National Healthcare Quality and Disparities Report
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Search All Research Studies
Topics
- Adverse Drug Events (ADE) (7)
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- Opioids (2)
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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 16 of 16 Research Studies DisplayedWong CI, Vannatta K, Gilleland Marchak J
Preventable harm because of outpatient medication errors among children with leukemia and lymphoma: a multisite longitudinal assessment.
The goal of this longitudinal study was to characterize rates and types of medication errors and harm to outpatient children with leukemia and lymphoma over seven months of treatment. The study included children taking medications at home for leukemia or lymphoma from three pediatric cancer centers. Ten percent experienced adverse drug events because of outpatient medication errors. Twenty-six percent of caregivers reported miscommunication leading to missed doses or overdoses. The authors concluded that improvements addressing communication with and among caregivers should be based on human-factors engineering and codeveloped with families.
AHRQ-funded; HS024390.
Citation: Wong CI, Vannatta K, Gilleland Marchak J .
Preventable harm because of outpatient medication errors among children with leukemia and lymphoma: a multisite longitudinal assessment.
Cancer 2023 Apr 1;129(7):1064-74. doi: 10.1002/cncr.34651.
Keywords: Children/Adolescents, Cancer, Adverse Drug Events (ADE), Adverse Events, Medical Errors, Ambulatory Care and Surgery, Medication: Safety, Patient Safety
Ramsden SC, Pergjika A, Janssen AC
A systematic review of the effectiveness and safety of droperidol for pediatric agitation in acute care settings.
This systematic review evaluated the effectiveness and safety of droperidol for the management of acute, severe agitation in children in acute care settings. The authors conclude that existing data indicate that droperidol is both effective and safe; however, data are limited by study designs that may introduce bias.
AHRQ-funded; HS026385.
Citation: Ramsden SC, Pergjika A, Janssen AC .
A systematic review of the effectiveness and safety of droperidol for pediatric agitation in acute care settings.
Acad Emerg Med 2022 Dec;29(12):1466-74. doi: 10.1111/acem.14515..
Keywords: Children/Adolescents, Medication, Medication: Safety, Intensive Care Unit (ICU), Patient Safety
Mackie TI, Kovacs KM, Simmel C
A best-worst scaling experiment to identify patient-centered claims-based outcomes for evaluation of pediatric antipsychotic monitoring programs.
This study utilized a best-worst scaling (BWS) experiment to identify the claims-based outcomes that matter most to patients and other relevant parties when evaluating pediatric antipsychotic monitoring programs, specifically in foster care children. Relevant parties included policymakers (n = 31), foster care alumni (n = 28), caseworkers (n=23), prescribing clinicians (n = 32), and caregivers (n = 18). Participants received surveys with a scenario on antipsychotic monitoring programs and ranked 11 candidate claims-based outcomes as most and least important. Safety indicators ranked among the top three candidate outcomes across respondent groups. Foster care alumni put “antipsychotic treatment reduction” and “increased psychosocial treatment” as the highest ranking. Caseworkers, prescribers, and caregivers gave top priority to “increased follow-up after treatment initiation”. Potential unintended consequences ranked lowest, including increased use of other psychotropic medication classes, increased psychiatric hospital stays, and increased emergency room utilization.
AHRQ-funded; HS026001.
Citation: Mackie TI, Kovacs KM, Simmel C .
A best-worst scaling experiment to identify patient-centered claims-based outcomes for evaluation of pediatric antipsychotic monitoring programs.
Health Serv Res 2021 Jun;56(3):418-31. doi: 10.1111/1475-6773.13610..
Keywords: Children/Adolescents, Medication, Medication: Safety, Patient Safety, Policy
Horton DB, Xie F, Chen L
Oral glucocorticoids and incident treatment of diabetes mellitus, hypertension, and venous thromboembolism in children.
The purpose of this study was to quantify rates of incident treatment for diabetes mellitus, hypertension, and venous thromboembolism (VTE) associated with oral glucocorticoid exposure in children aged 1-18 years. Participants were identified using US Medicaid claims data and included more than 930,000 children diagnosed with autoimmune diseases or a nonimmune comparator condition. Findings showed strong dose-dependent relationships between current glucocorticoid exposure and all outcomes, suggesting strong relative risks, but low absolute risks, of newly-treated VTE, diabetes, and especially hypertension in children taking high-dose oral glucocorticoids.
AHRQ-funded; HS021110.
Citation: Horton DB, Xie F, Chen L .
Oral glucocorticoids and incident treatment of diabetes mellitus, hypertension, and venous thromboembolism in children.
Am J Epidemiol 2021 Feb 1;190(3):403-12. doi: 10.1093/aje/kwaa197..
Keywords: Children/Adolescents, Diabetes, Chronic Conditions, Blood Clots, Medication: Safety, Medication, Adverse Drug Events (ADE), Adverse Events, Risk, Patient Safety, Blood Pressure
Toce MS, Michelson K, Hudgins J
Association of state-level opioid-reduction policies with pediatric opioid poisoning.
Opioid-reduction policies have been enacted by US states to address the opioid epidemic. Evidence of an association between policy implementation and decreased rates of pediatric opioid poisoning provides further justification for expanded implementation of these policies. The purpose of this study was to examine the association of 3 state-level opioid-reduction policies with the rate of opioid poisoning in children and adolescents.
AHRQ-funded; HS026503.
Citation: Toce MS, Michelson K, Hudgins J .
Association of state-level opioid-reduction policies with pediatric opioid poisoning.
JAMA Pediatr 2020 Oct;174(10):961-68. doi: 10.1001/jamapediatrics.2020.1980..
Keywords: Children/Adolescents, Opioids, Medication: Safety, Medication, Adverse Drug Events (ADE), Adverse Events, Patient Safety, Policy
Vyles D, Antoon JW, Norton A
Children with reported penicillin allergy: public health impact and safety of delabeling.
The objectives of this study were to: 1.) Review the relevant literature related to children with reported penicillin allergy 2.) Highlight the different ways in which children could be delabeled and 3.) Evaluate the public health impact that a penicillin allergy has for children. The investigators concluded that penicillin allergy was overdiagnosed, often incorrectly, and the label was frequently first applied during childhood.
AHRQ-funded; HS026395.
Citation: Vyles D, Antoon JW, Norton A .
Children with reported penicillin allergy: public health impact and safety of delabeling.
Ann Allergy Asthma Immunol 2020 Jun;124(6):558-65. doi: 10.1016/j.anai.2020.03.012..
Keywords: Children/Adolescents, Medication, Medication: Safety, Patient Safety, Adverse Drug Events (ADE), Adverse Events, Public Health
Johnson MD, Zorc JJ, Nelson DS
Intravenous magnesium in asthma pharmacotherapy: variability in use in the PECARN Registry.
Researchers examined the use, efficacy, and safety of intravenous magnesium sulfate (IVMg) in children with asthma whose emergency department (ED) management is recorded in the Pediatric Emergency Care Applied Research Network (PECARN) Registry. They found that, in PECARN Registry EDs, administration of IVMg occurred late in ED treatment, for a minority of the children likely to benefit, with variation between sites, which suggested the current clinical role for IVMg in preventing hospitalization was limited. Discharge after IVMg administration would likely be safe. They recommended further research to assess the efficacy and safety of early IVMg administration.
AHRQ-funded; HS020270.
Citation: Johnson MD, Zorc JJ, Nelson DS .
Intravenous magnesium in asthma pharmacotherapy: variability in use in the PECARN Registry.
J Pediatr 2020 May;220:165-74.e2. doi: 10.1016/j.jpeds.2020.01.062..
Keywords: Children/Adolescents, Asthma, Medication, Emergency Department, Registries, Treatments, Patient Safety, Medication: Safety
Hayden JD, Horter L, Parsons T
Metabolic monitoring rates of youth treated with second-generation antipsychotics in usual care: results of a large US national commercial health plan.
Researchers examined metabolic monitoring rates in commercially insured children and adolescents treated with a second-generation antipsychotic (SGA) during calendar years (CYs) 2016 and 2017. They concluded that, given the known potential for adverse cardiometabolic effects, rates of metabolic monitoring associated with SGA use in children and adolescents urgently need to be improved. They recommended determining barriers to routine monitoring, particularly of lipids, and developing interventions to enhance metabolic monitoring.
AHRQ-funded; HS026001.
Citation: Hayden JD, Horter L, Parsons T .
Metabolic monitoring rates of youth treated with second-generation antipsychotics in usual care: results of a large US national commercial health plan.
J Child Adolesc Psychopharmacol 2020 Mar;30(2):119-22. doi: 10.1089/cap.2019.0087..
Keywords: Children/Adolescents, Medication, Behavioral Health, Medication: Safety, Patient Safety
Bushnell GA, Crystal S, Olfson M
Prescription benzodiazepine use in privately insured U.S. children and adolescents.
The goal of this cohort study was to describe youth initiating prescription benzodiazepine treatment, identify potential indications and prescribing concerns, estimate the duration of treatment by potential indication, and identify factors that predict long-term use. Investigators found that U.S. children and adolescents are prescribed benzodiazepines for various mental health and other medical conditions, many lacking evidence of pediatric efficacy. They concluded that long-term benzodiazepine treatment, concurrent opioid prescriptions, psychotropic use, and prior substance use disorder diagnoses suggest safety risks among some youth prescribed benzodiazepines.
AHRQ-funded; HS026001; HS021112; HS023258.
Citation: Bushnell GA, Crystal S, Olfson M .
Prescription benzodiazepine use in privately insured U.S. children and adolescents.
Am J Prev Med 2019 Dec;57(6):775-85. doi: 10.1016/j.amepre.2019.07.006..
Keywords: Children/Adolescents, Medication, Medication: Safety, Patient Safety
Goswami E, Ogden RK, Bennett WE
Evidence-based development of a nephrotoxic medication list to screen for acute kidney injury risk in hospitalized children.
This paper describes an initiative to develop an evidence-based list of nephrotoxic medications to screen for acute kidney injury (AKI) risk in hospitalized children. This initiative, called the Nephrotoxic Injury Negated by Just-in-time Action quality improvement collaborative, convened a Nephrotoxic Medication (NTMx) Subcommittee composed of pediatric nephrologists, a pharmacist, and a pediatric intensivist. The committee reviewed NTMx lists, conducted a literature review of the disputed medications, and assigned an evidence grade based on the association between nephrotoxicity and the quality of the data. The subcommittee then came to a majority consensus to which medications should be included on the list. The list was presented to the larger collaborative and voted on. This list will be continually updated and voted on annually.
AHRQ-funded; HS023763.
Citation: Goswami E, Ogden RK, Bennett WE .
Evidence-based development of a nephrotoxic medication list to screen for acute kidney injury risk in hospitalized children.
Am J Health Syst Pharm 2019 Oct 30;76(22):1869-74. doi: 10.1093/ajhp/zxz203..
Keywords: Children/Adolescents, Medication: Safety, Medication, Patient Safety, Risk, Evidence-Based Practice, Adverse Drug Events (ADE), Adverse Events
Auger KA, Shah SS, Davis MM
Counting the ways to count medications: the challenges of defining pediatric polypharmacy.
Polypharmacy, the practice of taking multiple medications to manage health conditions, is common for children. Polypharmacy has been linked to a variety of pediatric and adult outcomes, including medication errors and readmission. In this paper, the authors sought consensus on how to count discharge medications through a series of informal interviews with hospitalists, nurses, and parents.
AHRQ-funded; HS024735.
Citation: Auger KA, Shah SS, Davis MM .
Counting the ways to count medications: the challenges of defining pediatric polypharmacy.
J Hosp Med 2019 Aug;14(8):506-07. doi: 10.12788/jhm.3213..
Keywords: Children/Adolescents, Medication, Medication: Safety, Patient Safety, Hospital Discharge, Hospitals
Cook BL, Wang Y, Sonik R
Assessing provider and racial/ethnic variation in response to the FDA antidepressant box warning.
This study analyzed the rate that providers discontinued antidepressants for youth after a 2004 FDA box warning. It was found that prescriptions decreased for White youth but even increased slightly for Black and Latino youth.
AHRQ-funded; HS021486.
Citation: Cook BL, Wang Y, Sonik R .
Assessing provider and racial/ethnic variation in response to the FDA antidepressant box warning.
Health Serv Res 2019 Feb; 54(Suppl 1):255-62. doi: 10.1111/1475-6773.13104..
Keywords: Adverse Drug Events (ADE), Medication, Children/Adolescents, Patient Safety, Racial and Ethnic Minorities, Medication: Safety
Ratwani RM, Savage E, Will A
Identifying electronic health record usability and safety challenges in pediatric settings.
To understand specific usability issues and medication errors in the care of children, the investigators analyzed 9,000 patient safety reports, made in the period 2012-17, from three different health care institutions that were likely related to EHR use. They found: the general pattern of usability challenges and medication errors were the same across the three sites; the most common usability challenges were associated with system feedback and the visual display; and the most common medication error was improper dosing.
AHRQ-funded; HS023701.
Citation: Ratwani RM, Savage E, Will A .
Identifying electronic health record usability and safety challenges in pediatric settings.
Health Aff 2018 Nov;37(11):1752-59. doi: 10.1377/hlthaff.2018.0699..
Keywords: Children/Adolescents, Electronic Health Records (EHRs), Health Information Technology (HIT), Medical Errors, Medication, Medication: Safety, Patient Safety, Children/Adolescents
Weitzman ER, Magane KM, Wisk LE
Alcohol use and alcohol-interactive medications among medically vulnerable youth.
Information about the prevalence of alcohol use among youth with chronic medical conditions (YCMCs) who take alcohol-interactive (AI) medications is scant. This study attempts to address gaps and inform interventions by quantifying simultaneous exposure to alcohol use and AI medications among YCMCs. Participants were adolescents with a variety of chronic conditions: type 1 diabetes, juvenile idiopathic arthritis, moderate persistent asthma, cystic fibrosis, attention-deficit/hyperactivity disorder, inflammatory bowel disease. Participants completed an electronic survey designed to measure prevalence of exposure to AI medications and associations with alcohol usage in the past year. Many of the participants reported alcohol use, but drinking was less likely among those who took AI medications. The authors conclude that perceptions about alcohol-medication interference mediated the association between drinking and AI medication exposure.
AHRQ-funded; HS022986.
Citation: Weitzman ER, Magane KM, Wisk LE .
Alcohol use and alcohol-interactive medications among medically vulnerable youth.
Pediatrics 2018 Oct;142(4). doi: 10.1542/peds.2017-4026..
Keywords: Alcohol Use, Children/Adolescents, Chronic Conditions, Medication, Medication: Safety, Patient Safety, Vulnerable Populations
Basco WT, Ebeling M, Garner SS
Opioid prescribing and potential overdose errors among children 0 to 36 months old.
This study estimated the frequency of potential overdoses among outpatient opioid-containing prescriptions. It found that, overall, 2.7 percent of the prescriptions contained potential overdose quantities, and the average excess amount dispensed was 48% above expected. Younger ages were associated with higher frequencies of potential overdose.
AHRQ-funded; HS015679.
Citation: Basco WT, Ebeling M, Garner SS .
Opioid prescribing and potential overdose errors among children 0 to 36 months old.
Clin Pediatr 2015 Jul;54(8):738-44. doi: 10.1177/0009922815586050..
Keywords: Adverse Drug Events (ADE), Children/Adolescents, Newborns/Infants, Medication, Medication: Safety, Newborns/Infants, Opioids, Patient Safety
Benjamin JM, Cox ED, Trapskin PJ
Family-initiated dialogue about medications during family-centered rounds.
The researchers sought to further understand the potential for family-centered rounds (FCRs) to foster pediatric medication safety. To that end, their study describes and quantifies medication-related topics raised by families during FCR and how this dialogue affects the children’s treatment plans. The families raised topics that altered treatment and were important for medication safety, adherence, and satisfaction.
AHRQ-funded; HS018680
Citation: Benjamin JM, Cox ED, Trapskin PJ .
Family-initiated dialogue about medications during family-centered rounds.
Pediatrics. 2015 Jan;135(1):94-101. doi: 10.1542/peds.2013-3885..
Keywords: Children/Adolescents, Communication, Medication: Safety, Patient Safety