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
176 to 200 of 209 Research Studies DisplayedBannuru RR, McAlindon TE, Sullivan MC
Effectiveness and implications of alternative placebo treatments: a systematic review and network meta-analysis of osteoarthritis trials.
The researchers evaluated the effects of alternative placebo types on pain outcomes in knee osteoarthritis. Their review concluded that all placebos are not equal, and some can trigger clinically relevant responses. Differential placebo effects can substantially alter estimates of the relative efficacies of active treatments.
AHRQ-funded; HS021396.
Citation: Bannuru RR, McAlindon TE, Sullivan MC .
Effectiveness and implications of alternative placebo treatments: a systematic review and network meta-analysis of osteoarthritis trials.
Ann Intern Med 2015 Sep 1;163(5):365-72. doi: 10.7326/m15-0623..
Keywords: Comparative Effectiveness, Arthritis, Medication, Pain, Outcomes
Meisel ZF, Smith RJ
Engaging patients around the risks of opioid misuse in the emergency.
The authors of this editorial considered a number of different types of strategies to increase patient awareness of risks and benefits associated with alternative pain management strategies in the ED. These include traditional education, communicating risks, shared decisionmaking, community interventions and “sticky” narratives. They conclude that patients, families and communities must be included in order to navigate the tight¬rope walk between providing adequate pain control and mitigating misuse and dependency.
AHRQ-funded; HS021956.
Citation: Meisel ZF, Smith RJ .
Engaging patients around the risks of opioid misuse in the emergency.
Pain Manag 2015 Sep;5(5):323-6. doi: 10.2217/pmt.15.31..
Keywords: Emergency Department, Opioids, Pain, Patient and Family Engagement
Wysham NG, Cox CE, Wolf SP
Symptom burden of chronic lung disease compared with lung cancer at time of referral for palliative care consultation.
The authors compared the symptom burden of chronic lung disease with that of lung cancer at the time of initial palliative care consultation. They found that patients with chronic lung disease have symptom burdens similar to those of patients with lung cancer at the time of the first palliative care encounter. They concluded that, given the population burden of chronic lung disease and limitations in the palliative care workforce, attention should be focused on ensuring that pulmonologists are prepared to assess and manage the common palliative care needs of patients with chronic lung disease.
AHRQ-funded; HS023681.
Citation: Wysham NG, Cox CE, Wolf SP .
Symptom burden of chronic lung disease compared with lung cancer at time of referral for palliative care consultation.
Ann Am Thorac Soc 2015 Sep;12(9):1294-301. doi: 10.1513/AnnalsATS.201503-180OC.
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Keywords: Respiratory Conditions, Cancer: Lung Cancer, Pain, Palliative Care, Patient-Centered Outcomes Research
Conover MM, Howell JO, Wu JM
Incidence of opioid-managed pelvic pain after hysteroscopic sterilization versus laparoscopic sterilization, US 2005-2012.
The researchers compared the incidence of opioid-managed pelvic pain within 12 months after hysteroscopic and laparoscopic sterilization. They found that among women without recent history of childbirth, there was no compelling evidence of a clinically meaningful increase in the incidence of pelvic pain requiring opioids during the year after hysteroscopic sterilization.
AHRQ-funded; HS017950.
Citation: Conover MM, Howell JO, Wu JM .
Incidence of opioid-managed pelvic pain after hysteroscopic sterilization versus laparoscopic sterilization, US 2005-2012.
Pharmacoepidemiol Drug Saf 2015 Aug;24(8):875-84. doi: 10.1002/pds.3766..
Keywords: Comparative Effectiveness, Medication, Opioids, Pain, Women
Hinami K, Smith J, Deamant CD
Health perceptions and symptom burden in primary care: measuring health using audio computer-assisted self-interviews.
The purpose of the study was to assess the relationships among somatic symptoms and health perception measures in data collected from the implementation of audio computer-assisted self-interviews. It found physical symptoms, notably lack of energy and pain, to be prevalent and severe in an urban safety-net general medical population. Poor health perception in the patient population was attributable largely to lack of energy and pain.
AHRQ-funded; HS019481.
Citation: Hinami K, Smith J, Deamant CD .
Health perceptions and symptom burden in primary care: measuring health using audio computer-assisted self-interviews.
Qual Life Res 2015 Jul;24(7):1575-83. doi: 10.1007/s11136-014-0884-4..
Keywords: Quality of Life, Primary Care, Health Status, Pain
Abrahamson K, DeCrane S, Mueller C
Implementation of a nursing home quality improvement project to reduce resident pain: a qualitative case study.
This article describes the experiences of staff members working within nursing homes that successfully implemented a quality improvement project aimed at reducing resident pain. Findings from the interviews were organized using the Consolidated Framework for Implementation Research. Interdisciplinary communication, supportive leadership, training, and nursing assistant participation facilitated implementation. Increased documentation, resistance to change, and difficulty measuring outcomes were perceived challenges.
AHRQ-funded; HS018464.
Citation: Abrahamson K, DeCrane S, Mueller C .
Implementation of a nursing home quality improvement project to reduce resident pain: a qualitative case study.
J Nurs Care Qual 2015 Jul-Sep;30(3):261-8. doi: 10.1097/ncq.0000000000000099..
Keywords: Nursing Homes, Quality Improvement, Pain, Chronic Conditions
Kenzik K, Pisu M, Johns SA
Unresolved pain interference among colorectal cancer survivors: Implications for patient care and outcomes.
This study describes pain interference (PI) prevalence across the cancer continuum; 2) identifies demographic and clinical factors associated with PI and changes in PI; and 3) examines PI’s relationship with survivors’ job changes. It concluded that almost half of survivors with PI during the initial phase of care had continued PI into posttreatment. Comorbidities, especially cardiovascular and pulmonary conditions, contributed to continued PI.
AHRQ-funded; HS013852.
Citation: Kenzik K, Pisu M, Johns SA .
Unresolved pain interference among colorectal cancer survivors: Implications for patient care and outcomes.
Pain Med 2015 Jul;16(7):1410-25. doi: 10.1111/pme.12727..
Keywords: Cancer, Cancer: Colorectal Cancer, Quality of Life, Pain, Patient-Centered Outcomes Research
Hartley KA, Miller CS, Gephart SM
Facilitated tucking to reduce pain in neonates: evidence for best practice.
The researchers investigated the effect of facilitated tucking on pain behaviors in those who received the intervention compared with those who did not, and what alternative interventions for nonpharmacologic pain reduction are supported by strong research evidence? Their review demonstrated that facilitated tucking reduces the expression of pain in premature infants.
AHRQ-funded; HS022908.
Citation: Hartley KA, Miller CS, Gephart SM .
Facilitated tucking to reduce pain in neonates: evidence for best practice.
Adv Neonatal Care 2015 Jun;15(3):201-8. doi: 10.1097/anc.0000000000000193..
Keywords: Care Management, Evidence-Based Practice, Newborns/Infants, Pain
Merlin JS, Westfall AO, Chamot E
Quantitative evaluation of an instrument to identify chronic pain in HIV-infected individuals.
The researchers assessed the construct validity of the two-question Brief Chronic Pain Questionnaire (BCPQ) in HIV-infected patients by assessing the association between BCPQ responses and known correlates of chronic pain. Their study provides preliminary evidence for the BCPQ as a brief questionnaire to identify the presence of chronic pain in HIV care settings.
AHRQ-funded; HS021694.
Citation: Merlin JS, Westfall AO, Chamot E .
Quantitative evaluation of an instrument to identify chronic pain in HIV-infected individuals.
AIDS Res Hum Retroviruses 2015 Jun;31(6):623-7. doi: 10.1089/aid.2014.0362..
Keywords: Chronic Conditions, Human Immunodeficiency Virus (HIV), Pain
Haywood C, Lanzkron S, Hughes M
The association of clinician characteristics with their attitudes toward patients with sickle cell disease: secondary analyses of a randomized controlled trial.
The researchers explore the extent to which clinician characteristics such as race, sex, professional discipline, and amount of exposure to sickle cell disease (SCD) patients in pain may be associated with attitudes toward SCD patients generally. They concluded that clinician attitudes toward sickle cell patients vary notably by the demographic and clinical experiences of the clinician.
AHRQ-funded; HS013903.
Citation: Haywood C, Lanzkron S, Hughes M .
The association of clinician characteristics with their attitudes toward patients with sickle cell disease: secondary analyses of a randomized controlled trial.
J Natl Med Assoc 2015 Jun;107(2):89-96..
Keywords: Sickle Cell Disease, Pain, Disparities
Juckett DA, Davis FN, Gostine M
Patient-reported outcomes in a large community-based pain medicine practice: evaluation for use in phenotype modeling.
The researchers aimed to build a phenotype-to-outcome model targeting chronic pain to be used to drive clinical decision support for pain medicine in the community setting. Exploratory factor analysis of the intake Pain Health Assessment revealed 15 orthogonal factors representing pain levels; physical, social, and emotional functions; the effects of pain on these functions; vitality and health; and measures of outcomes and satisfaction.
AHRQ-funded; HS022335.
Citation: Juckett DA, Davis FN, Gostine M .
Patient-reported outcomes in a large community-based pain medicine practice: evaluation for use in phenotype modeling.
BMC Med Inform Decis Mak 2015 May 28;15:41. doi: 10.1186/s12911-015-0164-4..
Keywords: Care Management, Chronic Conditions, Community-Based Practice, Electronic Health Records (EHRs), Health Information Technology (HIT), Outcomes, Pain
Jules-Elysee KM, Goon AK, Westrich GH
Patient-controlled epidural analgesia or multimodal pain regimen with periarticular injection after total hip arthroplasty: a randomized, double-blind, placebo-controlled study.
This randomized, double-blind, placebo-controlled study compared the use of patient-controlled epidural analgesia (PCEA) with use of a multimodal pain regimen including periarticular injection (PAI). It found that PAI did not decrease the time to discharge and was associated with higher pain scores and greater opioid consumption but lower ORSDS scores compared with PCEA.
AHRQ-funded; HS021734.
Citation: Jules-Elysee KM, Goon AK, Westrich GH .
Patient-controlled epidural analgesia or multimodal pain regimen with periarticular injection after total hip arthroplasty: a randomized, double-blind, placebo-controlled study.
J Bone Joint Surg Am 2015 May 20;97(10):789-98. doi: 10.2106/jbjs.n.00698..
Keywords: Medication, Opioids, Outcomes, Pain, Surgery
Petrov ME, Goodin BR, Cruz-Almeida Y
Disrupted sleep is associated with altered pain processing by sex and ethnicity in knee osteoarthritis.
This study examines the association between sleep disruption with increased pain sensitivity and enhanced pain facilitation in addition to reduced pain inhibition in persons with chronic pain such as knee OA. It found that disrupted sleep was associated with altered pain processing by sex and ethnicity/race.
AHRQ-funded; HS013852.
Citation: Petrov ME, Goodin BR, Cruz-Almeida Y .
Disrupted sleep is associated with altered pain processing by sex and ethnicity in knee osteoarthritis.
J Pain 2015 May;16(5):478-90. doi: 10.1016/j.jpain.2015.02.004..
Keywords: Pain, Sleep Problems, Arthritis, Racial and Ethnic Minorities, Sex Factors
Hughes HK, Korthuis PT, Saha S
A mixed methods study of patient-provider communication about opioid analgesics.
The researchers sought to describe patient-provider communication about opioid pain medicine and explore how these discussions affect provider attitudes toward patients. They found that pain management discussions are common in routine outpatient HIV encounters and providers may regard patients less favorably if opioids are discussed during visits. The sometimes-adversarial nature of these discussions may negatively affect provider attitudes toward patients.
AHRQ-funded; 290010012; HS013903.
Citation: Hughes HK, Korthuis PT, Saha S .
A mixed methods study of patient-provider communication about opioid analgesics.
Patient Educ Couns 2015 Apr;98(4):453-61. doi: 10.1016/j.pec.2014.12.003..
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Keywords: Communication, Medication, Opioids, Pain, Clinician-Patient Communication
Merlin JS, Walcott M, Kerns R
Pain self-management in HIV-infected individuals with chronic pain: a qualitative study.
The objective of this investigation is to develop an understanding of self-management strategies already used by persons living with these conditions. It found that the primary pain self-management strategies articulated by participants were: physical activity; cognitive and spiritual strategies; spending time with family and friends and social support; avoidance of physical/social activity; medication-centric pain management; and substance use.
AHRQ-funded; HS021694.
Citation: Merlin JS, Walcott M, Kerns R .
Pain self-management in HIV-infected individuals with chronic pain: a qualitative study.
Pain Med 2015 Apr;16(4):706-14. doi: 10.1111/pme.12701..
Keywords: Chronic Conditions, Human Immunodeficiency Virus (HIV), Pain, Patient Self-Management
Ringwalt C, Roberts AW, Gugelmann H
Racial disparities across provider specialties in opioid prescriptions dispensed to Medicaid beneficiaries with chronic noncancer pain.
The purpose of this study was to examine differences across providers’ specialties in prescriptions filled by white and black Medicaid beneficiaries with chronic noncancer pain (CNCP). It found that race-based differences in beneficiaries’ dispensed opioid prescriptions were more prominent among patients of specialists in obstetrics and gynecology and internal medicine, as well as general practitioners/family medicine physicians.
AHRQ-funded; HS000032.
Citation: Ringwalt C, Roberts AW, Gugelmann H .
Racial disparities across provider specialties in opioid prescriptions dispensed to Medicaid beneficiaries with chronic noncancer pain.
Pain Med 2015 Apr;16(4):633-40. doi: 10.1111/pme.12555..
Keywords: Chronic Conditions, Disparities, Medicaid, Medication, Opioids, Pain, Racial and Ethnic Minorities
Memtsoudis SG, Yoo D, Stundner O
Subsartorial adductor canal vs femoral nerve block for analgesia after total knee replacement.
This study compares both single-shot femoral nerve block (FNB) and adductor canal block (ACB), side to side, in the same patients undergoing bilateral TKA. It found that the use of ACBs vs FNBs in knee arthroplasty patients yielded similar results in absolute pain scores, motor strength and patient satisfaction.
AHRQ-funded; HS021734.
Citation: Memtsoudis SG, Yoo D, Stundner O .
Subsartorial adductor canal vs femoral nerve block for analgesia after total knee replacement.
Int Orthop 2015 Apr;39(4):673-80. doi: 10.1007/s00264-014-2527-3..
Keywords: Comparative Effectiveness, Treatments, Outcomes, Patient Experience, Pain
Ragsdale L, Zhong W, Morrison W
Pediatric exposure to opioid and sedation medications during terminal hospitalizations in the United States, 2007-2011.
The researchers conducted a retrospective study in which they examined the prescribing patterns of opioid and sedation medications among 37,459 children who died in 430 hospitals in the US 2007-2011. Their study reveals an overall high prevalence of exposure to opioid and sedation medications among pediatric terminal hospitalizations, yet with slightly less than one-half of patients receiving both opioids and sedatives daily near the end of life.
AHRQ-funded; HS018425.
Citation: Ragsdale L, Zhong W, Morrison W .
Pediatric exposure to opioid and sedation medications during terminal hospitalizations in the United States, 2007-2011.
J Pediatr 2015 Mar;166(3):587-93.e1. doi: 10.1016/j.jpeds.2014.10.017..
Keywords: Children/Adolescents, Hospitalization, Medication, Opioids, Pain, Palliative Care
Chou R, Turner JA, Devine EB
The effectiveness and risks of long-term opioid therapy for chronic pain: a systematic review for a National Institutes of Health Pathways to Prevention Workshop.
This systematic review evaluated evidence on the effectiveness and harms of long-term (more than 3 months) opiod therapy for chronic pain in adults. It concluded that evidence is insufficient to determine the effectiveness of this therapy for improving chronic pain and function.
AHRQ-funded; 290201200014I
Citation: Chou R, Turner JA, Devine EB .
The effectiveness and risks of long-term opioid therapy for chronic pain: a systematic review for a National Institutes of Health Pathways to Prevention Workshop.
Ann Intern Med. 2015 Feb 17;162(4):276-86. doi: 10.7326/M14-2559..
Keywords: Chronic Conditions, Comparative Effectiveness, Medication, Opioids, Outcomes, Pain, Patient-Centered Outcomes Research
Bannuru RR, Schmid CH, Kent DM
Comparative effectiveness of pharmacologic interventions for knee osteoarthritis: a systematic review and network meta-analysis.
To determine the relative efficacy of the primary knee osteoarthritis (OA) treatments, the researchers performed a comprehensive review of the literature, using a network meta-analysis design. Their comparison of seven different medications found that intra-articular (IA) treatments (IA corticosteroids, IA hyaluronic acid) were superior to non-steroidal anti-inflammatory drugs.
AHRQ-funded; HS021396; HS018574
Citation: Bannuru RR, Schmid CH, Kent DM .
Comparative effectiveness of pharmacologic interventions for knee osteoarthritis: a systematic review and network meta-analysis.
Ann Intern Med. 2015 Jan 6;162(1):46-54. doi: 10.7326/M14-1231..
Keywords: Comparative Effectiveness, Medication, Arthritis, Outcomes, Pain
Cagle JG, Zimmerman S, Cohen LW
EMPOWER: an intervention to address barriers to pain management in hospice.
The researchers tested the preliminary efficacy of the Effective Management of Pain: Overcoming Worries to Enable Relief (EMPOWER) intervention. At two weeks, caregivers in the intervention group reported better knowledge about pain management, fewer concerns about pain and pain medications, lower patient pain over the past week, and trended toward improvement in most other areas under study. EMPOWER had a greater effect for black subjects vs. whites on reducing concern about stigma. At three months, the intervention group trended better on most study outcomes. The researchers concluded that EMPOWER is a promising model to reduce barriers to pain management in hospice.
AHRQ-funded; HS019068.
Citation: Cagle JG, Zimmerman S, Cohen LW .
EMPOWER: an intervention to address barriers to pain management in hospice.
J Pain Symptom Manage 2015 Jan;49(1):1-12. doi: 10.1016/j.jpainsymman.2014.05.007.
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Keywords: Care Management, Caregiving, Comparative Effectiveness, Education: Patient and Caregiver, Medication, Pain, Palliative Care
Ayers DC, Li W, Harrold L
Preoperative pain and function profiles reflect consistent TKA patient selection among US surgeons.
This study compared early data from a recently established US national total knee arthroplasty (TKA) cohort including patients from 123 surgeons in 22 states to evaluate preoperative variability in patient selection across surgeons. Their findings suggest that no clinical difference could be detected in the median (typical) patient across all sites.
AHRQ-funded; HS018910.
Citation: Ayers DC, Li W, Harrold L .
Preoperative pain and function profiles reflect consistent TKA patient selection among US surgeons.
Clin Orthop Relat Res 2015 Jan;473(1):76-81. doi: 10.1007/s11999-014-3716-5..
Keywords: Surgery, Pain, Healthcare Utilization, Practice Patterns
Singh JA, Lewallen DG
Are outcomes after total knee arthroplasty worsening over time? A time-trends study of activity limitation and pain outcomes.
The authors examined whether function and pain outcomes of patients undergoing primary total knee arthroplasty (TKA) are changing over time. Using Mayo Clinic Total Joint Registry data, they found that patient-reported function and pain outcomes after primary TKA have worsened over the study period 1993-95 to 2002-05; this time-trend is independent of changes in preoperative pain/limitation and certain patient characteristics.
AHRQ-funded; HS021110.
Citation: Singh JA, Lewallen DG .
Are outcomes after total knee arthroplasty worsening over time? A time-trends study of activity limitation and pain outcomes.
BMC Musculoskelet Disord 2014 Dec 17;15:440. doi: 10.1186/1471-2474-15-440.
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Keywords: Centers for Education and Research on Therapeutics (CERTs), Orthopedics, Pain, Patient-Centered Outcomes Research, Surgery
Raebel MA, Newcomer SR, Bayliss EA
Chronic opioid use emerging after bariatric surgery.
The purpose of this study was to determine opioid use the year after bariatric surgery among patients who did not use opioids chronically pre-surgery and to identify pre-surgery characteristics associated with chronic opioid use after surgery. It found that patients dispensed 60 to 119 days’ supply during the pre-surgery year were 13.23 to 14.29 times more likely to use opioids chronically post-surgery than patients without opioid use pre-surgery.
AHRQ-funded; HS019912.
Citation: Raebel MA, Newcomer SR, Bayliss EA .
Chronic opioid use emerging after bariatric surgery.
Pharmacoepidemiol Drug Saf 2014 Dec;23(12):1247-57. doi: 10.1002/pds.3625..
Keywords: Medication, Obesity, Opioids, Pain, Substance Abuse, Surgery
Merlin JS, Walcott M, Ritchie C
'Two pains together': patient perspectives on psychological aspects of chronic pain while living with HIV.
The researchers’ objective was to explore HIV-infected patients’ perspectives on psychological aspects of chronic pain using in-depth qualitative interviews. Key themes that emerged included the close relationship between mood and pain; mood and pain in the context of living with HIV; use of alcohol/drugs to self-medicate for pain; and the challenge of receiving prescription pain medications while dealing with substance use disorders.
AHRQ-funded; HS021694.
Citation: Merlin JS, Walcott M, Ritchie C .
'Two pains together': patient perspectives on psychological aspects of chronic pain while living with HIV.
PLoS One 2014 Nov 3;9(11):e111765. doi: 10.1371/journal.pone.0111765..
Keywords: Care Management, Chronic Conditions, Human Immunodeficiency Virus (HIV), Pain, Patient-Centered Outcomes Research, Patient Self-Management