-term (less than 1 year) and intermediate-term (2 to 5 years) vascular toxicity of platinum agents in older patients with bladder cancer. They found that patients receiving platinum based chemotherapy were at higher risk for thromboembolism but not other vascular events, particularly in the first year after diagnosis. This risk of thromboembolism is similar for cisplatin and carboplatin.
AHRQ-funded; HS018781.
Citation: Gupta A, Long JB, Chen J .
Risk of vascular toxicity with platinum based chemotherapy in elderly patients with bladder cancer.
J Urol 2016 Jan;195(1):33-40. doi: 10.1016/j.juro.2015.08.088..
Keywords: Adverse Drug Events (ADE), Adverse Events, Cancer, Treatments, Elderly
Lairson DR, Parikh RC, Cormier JN
Cost-effectiveness of chemotherapy for breast cancer and age effect in older women.
The researchers assessed the cost-effectiveness of chemotherapy regimens by age and disease stage under "real-world" conditions for patients with breast cancer. They found that anthracycline-based chemotherapy was found cost-effective for elderly patients with early stage (stage I, II, IIIa) breast cancer considering the US threshold of $100,000 per QALY.
AHRQ-funded; HS018956.
Citation: Lairson DR, Parikh RC, Cormier JN .
Cost-effectiveness of chemotherapy for breast cancer and age effect in older women.
Value Health 2015 Dec;18(8):1070-8. doi: 10.1016/j.jval.2015.08.008..
Keywords: Cancer: Breast Cancer, Treatments, Healthcare Costs, Elderly, Social Determinants of Health
Suskind AM, Clemens JQ, Zhang Y
Physician use of sacral neuromodulation among Medicare beneficiaries with overactive bladder and urinary retention.
This study identified physician-level factors associated with high rates of sacral neuromodulation testing. It found that, over time, physicians are testing more patients but are not implanting more devices. Additionally, there is an inverse relationship between rates of device testing and implantation, suggesting opportunities to improve efficiency and resource utilization.
AHRQ-funded; HS018726.
Citation: Suskind AM, Clemens JQ, Zhang Y .
Physician use of sacral neuromodulation among Medicare beneficiaries with overactive bladder and urinary retention.
Urology 2015 Jul;86(1):30-4. doi: 10.1016/j.urology.2015.04.003..
Keywords: Elderly, Medicare, Treatments, Women
Huo J, Du XL, Lairson DR
Utilization of surgery, chemotherapy, radiation therapy, and hospice at the end of life for patients diagnosed with metastatic melanoma.
The authors examined the patterns of utilization of radiation therapy, chemotherapy, surgery, and hospice at the end-of-life care for patients diagnosed with metastatic melanoma. They found that surgery and hospice care use increased over the 8 years of this study, whereas the use of chemotherapy and radiation therapy remained consistent for patients diagnosed with metastatic melanoma.
AHRQ-funded; HS018956.
Citation: Huo J, Du XL, Lairson DR .
Utilization of surgery, chemotherapy, radiation therapy, and hospice at the end of life for patients diagnosed with metastatic melanoma.
Am J Clin Oncol 2015 Jun;38(3):235-41. doi: 10.1097/COC.0b013e31829378f9.
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Keywords: Cancer, Cancer: Skin Cancer, Treatments, Elderly, Healthcare Utilization, Palliative Care, Patient-Centered Outcomes Research, Surgery
Duong VH, Baer MR, Hendrick F
AHRQ Author: Davidoff AJ
Variations in erythropoiesis-stimulating agent administration in transfusion-dependent myelodysplastic syndromes impact response.
The researchers studied the association of timing of erythropoiesis-stimulating agents (ESA) initiation, agent, and number of weeks of ESA use with response in myelodysplastic syndrome (MDS) patients in routine practice. They found that variations in ESA administration impacted response in transfusion-dependent MDS patients, with higher response rates with early administration and use of darbepoetin, and low response likelihood in non-responders beyond 16 weeks of therapy.
AHRQ-authored.
Citation: Duong VH, Baer MR, Hendrick F .
Variations in erythropoiesis-stimulating agent administration in transfusion-dependent myelodysplastic syndromes impact response.
Leuk Res 2015 Jun;39(6):586-91. doi: 10.1016/j.leukres.2015.03.013.
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Keywords: Comparative Effectiveness, Elderly, Treatments
Malhotra J, Mhango G, Gomez JE
Adjuvant chemotherapy for elderly patients with stage I non-small-cell lung cancer >/=4 cm in size: an SEER-Medicare analysis.
The researchers compared overall survival and rates of serious adverse events (defined as those requiring admission to hospital) between patients treated with resection alone, platinum-based adjuvant chemotherapy, or postoperative radiation (PORT) with or without adjuvant chemotherapy. Platinum-based adjuvant chemotherapy is associated with reduced mortality and increased serious adverse events in elderly patients with stage I non-small-cell lung cancer ≥4 cm in size.
AHRQ-funded; HS019670.
Citation: Malhotra J, Mhango G, Gomez JE .
Adjuvant chemotherapy for elderly patients with stage I non-small-cell lung cancer >/=4 cm in size: an SEER-Medicare analysis.
Ann Oncol 2015 Apr;26(4):768-73. doi: 10.1093/annonc/mdv008..
Keywords: Cancer: Lung Cancer, Elderly, Treatments, Adverse Events, Comparative Effectiveness
Kadakia A, Rajan SS, Abughosh S
CMF-regimen preferred as first-course chemotherapy for older and sicker women with breast cancer: findings from a SEER-Medicare-based population study.
This study aimed to determine the utilization of Cyclophosphamide, Methotrexate, and 5-Fluorouracil (CMF) as first-course chemotherapy in recent years, and identify the sociodemographic and clinical characteristics associated with its prescription. It found that older and sicker women, living in census tracts with lower average education, and diagnosed with advanced stage, hormone receptor-negative tumors have a higher probability of CMF administration.
AHRQ-funded; HS018956.
Citation: Kadakia A, Rajan SS, Abughosh S .
CMF-regimen preferred as first-course chemotherapy for older and sicker women with breast cancer: findings from a SEER-Medicare-based population study.
Am J Clin Oncol 2015 Apr;38(2):165-73. doi: 10.1097/COC.0b013e31828f5b01..
Keywords: Cancer: Breast Cancer, Treatments, Elderly, Social Determinants of Health
Rundell SD, Sherman KJ, Heagerty PJ
Patient-reported outcomes associated with use of physical therapist services by older adults with a new visit for back pain.
The researchers conducted an observational comparative effectiveness research study to investigate the association between types or amounts of physical therapist services and outcomes, such as disability and pain intensity, among older adults. Higher amounts of active physical therapy were associated with decreased back and leg pain and increased odds of clinically meaningful improvements in back and leg pain relative to results obtained with no active physical therapy.
AHRQ-funded; HS019222.
Citation: Rundell SD, Sherman KJ, Heagerty PJ .
Patient-reported outcomes associated with use of physical therapist services by older adults with a new visit for back pain.
Phys Ther 2015 Feb;95(2):190-201. doi: 10.2522/ptj.20140132..
Keywords: Back Health and Pain, Patient-Centered Outcomes Research, Comparative Effectiveness, Treatments, Elderly
Makris UE, Abrams RC, Gurland B
Management of persistent pain in the older patient: a clinical review.
The purpose of this study was to 1.) Describe barriers to the management of persistent pain among older adults; 2.) Summarize current management approaches, including pharmacologic and nonpharmacologic modalities; 3.) Present rehabilitative approaches; and 4.) Highlight aspects of the patient-physician relationship that can help to improve treatment outcomes.
AHRQ-funded; HS020648.
Citation: Makris UE, Abrams RC, Gurland B .
Management of persistent pain in the older patient: a clinical review.
JAMA 2014 Aug 27;312(8):825-36. doi: 10.1001/jama.2014.9405..
Keywords: Care Management, Chronic Conditions, Elderly, Medication, Treatments
Tong L, Ahn C, Symanski E
Effects of newly developed chemotherapy regimens, comorbidities, chemotherapy-related toxicities on the changing patterns of the leading causes of death in elderly patients with colorectal cancer.
This study examined the effects of newly developed chemotherapy regimens, comorbidities, and chemotherapy-related toxicities on the changing patterns of the leading causes of death in elderly patients with colorectal cancer (CRC). It found that the risks of CRC-specific death decreased with diagnostic time periods only in chemotherapy recipients.
AHRQ-funded; HS018956
Citation: Tong L, Ahn C, Symanski E .
Effects of newly developed chemotherapy regimens, comorbidities, chemotherapy-related toxicities on the changing patterns of the leading causes of death in elderly patients with colorectal cancer.
Ann Oncol. 2014 Jun;25(6):1234-42. doi: 10.1093/annonc/mdu131..
Keywords: Elderly, Mortality, Treatments, Medicare