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
201 to 225 of 299 Research Studies DisplayedSekhri S, Arora NS, Cottrell H
Probability of opioid prescription refilling after surgery: does initial prescription dose matter?
In this study, the investigators sought to determine the correlation between the probability of postoperative opioid prescription refills and the amount of opioid prescribed, hypothesizing that a greater initial prescription yields a lower probability of refill. The investigators concluded that the probability of refilling prescription opioids after surgery was not correlated with initial prescription strength, suggesting surgeons could prescribe smaller prescriptions without influencing refill requests.
AHRQ-funded; HS023313.
Citation: Sekhri S, Arora NS, Cottrell H .
Probability of opioid prescription refilling after surgery: does initial prescription dose matter?
Ann Surg 2018 Aug;268(2):271-76. doi: 10.1097/sla.0000000000002308..
Keywords: Medication, Opioids, Pain, Practice Patterns, Substance Abuse, Surgery
Olfson M, Crystal S, Wall M
Causes of death after nonfatal opioid overdose.
The purpose of this study was to describe all-cause mortality rates, selected cause-specific mortality rates, and standardized mortality rate ratios (SMRs) of adults during their first year after nonfatal opioid overdose. In a US national cohort of adults who had experienced a nonfatal opioid overdose, a marked excess of deaths was attributable to a wide range of substance use-associated, mental health, and medical conditions, underscoring the importance of closely coordinating the substance use, mental health, and medical care of this patient population.
AHRQ-funded; HS021112.
Citation: Olfson M, Crystal S, Wall M .
Causes of death after nonfatal opioid overdose.
JAMA Psychiatry 2018 Aug;75(8):820-27. doi: 10.1001/jamapsychiatry.2018.1471..
Keywords: Behavioral Health, Mortality, Opioids, Patient-Centered Healthcare, Substance Abuse
Andrews CM, Grogan CM, Smith BT
Medicaid benefits for addiction treatment expanded after implementation of the Affordable Care Act.
This study looked at the effects the Affordable Care Act (ACA) had on Medicaid benefits for addiction treatment. The ACA established a minimum standard of benefits and required state Medicaid programs to make changes to their treatment benefits. Researchers surveyed all 50 states and the District of Columbia in 2014 and 2017 when the ACA requirements came into effect. There was a substantial increase in benefits with a decrease in annual service limits of over 50 percent. There was a large reduction in preauthorization requirements for medications to treat opioid use disorder as well as other reductions in preauthorizations.
AHRQ-funded; HS000084.
Citation: Andrews CM, Grogan CM, Smith BT .
Medicaid benefits for addiction treatment expanded after implementation of the Affordable Care Act.
Health Aff 2018 Aug;37(8):1216-22. doi: 10.1377/hlthaff.2018.0272..
Keywords: Access to Care, Behavioral Health, Health Insurance, Medicaid, Policy, Substance Abuse
Axeen S, Seabury SA, Menchine M
Emergency department contribution to the prescription opioid epidemic.
The investigators used MEPS data to characterize the relative contribution of emergency departments (EDs) to national opioid prescribing, to estimate trends in opioid prescribing by site of care, and to examine whether higher-risk opioid users receive a disproportionate quantity of their opioids from ED settings. During the study period, they found that the relative contribution of EDs to the prescription opioid problem was modest and declining. They therefore recommended that further efforts to reduce the quantity of opioids prescribed focus on office-based settings.
AHRQ-funded; HS024251.
Citation: Axeen S, Seabury SA, Menchine M .
Emergency department contribution to the prescription opioid epidemic.
Ann Emerg Med 2018 Jun;71(6):659-67.e3. doi: 10.1016/j.annemergmed.2017.12.007..
Keywords: Behavioral Health, Emergency Department, Medical Expenditure Panel Survey (MEPS), Medication, Opioids, Practice Patterns, Substance Abuse
Cook B, Creedon T, Wang Y
Examining racial/ethnic differences in patterns of benzodiazepine prescription and misuse.
Electronic health record data from a large healthcare system were used to describe racial/ethnic, sex, and age differences in benzodiazepines (BZD) use and dependence. Among patients with a BZD prescription, the investigators assessed differences in: 1.) the likelihood of subsequently receiving a BZD dependence diagnosis, 2.) the number of BZD prescriptions, 3.) receiving only one BZD prescription, and 4.) receiving 18 or more BZD prescriptions.
AHRQ-funded; HS021486.
Citation: Cook B, Creedon T, Wang Y .
Examining racial/ethnic differences in patterns of benzodiazepine prescription and misuse.
Drug Alcohol Depend 2018 Jun 1;187:29-34. doi: 10.1016/j.drugalcdep.2018.02.011..
Keywords: Medication, Practice Patterns, Racial and Ethnic Minorities, Substance Abuse
Westover AN, Nakonezny PA, Halm EA
Risk of amphetamine use disorder and mortality among incident users of prescribed stimulant medications in the Veterans Administration.
This study's aims were to ascertain the demographics of stimulant medication users compared with non-users, examine temporal trends of stimulant medication use and estimate risk factors for development of amphetamine use disorder (AUD) and mortality among new users of stimulant medications. The investigators concluded that in their cohort comorbid substance use disorders were common and were risk factors for development of (AUD).
AHRQ-funded; HS022418.
Citation: Westover AN, Nakonezny PA, Halm EA .
Risk of amphetamine use disorder and mortality among incident users of prescribed stimulant medications in the Veterans Administration.
Addiction 2018 May;113(5):857-67. doi: 10.1111/add.14122..
Keywords: Substance Abuse, Medication, Risk, Mortality, Patient-Centered Outcomes Research, Outcomes
Ross MM, Arria AM, Brown JP
College students' perceived benefit-to-risk tradeoffs for nonmedical use of prescription stimulants: implications for intervention designs.
This study examined the variation in college students' perceived risks and benefits for nonmedical use of prescription stimulants (NPS). The study findings identified subgroups of college NPS users that could have vastly different trajectories in terms of future drug use and college performance. The authors assert that given this heterogeneity among students regarding perceived risks and benefits of NPS, interventions should be designed to assess motives and provide personalized feedback.
AHRQ-funded; HS022135.
Citation: Ross MM, Arria AM, Brown JP .
College students' perceived benefit-to-risk tradeoffs for nonmedical use of prescription stimulants: implications for intervention designs.
Addict Behav 2018 Apr;79:45-51. doi: 10.1016/j.addbeh.2017.12.002..
Keywords: Medication, Substance Abuse, Young Adults
Cartmell KB, Dooley M, Mueller M
Effect of an evidence-based inpatient tobacco dependence treatment service on 30-, 90-, and 180-day hospital readmission rates.
This study explored the effect of an inpatient tobacco dependence treatment services (TDTS) on 30-, 90-, and 180-day hospital readmissions. The investigators suggest that findings from their study, which are supported by prior studies, provide evidence that delivery of TDTS is a strategy that may help to reduce hospital readmissions.
AHRQ-funded; HS023863.
Citation: Cartmell KB, Dooley M, Mueller M .
Effect of an evidence-based inpatient tobacco dependence treatment service on 30-, 90-, and 180-day hospital readmission rates.
Med Care 2018 Apr;56(4):358-63. doi: 10.1097/mlr.0000000000000884..
Keywords: Evidence-Based Practice, Hospital Readmissions, Substance Abuse, Tobacco Use
Marsh JC, Park K, Lin YA
Gender differences in trends for heroin use and nonmedical prescription opioid use, 2007-2014.
This study uses National Survey on Drug Use and Health (NSDUH) data to study gender differences in trends for heroin use and nonmedical prescription opioid use from 2007-2014. There has been a steady decline in nonmedical prescription heroin use but a notable increase in heroin use during this period for both men and women. However, women are increasing heroin use at a faster rate than men but their nonmedical prescription opioid use is not decreasing as fast as men. The researchers conclude that more study is needed on gender differences in use and treatment access.
AHRQ-funded; HS000084.
Citation: Marsh JC, Park K, Lin YA .
Gender differences in trends for heroin use and nonmedical prescription opioid use, 2007-2014.
J Subst Abuse Treat 2018 Apr;87:79-85. doi: 10.1016/j.jsat.2018.01.001..
Keywords: Medication, Opioids, Sex Factors, Substance Abuse
Chhatre S, Jayadevappa R
Racial and ethnic disparities in substance use disorders and outcomes in elderly prostate cancer patients.
This study used Surveillance, Epidemiology, and End Results (SEER)-Medicare linked data to identify prevalence of substance use among patients with advanced-stage prostate cancer. There are racial and ethnic disparities between substance use and outcomes. A multidisciplinary coordinated care approach is recommended to address these disparities.
AHRQ-funded; HS024106.
Citation: Chhatre S, Jayadevappa R .
Racial and ethnic disparities in substance use disorders and outcomes in elderly prostate cancer patients.
J Ethn Subst Abuse 2018 Apr-Jun;17(2):135-49. doi: 10.1080/15332640.2016.1160019..
Keywords: Cancer: Prostate Cancer, Disparities, Elderly, Outcomes, Racial and Ethnic Minorities, Substance Abuse
Molfenter T, Brown R, O'Neill A
Use of telemedicine in addiction treatment: current practices and organizational implementation characteristics.
Telemedicine applications offer innovative approaches for treating and reducing the effects of substance use disorders (SUDs). This analysis assessed the interest in and use of 11 telemedicine applications in a sample of 363 SUD organizations. The top three self-reported telemedicine applications being used were (1) computerized screening/assessments (44.6 percent), (2) telephone-based recovery supports (29.5 percent), and (3) telephone-based therapy (28.37 percent).
AHRQ-funded; HS024086.
Citation: Molfenter T, Brown R, O'Neill A .
Use of telemedicine in addiction treatment: current practices and organizational implementation characteristics.
Int J Telemed Appl. 2018 Mar 11;2018:3932643. doi: 10.1155/2018/3932643. .
Keywords: Health Information Technology (HIT), Substance Abuse, Telehealth
Tran Smith B, Seaton K, Andrews C
Benefit requirements for substance use disorder treatment in state health insurance exchanges.
This study assessed the extent to which state insurance departments regulate the types of substance use disorder (SUD) treatment that services and medications plans must provide, and also their use of utilization controls. Data were obtained from state insurance departments via an internet-based survey, as part of the National Drug Abuse Treatment System Survey. The results indicate that states vary widely in regulations on qualified health plans’ (QHPs) administration of SUD treatment benefits; some required plans to cover all the SUD treatment services and medications assessed in this study, while others did not require plans to cover any at all. Nearly all states allowed the plans to employ utilization controls, but reported little guidance on their usage. The authors conclude that by not requiring coverage for the entire SUD continuum of care, some states hinder client access to the appropriate types of care needed for recovery.
AHRQ-funded; HS000084.
Citation: Tran Smith B, Seaton K, Andrews C .
Benefit requirements for substance use disorder treatment in state health insurance exchanges.
Am J Drug Alcohol Abuse 2018;44(4):426-30. doi: 10.1080/00952990.2017.111934..
Keywords: Access to Care, Health Insurance, Medication, Policy, Substance Abuse
Heslin KC, Owens PL, Karaca Z
AHRQ Author: Heslin KC; Owens PL; Karaca Z; Elixhauser A
Trends in opioid-related inpatient stays shifted after the US transitioned to ICD-10-CM diagnosis coding in 2015.
This study examines how trend analyses of inpatient stays involving opioid diagnoses were affected by the transition to ICD-10-CM. It found a sharp increase in opioid-related stays overall during the transition to ICD-10-CM. This may indicate that the new classification system is capturing stays that were missed by ICD-9-CM data.
AHRQ-authored.
Citation: Heslin KC, Owens PL, Karaca Z .
Trends in opioid-related inpatient stays shifted after the US transitioned to ICD-10-CM diagnosis coding in 2015.
Med Care 2017 Nov;55(11):918-23. doi: 10.1097/mlr.0000000000000805.
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Keywords: Critical Care, Healthcare Cost and Utilization Project (HCUP), Hospitalization, Opioids, Substance Abuse
Tedesco D, Asch SM, Curtin C
Opioid abuse and poisoning: trends in inpatient and emergency department discharges.
This study analyzed national trends in inpatient and emergency department (ED) discharges for opioid abuse, dependence, and poisoning using Healthcare Cost and Utilization Project data.
AHRQ-funded; HS024096.
Citation: Tedesco D, Asch SM, Curtin C .
Opioid abuse and poisoning: trends in inpatient and emergency department discharges.
Health Aff 2017 Oct;36(10):1748-53. doi: 10.1377/hlthaff.2017.0260..
Keywords: Emergency Department, Healthcare Cost and Utilization Project (HCUP), Hospital Discharge, Opioids, Substance Abuse
McKernan LC, Finn MTM, Carr ER
Personality and affect when the central nervous system is sensitized: an analysis of central sensitization syndromes in a substance use disorder population.
This article examined the impact of central sensitivity syndromes (CSS) on the clinical presentation of individuals presenting to treatment for a substance use disorder (SUD), with an emphasis on personality and emotional functioning. Exploratory analyses indicated which personality traits most strongly predicted the presence of CSS. The authors discuss these findings using descriptive psychopathology literature, with recommendations for future research.
AHRQ-funded; HS022990.
Citation: McKernan LC, Finn MTM, Carr ER .
Personality and affect when the central nervous system is sensitized: an analysis of central sensitization syndromes in a substance use disorder population.
Psychodyn Psychiatry 2017 Fall;45(3):385-409. doi: 10.1521/pdps.2017.45.3.385..
Keywords: Anxiety, Behavioral Health, Chronic Conditions, Substance Abuse
Young LE, Michaels S, Jonas A
Sex behaviors as social cues motivating social venue patronage among young black men who have sex with men.
This study presents a two-mode network analysis that determines the extent that three types of sex behaviors-condomless sex, sex-drug use, and group sex-influence the patronage of different types of social venues among a population sample of young Black men who have sex with men. Its findings demonstrate that social venues can function as intermediary contexts in which relationships can form between individuals that have greater risk potential.
AHRQ-funded; HS000084.
Citation: Young LE, Michaels S, Jonas A .
Sex behaviors as social cues motivating social venue patronage among young black men who have sex with men.
AIDS Behav 2017 Oct;21(10):2924-34. doi: 10.1007/s10461-017-1679-8.
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Keywords: Lifestyle Changes, Human Immunodeficiency Virus (HIV), Racial and Ethnic Minorities, Substance Abuse
Balbale SN, Trivedi I, O'Dwyer LC
Strategies to identify and reduce opioid misuse among patients with gastrointestinal disorders: a systematic scoping review.
In this study, the investigators conducted a systematic scoping review to describe published scientific literature on strategies to identify and reduce opioid misuse among patients with gastrointestinal (GI) symptoms and disorders. They concluded that prescription drug monitoring and self-management interventions may be promising strategies to identify and reduce opioid misuse in GI care. They suggest that rigorous, empirical research is needed to evaluate the longer-term impact of these strategies.
AHRQ-funded; HS000084.
Citation: Balbale SN, Trivedi I, O'Dwyer LC .
Strategies to identify and reduce opioid misuse among patients with gastrointestinal disorders: a systematic scoping review.
Dig Dis Sci 2017 Oct;62(10):2668-85. doi: 10.1007/s10620-017-4705-9..
Keywords: Behavioral Health, Chronic Conditions, Digestive Disease and Health, Medication, Medication: Safety, Opioids, Patient Self-Management, Prevention, Substance Abuse
Friedman S, Xu H, Harwood JM
The Mental Health Parity and Addiction Equity Act evaluation study: impact on specialty behavioral healthcare utilization and spending among enrollees with substance use disorders.
The purpose of this study was to determine whether Mental Health Parity and Addiction Equity Act (MHPAEA) was associated with increased behavioral health expenditures and utilization among a population with substance use disorder (SUD) diagnoses. The investigators found that MHPAEA was associated with modest increases in total, plan, and patient out-of-pocket spending and outpatient and inpatient utilization.
AHRQ-funded; HS024866.
Citation: Friedman S, Xu H, Harwood JM .
The Mental Health Parity and Addiction Equity Act evaluation study: impact on specialty behavioral healthcare utilization and spending among enrollees with substance use disorders.
J Subst Abuse Treat 2017 Sep;80:67-78. doi: 10.1016/j.jsat.2017.06.006..
Keywords: Behavioral Health, Healthcare Costs, Healthcare Utilization, Health Insurance, Policy, Health Services Research (HSR), Substance Abuse
Chhatre S, Cook R, Mallik E
Trends in substance use admissions among older adults.
Researchers sought to analyze the trends in admissions for substance abuse treatment among older adults (aged 55 and older). Substantial changes in the demographic, substance use pattern, and treatment characteristics for the older adult admissions were noted. The proportion of admissions for following primary substances showed increase: cocaine/crack, marijuana/hashish, heroin, non-prescription methadone, and other opiates and synthetics.
AHRQ-funded; HS024106.
Citation: Chhatre S, Cook R, Mallik E .
Trends in substance use admissions among older adults.
BMC Health Serv Res 2017 Aug 22;17(1):584. doi: 10.1186/s12913-017-2538-z.
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Keywords: Behavioral Health, Elderly, Hospitalization, Opioids, Substance Abuse
Horton M, McDonald R, Green TC
A mapping review of take-home naloxone for people released from correctional settings.
The objective of this review is to map research into take-home naloxone (THN) for people released from correctional settings in order to identify further research needs. It concluded that the feasibility of THN in the context of release from a correctional setting has been established, but there is a need for rigorous research into health outcomes and program implementation.
AHRQ-funded; HS024021.
Citation: Horton M, McDonald R, Green TC .
A mapping review of take-home naloxone for people released from correctional settings.
Int J Drug Policy 2017 Aug;46:7-16. doi: 10.1016/j.drugpo.2017.05.015.
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Keywords: Adverse Drug Events (ADE), Medication, Opioids, Substance Abuse, Vulnerable Populations
Bersamira CS, Lin YA, Park K
Drug use among Asian Americans: Differentiating use by acculturation status and gender.
This study examined past-year drug use among Asian Americans with respect to ethnic subgroup, acculturation, and gender differences. Survey data were collected during the National Latino and Asian American Survey, a national epidemiological household survey of behavioral health prevalence and service utilization rates. The investigators indicate that findings suggest the need to better understand the heterogeneous character of Asian American drug use when considering the provision of culturally competent and linguistically appropriate prevention and treatment services.
AHRQ-funded; HS000084.
Citation: Bersamira CS, Lin YA, Park K .
Drug use among Asian Americans: Differentiating use by acculturation status and gender.
J Subst Abuse Treat 2017 Aug;79:76-81. doi: 10.1016/j.jsat.2017.06.002..
Keywords: Racial and Ethnic Minorities, Sex Factors, Substance Abuse
Carroll JJ, Marshall BDL, Rich JD
Exposure to fentanyl-contaminated heroin and overdose risk among illicit opioid users in Rhode Island: a mixed methods study.
This study describes patterns and perceptions of fentanyl exposure among opioid users in Rhode Island. It concluded that among illicit opioid users in Rhode Island, known or suspected fentanyl exposure is common, yet demand for fentanyl is low. Fentanyl-contaminated drugs are generating user interest in effective risk mitigation strategies, including treatment.
AHRQ-funded; HS024021.
Citation: Carroll JJ, Marshall BDL, Rich JD .
Exposure to fentanyl-contaminated heroin and overdose risk among illicit opioid users in Rhode Island: a mixed methods study.
Int J Drug Policy 2017 Aug;46:136-45. doi: 10.1016/j.drugpo.2017.05.023.
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Keywords: Opioids, Substance Abuse, Medication, Adverse Drug Events (ADE)
Olfson M, Wall M, Wang S
Service use preceding opioid-related fatality.
The authors analyzed health service patterns before opioid-related death among nonelderly individuals in the Medicaid program, focusing on decedents with and without past-year diagnoses of non-cancer chronic pain. They found that persons dying of opioid-related causes, particularly those who were diagnosed with chronic pain conditions, commonly received services related to drug use disorders and mental disorders in the last year of life, though opioid use disorder diagnoses near the time of death were rare.
AHRQ-funded; HS021112.
Citation: Olfson M, Wall M, Wang S .
Service use preceding opioid-related fatality.
Am J Psychiatry 2017 Jun;175(6):538-44. doi: 10.1176/appi.ajp.2017.17070808.
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Keywords: Chronic Conditions, Opioids, Medicaid, Mortality, Substance Abuse
Kazemi DM, Borsari B, Levine MJ
A systematic review of the mhealth interventions to prevent alcohol and substance abuse.
This systematic review evaluated the recent body of research on mHealth-based interventions for substance use, with aims of (a) examining the functionality and effectiveness of these interventions, (b) evaluating the available research on the effectiveness of these interventions for substance use, and (c) evaluating the design, methodology, results, theoretical grounding, limitations, and implications of each study.
AHRQ-funded; HS023875.
Citation: Kazemi DM, Borsari B, Levine MJ .
A systematic review of the mhealth interventions to prevent alcohol and substance abuse.
J Health Commun 2017 May;22(5):413-32. doi: 10.1080/10810730.2017.1303556.
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Keywords: Alcohol Use, Prevention, Substance Abuse, Telehealth, Young Adults
Kozhimannil KB, Graves AJ, Jarlenski M
Non-medical opioid use and sources of opioids among pregnant and non-pregnant reproductive-aged women.
This study characterized non-medical use (NMU) of prescription opioids among reproductive-age U.S. women, with a focus on pregnancy status. Nearly 1 percent of pregnant women and 2.3 percent of non-pregnant reproductive-age women reported opioid NMU in the past 30 days. Forty-six percent of pregnant women identified a doctor as their source compared with 27.6 percent of non-pregnant women reporting NMU.
AHRQ-funded; HS000029.
Citation: Kozhimannil KB, Graves AJ, Jarlenski M .
Non-medical opioid use and sources of opioids among pregnant and non-pregnant reproductive-aged women.
Drug Alcohol Depend 2017 May 1;174:201-08. doi: 10.1016/j.drugalcdep.2017.01.003.
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Keywords: Medication, Opioids, Pregnancy, Substance Abuse, Women