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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 15 of 15 Research Studies DisplayedChing JH, Owens DK, Trafton JA
Impact of treatment duration on mortality among Veterans with opioid use disorder in the United States Veterans Health Administration.
This study used simulation of a Veterans Health Administration cohort to identify the opioid use disorder (OUD) treatment durations necessary for the elevated mortality risks during treatment transitions balanced by reductions in mortality while receiving medication-assisted treatment (MAT) with methadone or buprenorphine. A simulated cohort of 10,000 individuals with OUD was created by using parameters obtained through calibration and published meta-analyses of studies from North America, Europe, and Australia. Methadone treatment for 4 months or longer or buprenorphine for 2 months or longer resulted in 54 and 65 fewer deaths relative to not receiving MAT for the same duration. The authors estimated shorter treatment durations necessary to achieve net mortality benefits of 2 months or longer for methadone and 1 month or longer for buprenorphine. Necessary treatment increased more with smaller mortality reductions on treatment with larger relative risks during treatment transitions.
AHRQ-funded; HS027935; HS026128.
Citation: Ching JH, Owens DK, Trafton JA .
Impact of treatment duration on mortality among Veterans with opioid use disorder in the United States Veterans Health Administration.
Addiction 2021 Dec;116(12):3494-503. doi: 10.1111/add.15574.
AHRQ-funded; HS027935; HS026128..
AHRQ-funded; HS027935; HS026128..
Keywords: Opioids, Substance Abuse, Behavioral Health, Mortality
Rogal S, Youk A, Agbalajobi O
Medication treatment of active opioid use disorder in veterans with cirrhosis.
Although opioid use disorder (OUD) is common in patients with cirrhosis, it is unclear how medication treatment for OUD (MOUD) is used in this population. In this study, the investigators aimed to assess the factors associated with MOUD and mortality in a cohort of Veterans with cirrhosis and OUD. The investigators found that few Veterans with active OUD and cirrhosis received MOUD, and those with alcohol use disorder, schizophrenia, and previous prescriptions for opioids were least likely to receive these effective therapies.
AHRQ-funded; HS019461.
Citation: Rogal S, Youk A, Agbalajobi O .
Medication treatment of active opioid use disorder in veterans with cirrhosis.
Am J Gastroenterol 2021 Jul;116(7):1406-13. doi: 10.14309/ajg.0000000000001228..
Keywords: Opioids, Substance Abuse, Medication
Clair K, Ijadi-Maghsoodi R, Nazinyan M
Veteran perspectives on adaptations to a VA residential rehabilitation program for substance use disorders during the novel coronavirus pandemic.
This paper looks at veterans’ perspectives on adaptations made to a VA residential rehabilitation program for substance use disorders during the novel coronavirus pandemic. Adaptations to services are described within a large residential rehabilitation program for under-resourced veterans; reports veterans’ experiences; and outlines successes and challenges encountered. Data was collected from two focus groups with nine veterans in the program. The groups highlighted experiences of inconsistent communication about residential policies, interruptions to medical and addiction services, and feelings of confinement and social isolation.
AHRQ-funded; HS026407.
Citation: Clair K, Ijadi-Maghsoodi R, Nazinyan M .
Veteran perspectives on adaptations to a VA residential rehabilitation program for substance use disorders during the novel coronavirus pandemic.
Community Ment Health J 2021 Jul;57(5):801-07. doi: 10.1007/s10597-021-00810-z..
Keywords: Substance Abuse, Rehabilitation, COVID-19, Healthcare Delivery, Access to Care, Patient Experience
Lewis JA, Senft N, Chen H
Evidence-based smoking cessation treatment: a comparison by healthcare system.
The authors surveyed general medicine providers and specialists in a large academic health center (AHC) and its affiliated Veterans Health Administration (VHA) in the Mid-South in 2017 to determine the cross-sectional association of healthcare system in which the provider practiced (AHC versus VHA) with self-reported provision of evidence-based smoking cessation treatment at least once in the past 12 months. They found that VHA healthcare providers were significantly more likely to provide evidence-based smoking cessation treatment compared to AHC healthcare providers.
AHRQ-funded; HS026122.
Citation: Lewis JA, Senft N, Chen H .
Evidence-based smoking cessation treatment: a comparison by healthcare system.
BMC Health Serv Res 2021 Jan 7;21(1):33. doi: 10.1186/s12913-020-06016-5..
Keywords: Health Systems, Tobacco Use: Smoking Cessation, Tobacco Use, Evidence-Based Practice, Substance Abuse
Rogal S, Youk A, Zhang H
Impact of alcohol use disorder treatment on clinical outcomes among patients with cirrhosis.
Despite significant medical and economic consequences of coexisting alcohol use disorder (AUD) in patients with cirrhosis, little is known about AUD treatment patterns and their impact on clinical outcomes in this population. In this study the investigators aimed to characterize the use of and outcomes associated with AUD treatment in patients with cirrhosis. This retrospective cohort study included Veterans with cirrhosis who received Veterans Health Administration (VA) care and had an index diagnosis of AUD between 2011 and 2015.
AHRQ-funded; HS019461.
Citation: Rogal S, Youk A, Zhang H .
Impact of alcohol use disorder treatment on clinical outcomes among patients with cirrhosis.
Hepatology 2020 Jun;71(6):2080-92. doi: 10.1002/hep.31042..
Keywords: Alcohol Use, Substance Abuse, Patient-Centered Outcomes Research, Outcomes
Hernandez-Boussard T, Graham LA, Carroll I
Perioperative opioid use and pain-related outcomes in the Veterans Health Administration.
This study characterized perioperative exposure to morphine and its association with postoperative pain and 30-day readmissions. Utilizing nationwide Veterans Healthcare Administration (VHA) data on four high-volume surgical procedures, the researchers found that patients receiving high perioperative oral morphine equivalents were more likely to return to care for pain-related problems.
AHRQ-funded; HS024096.
Citation: Hernandez-Boussard T, Graham LA, Carroll I .
Perioperative opioid use and pain-related outcomes in the Veterans Health Administration.
Am J Surg 2020 Jun;219(6):969-75. doi: 10.1016/j.amjsurg.2019.06.022..
Keywords: Opioids, Medication, Pain, Substance Abuse, Surgery, Hospital Readmissions
BJ BJ, McGinnis KA, Edelman EJ
Predictors of initiation of and retention on medications for alcohol use disorder among people living with and without HIV.
Researchers examined predictors of medications for alcohol use disorder initiation and retention across HIV status. Data from the Veterans Aging Cohort Study data was used to identify new alcohol use disorder diagnoses among 163,339 individuals from 1998 to 2015. The researchers found that the low frequency of retention precluded multivariable analyses for retention. They concluded that, for people living with HIV and uninfected individuals, targeted implementation strategies to expand medications for alcohol use disorder are needed, particularly for specific subpopulations.
AHRQ-funded; HS021112.
Citation: BJ BJ, McGinnis KA, Edelman EJ .
Predictors of initiation of and retention on medications for alcohol use disorder among people living with and without HIV.
J Subst Abuse Treat 2020 Feb;109:14-22. doi: 10.1016/j.jsat.2019.11.002..
Keywords: Alcohol Use, Substance Abuse, Medication, Human Immunodeficiency Virus (HIV)
Rentsch CT, Edelman EJ, Justice AC
Patterns and correlates of prescription opioid receipt among US Veterans: a national, 18-year observational cohort study.
A better understanding of predisposition to transition to high-dose, long-term opioid therapy after initial opioid receipt could facilitate efforts to prevent opioid use disorder (OUD). In this study, the investigators extracted data on 69,268 patients in the Veterans Aging Cohort Study who received any opioid prescription between 1998 and 2015. They identified four distinguishable dose trajectories. The authors indicate that their measures could potentially be used in future prevention research, including genetic discovery.
AHRQ-funded; HS021112; HS023258.
Citation: Rentsch CT, Edelman EJ, Justice AC .
Patterns and correlates of prescription opioid receipt among US Veterans: a national, 18-year observational cohort study.
AIDS Behav 2019 Dec;23(12):3340-49. doi: 10.1007/s10461-019-02608-3..
Keywords: Opioids, Medication, Substance Abuse, Human Immunodeficiency Virus (HIV), Pain, Chronic Conditions
Barry DT, Marshall BDL, Becker WC
Duration of opioid prescriptions predicts incident nonmedical use of prescription opioids among U.S. veterans receiving medical care.
Although nonmedical use of prescription opioids (NMUPO) is a public health problem, few studies have examined the new-onset NMUPO in clinical populations. This prospective cohort study estimated NMUPO incidence among veterans in medical care who had received prescription opioid medication and examined correlates of new-onset NMUPO. The investigators concluded that duration of prescription opioid receipt was a risk factor for incident NMUPO among veterans receiving medical care.
AHRQ-funded; HS021112; HS023258.
Citation: Barry DT, Marshall BDL, Becker WC .
Duration of opioid prescriptions predicts incident nonmedical use of prescription opioids among U.S. veterans receiving medical care.
Drug Alcohol Depend 2018 Oct 1;191:348-54. doi: 10.1016/j.drugalcdep.2018.07.008..
Keywords: Medication, Opioids, 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
Bensley KM, Harris AH, Gupta S
Racial/ethnic differences in initiation of and engagement with addictions treatment among patients with alcohol use disorders in the Veterans Health Administration.
In this study, the researchers investigated racial/ethnic variation in initiation of and engagement with specialty addictions treatment in a national sample of Black, Hispanic, and White patients with clinically recognized alcohol use disorders (AUD) from the US Veterans Health Administration (VA). The investigators found, after accounting for facility- and patient-level characteristics, Black and Hispanic patients with AUD were more likely than Whites to initiate specialty addictions treatment, and Black patients were more likely than Whites to engage.
AHRQ-funded; HS013853.
Citation: Bensley KM, Harris AH, Gupta S .
Racial/ethnic differences in initiation of and engagement with addictions treatment among patients with alcohol use disorders in the Veterans Health Administration.
J Subst Abuse Treat 2017 Feb;73:27-34. doi: 10.1016/j.jsat.2016.11.001..
Keywords: Alcohol Use, Racial and Ethnic Minorities, Substance Abuse
Banerjee G, Edelman EJ, Barry DT
Non-medical use of prescription opioids is associated with heroin initiation among US veterans: a prospective cohort study.
The researchers estimated the influence of non-medical use of prescription opioids on heroin initiation among US veterans receiving medical care. Using a multivariable Cox regression model, they found that non-medical use of prescription opioids was associated positively and independently with heroin initiation.
AHRQ-funded; HS021112; HS023258.
Citation: Banerjee G, Edelman EJ, Barry DT .
Non-medical use of prescription opioids is associated with heroin initiation among US veterans: a prospective cohort study.
Addiction 2016 Nov;111(11):2021-31. doi: 10.1111/add.13491.
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Keywords: Medication, Opioids, Substance Abuse
Clark BJ, Rubinsky AD, Ho PM
Alcohol screening scores and the risk of intensive care unit admission and hospital readmission.
This study sought to determine whether alcohol misuse was associated with admission to an intensive care unit (ICU) among patients receiving outpatient care. Among 486,115 veterans receiving outpatient care, the adjusted probability of ICU admission within 1 year was 2.0 percent for abstinent patients, 1.6 percent for patients with lower-risk alcohol use, 1.8 percent for patients with moderate alcohol misuse, and 2.5 percent for patients with severe alcohol misuse.
AHRQ-funded; HS022800.
Citation: Clark BJ, Rubinsky AD, Ho PM .
Alcohol screening scores and the risk of intensive care unit admission and hospital readmission.
Subst Abus 2016 Jul-Sep;37(3):466-73. doi: 10.1080/08897077.2015.1137259.
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Keywords: Alcohol Use, Hospital Readmissions, Intensive Care Unit (ICU), Ambulatory Care and Surgery, Screening, Substance Abuse
Chavez LJ, Williams EC, Lapham GT
Changes in patient-reported alcohol-related advice following veterans health administration implementation of brief alcohol interventions.
The researchers examined whether an independent measure of brief interventions-patient-reported alcohol-related advice-also increased among VA outpatients who screened positive for alcohol misuse on a mailed survey. They found that among patients with alcohol misuse, the adjusted prevalence of alcohol-related advice increased from 40.4% in 2007 to 55.5% in 2011. Rates of alcohol-related advice increased significantly each year except the last.
AHRQ-funded; HS022800.
Citation: Chavez LJ, Williams EC, Lapham GT .
Changes in patient-reported alcohol-related advice following veterans health administration implementation of brief alcohol interventions.
J Stud Alcohol Drugs 2016 May;77(3):500-8.
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Keywords: Alcohol Use, Behavioral Health, Primary Care, Substance Abuse
Heslin KC, Gable A, Dobalian A
AHRQ Author: Heslin KC
Special services for women in substance use disorders treatment: how does the Department of Veterans Affairs compare with other providers?
The researchers examined the prevalence of programs and key services for women in VA facilities in a survey of 14,311 substance use disorder treatment facilities. Approximately 31 percent of facilities had special programs exclusively for women. Although the VA had the lowest prevalence of programs for women, at 19.1 percent, it offered a significantly higher average number of key services for women.
AHRQ-authored.
Citation: Heslin KC, Gable A, Dobalian A .
Special services for women in substance use disorders treatment: how does the Department of Veterans Affairs compare with other providers?
Womens Health Issues 2015 Nov-Dec;25(6):666-72. doi: 10.1016/j.whi.2015.07.005.
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Keywords: Substance Abuse, Women, Healthcare Delivery