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Research Studies is a monthly compilation of research articles funded by AHRQ or authored by AHRQ researchers and recently published in journals or newsletters.
Results1 to 7 of 7 Research Studies Displayed
Iroz CB, Dahl CM, Cassimatis IR
Prophylactic anticoagulation for preterm premature rupture of membranes: a decision analysis.
The objective of this study was to determine the optimal modality for venous thromboembolism prophylaxis during hospitalization for preterm premature rupture of membranes using a decision analysis model. The investigators concluded that their results did not support the routine use of prophylactic anticoagulation in women admitted to the hospital for preterm premature rupture of membranes.
Citation: Iroz CB, Dahl CM, Cassimatis IR . Prophylactic anticoagulation for preterm premature rupture of membranes: a decision analysis. Am J Obstet Gynecol MFM 2021 May;3(3):100311. doi: 10.1016/j.ajogmf.2021.100311..
Keywords: Blood Clots, Blood Thinners, Prevention, Decision Making, Pregnancy, Maternal Care, Inpatient Care, Women, Medication
Brand-McCarthy SR, Delaney RK, Noseworthy PA
Can shared decision making improve stroke prevention in atrial fibrillation?: Implications of the updated guidelines.
This paper discusses the need for shared decision making (SDM) in atrial fibrillation (AF) patients not just at the beginning of treatment but throughout during ongoing care. Use of SDM can help with patient adherence to recommended anticoagulation treatment regimens and lifestyle changes. It can help build a strong partnership between clinician and patient.
Citation: Brand-McCarthy SR, Delaney RK, Noseworthy PA . Can shared decision making improve stroke prevention in atrial fibrillation?: Implications of the updated guidelines. Circ Cardiovasc Qual Outcomes 2020 Mar;13(3):e006080. doi: 10.1161/circoutcomes.119.006080..
Keywords: Decision Making, Stroke, Heart Disease and Health, Cardiovascular Conditions, Prevention, Guidelines, Blood Thinners, Medication, Clinician-Patient Communication, Communication
Antiplatelets, anticoagulants, and colonoscopic polypectomy.
This article is a review of current best practice recommendations focusing on the risk of immediate and delayed postpolypectomy bleeding in the context of drug discontinuation or continuation of antiplatelet and anticoagulant drugs. Data was assessed whether cold snare vs conventional thermal-based polypectomy technology and prophylactic placement of hemostatic clips are endoscopic techniques that are beneficial in reducing polypectomy bleeding. Clinical takeaways are also provided to facilitate safer polypectomy among patients on antiplatelet and anticoagulant agents.
Citation: Abraham NS . Antiplatelets, anticoagulants, and colonoscopic polypectomy. Gastrointest Endosc 2020 Feb;91(2):257-65. doi: 10.1016/j.gie.2019.09.033..
Keywords: Blood Thinners, Medication, Medication: Safety, Colonoscopy, Adverse Drug Events (ADE), Adverse Events, Guidelines, Prevention, Patient Safety
Wang SV, Huybrechts KF, Fischer MA
Generalized boosted modeling to identify subgroups where effect of dabigatran versus warfarin may differ: an observational cohort study of patients with atrial fibrillation.
The purpose of this study was to explore generalized boosted modeling (GBM) as a method for identifying subgroups with greater benefit or harm with dabigatran versus warfarin for treatment of atrial fibrillation. The investigators concluded that dabigatran's superiority to warfarin at prevention of thromboembolism may be greater in secondary than primary prevention. They indicated that in practice, secondary prevention patients are more often treated with warfarin.
Citation: Wang SV, Huybrechts KF, Fischer MA . Generalized boosted modeling to identify subgroups where effect of dabigatran versus warfarin may differ: an observational cohort study of patients with atrial fibrillation. Pharmacoepidemiol Drug Saf 2018 Apr;27(4):383-90. doi: 10.1002/pds.4395..
Keywords: Blood Clots, Blood Thinners, Cardiovascular Conditions, Comparative Effectiveness, Evidence-Based Practice, Heart Disease and Health, Medication, Outcomes, Patient-Centered Outcomes Research, Prevention
Lau BD, Streiff MB, Kraus PS
Missed doses of venous thromboembolism (VTE) prophylaxis at community hospitals: cause for alarm.
This study examined the rate of missed doses of venous thromboembolism (VTE) prophylaxis at community hospitals in the Washington, DC and greater Baltimore metropolitan areas. This retrospective study included four hospitals within the Johns Hopkins Health System. Non-administration of VTE prophylaxis was found 10.9% to 15.0% of the time among the three community hospitals. About 43.6% of patients missed at least one dose in all four hospitals. The investigators weren’t able to categorize patients by specialty, however it has been reported that more doses are missed with medically ill patients than other hospitalized patients.
Citation: Lau BD, Streiff MB, Kraus PS . Missed doses of venous thromboembolism (VTE) prophylaxis at community hospitals: cause for alarm. J Gen Intern Med 2018 Jan;33(1):19-20. doi: 10.1007/s11606-017-4203-y..
Keywords: Blood Clots, Prevention, Blood Thinners, Patient Adherence/Compliance, Medication, Hospitals
Jones CE, Hollis RH, Gullick AA
Venous thromboembolic events: how low can you go?
This study evaluated postoperative venous thromboembolism (VTE) chemical prophylaxis adherence to assess the preventability of VTEs. It found that nearly half of patients who experienced postoperative VTEs received appropriate guideline-driven care. Most interruptions in chemical prophylaxis were justified medically. This further questions the preventability of postoperative VTEs and the utility of this outcome as a valid measure of hospital quality.
Citation: Jones CE, Hollis RH, Gullick AA . Venous thromboembolic events: how low can you go? Am J Surg 2017 Apr;213(4):706-10. doi: 10.1016/j.amjsurg.2016.10.037.
Keywords: Adverse Events, Blood Clots, Blood Thinners, Patient-Centered Outcomes Research, Prevention
Metersky ML, Eldridge N, Wang Y
AHRQ Author: Eldridge N
Predictors of warfarin-associated adverse events in hospitalized patients: Opportunities to prevent patient harm.
The researchers assessed the relationship between daily versus less frequent international normalized ratio ( INR) monitoring and overanticoagulation and warfarin-related adverse events. They bconcluded that daily INR measurement and recognition of a rapidly rising INR might decrease the frequency of warfarin-associated adverse events in hospitalized patients.
AHRQ-authored; AHRQ-funded; 290201200003C.
Citation: Metersky ML, Eldridge N, Wang Y . Predictors of warfarin-associated adverse events in hospitalized patients: Opportunities to prevent patient harm. J Hosp Med 2016 Apr;11(4):276-82. doi: 10.1002/jhm.2528.
Keywords: Blood Thinners, Care Management, Adverse Drug Events (ADE), Patient Safety, Hospitalization, Prevention