National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (7)
- Adverse Events (5)
- Ambulatory Care and Surgery (1)
- Antibiotics (9)
- Antimicrobial Stewardship (8)
- Behavioral Health (2)
- Blood Clots (1)
- Blood Thinners (1)
- Burnout (1)
- Children/Adolescents (4)
- Clinical Decision Support (CDS) (1)
- Clostridium difficile Infections (1)
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) (1)
- Critical Care (1)
- Decision Making (2)
- Diabetes (1)
- Disparities (1)
- Elderly (1)
- Electronic Health Records (EHRs) (3)
- Emergency Department (1)
- Evidence-Based Practice (1)
- Falls (1)
- Healthcare-Associated Infections (HAIs) (1)
- Healthcare Cost and Utilization Project (HCUP) (3)
- Healthcare Costs (2)
- Healthcare Delivery (1)
- Healthcare Utilization (1)
- Health Information Exchange (HIE) (1)
- Health Information Technology (HIT) (3)
- Health Systems (1)
- Hospital Discharge (4)
- Hospitalization (2)
- Hospital Readmissions (1)
- (-) Hospitals (35)
- Implementation (2)
- Infectious Diseases (2)
- Inpatient Care (3)
- Long-Term Care (1)
- Medical Errors (3)
- Medicare (1)
- (-) Medication (35)
- Medication: Safety (9)
- Mortality (1)
- Nursing Homes (1)
- Opioids (3)
- Organizational Change (1)
- Outcomes (1)
- Pain (1)
- Patient Adherence/Compliance (1)
- Patient and Family Engagement (1)
- Patient Safety (11)
- Payment (1)
- Practice Patterns (2)
- Prevention (2)
- Provider: Pharmacist (1)
- Quality Improvement (4)
- Quality Indicators (QIs) (1)
- Quality of Care (3)
- Respiratory Conditions (1)
- Risk (1)
- Sepsis (2)
- Social Determinants of Health (1)
- Substance Abuse (2)
- Surgery (1)
- Tools & Toolkits (1)
- Transitions of Care (2)
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 25 of 35 Research Studies DisplayedWolf RM, Hall M, Williams DJ
Disparities in pharmacologic restraint for children hospitalized in mental health crisis.
This retrospective cohort study examined associations between pharmacologic restraint use and race and ethnicity among children (aged 5-≤18 years) admitted for mental health conditions to acute care nonpsychiatric children's hospitals. Study period was 2018 to 2022 and was conducted at 41 US children’s hospitals and included a cohort of 61,503 hospitalizations. Compared with non-Hispanic Black children, children of non-Hispanic White (adjusted odds ratio [aOR], 0.81), Asian (aOR, 0.82), or other race and ethnicity (aOR, 0.68) were less likely to receive pharmacologic restraint, with no significant difference with Hispanic children. When stratified by sex, racial/ethnic differences were magnified in males, except for Hispanic males, and not found in females. Sensitivity analysis revealed amplified disparities for all racial/ethnic groups, including Hispanic youth.
AHRQ-funded; HS026122.
Citation: Wolf RM, Hall M, Williams DJ .
Disparities in pharmacologic restraint for children hospitalized in mental health crisis.
Pediatrics 2024 Jan; 153(1). doi: 10.1542/peds.2023-061353..
Keywords: Disparities, Children/Adolescents, Behavioral Health, Inpatient Care, Hospitals, Medication
Wolf RM, Hall M, Williams DJ
Pharmacologic restraint use for children experiencing mental health crises in pediatric hospitals.
This study’s objective was to determine hospital-level incidence and variation of pharmacologic restraint use among children admitted for mental health conditions in children's hospitals. The authors examined data for children (5 to ≤18 years) admitted to children's hospitals with a primary mental health condition from 2018 to 2020 using the Pediatric Health Information System database. Of 29,834 included encounters, 12.6% had pharmacologic restraint use, with three hospitals the highest utilizers of all drug classes. Adjusted hospital rates ranged from 35 to 389 pharmacologic restraint use days per 1000 mental health bed days with a mean of 175. There were no significant differences in pharmacologic restraint use found in the hospital-level analysis.
AHRQ-funded; HS026122.
Citation: Wolf RM, Hall M, Williams DJ .
Pharmacologic restraint use for children experiencing mental health crises in pediatric hospitals.
J Hosp Med 2023 Feb; 18(2):120-29. doi: 10.1002/jhm.13009..
Keywords: Children/Adolescents, Behavioral Health, Hospitals, Medication
Xiao Y, Smith A, Abebe E
Understanding hazards for adverse drug events among older adults after hospital discharge: insights from frontline care professionals.
The purpose of this study was to utilize a systems approach to examine hazards to medication safety for older adults during care transitions. The researchers interviewed 38 hospital-based professionals (5 hospitalists, 24 nurses, 4 clinical pharmacists, 3 pharmacy technicians, and 2 social workers) from 4 hospitals about ADE risks after hospital discharge among older adults. For each concern the participants provided, the hazard for medication-related harms was coded and grouped by its sources utilizing a human factors and systems engineering model. The study found that the hazards fell into 6 groups: 1) medication tasks related at home, 2) patient and caregiver related, 3) hospital work system related, 4) home resource related, 5) hospital professional-patient collaborative work related, and 6) external environment related. The type of medications indicated most frequently when describing concerns included anticoagulants, insulins, and diuretics. The types of hazards coded the most were: complex dosing, patient and caregiver knowledge gaps in medication management, errors in discharge medications, unaffordable cost, inadequate understanding about changes in medications, and gaps in access to care or in sharing medication information.
AHRQ-funded; HS024436.
Citation: Xiao Y, Smith A, Abebe E .
Understanding hazards for adverse drug events among older adults after hospital discharge: insights from frontline care professionals.
J Patient Saf 2022 Dec 1;18(8):e1174-e80. doi: 10.1097/pts.0000000000001046..
Keywords: Elderly, Adverse Drug Events (ADE), Medication, Medication: Safety, Hospital Discharge, Hospitals, Transitions of Care
Prescott HC, Seelye S, Wang XQ
Temporal trends in antimicrobial prescribing during hospitalization for potential infection and sepsis.
This study examined whether the push to administer antimicrobials to prevent sepsis has increased antimicrobial use in general. This observational cohort study of hospitalized patients at 152 hospitals in 2 health care systems during 2013 to 2018 looked at almost 1.6 million patients (81% male), admitted via the emergency department with 2 or more systemic inflammatory response syndrome (SIRS) criteria. From 2013 to 2018 first antimicrobial administration to patients with sepsis decreased by 37 minutes. At the same time, antimicrobial use within 48 hours, days of antimicrobial therapy, and receipt of broad-spectrum coverage decreased among the broader cohort of patients with systemic inflammatory response syndrome (SIRS). This may have caused a decrease in in-hospital mortality, 30-day mortality, length of hospitalization, new MDR culture positivity, and new MDR blood culture positivity over the study period among both patients with sepsis and those with SIRS. For the overall hospital population there was no evidence that increasing antimicrobial timing for sepsis was associated with increasing antimicrobial use or impaired antimicrobial stewardship.
AHRQ-funded; HS026725.
Citation: Prescott HC, Seelye S, Wang XQ .
Temporal trends in antimicrobial prescribing during hospitalization for potential infection and sepsis.
JAMA Intern Med 2022 Aug;182(8):805-13. doi: 10.1001/jamainternmed.2022.2291..
Keywords: Antimicrobial Stewardship, Antibiotics, Medication, Sepsis, Inpatient Care, Hospitals
Vaughn VM, Hersh AL, Spivak ES
Antibiotic overuse and stewardship at hospital discharge: the reducing overuse of antibiotics at discharge home framework.
In this review, the authors discussed what is currently known about antibiotic overuse at hospital discharge, key barriers, and targets for improving antibiotic prescribing at discharge. They introduced an evidence-based framework, the Reducing Overuse of Antibiotics at Discharge Home Framework, for conducting discharge antibiotic stewardship.
AHRQ-funded; HS026530.
Citation: Vaughn VM, Hersh AL, Spivak ES .
Antibiotic overuse and stewardship at hospital discharge: the reducing overuse of antibiotics at discharge home framework.
Clin Infect Dis 2022 May 3;74(9):1696-702. doi: 10.1093/cid/ciab842..
Keywords: Antimicrobial Stewardship, Antibiotics, Medication, Hospital Discharge, Hospitals
Moehring RW, Yarrington ME, Davis AE
Effects of a collaborative, community hospital network for antimicrobial stewardship program implementation.
The authors investigated expertise, data resources, and educational tools to support antimicrobial stewardship programs (ASP) in hospitals. They found that network hospitals increased ASP activities and demonstrated decline in antimicrobial use over the 42-month study period. They concluded that their collaborative, consultative network proved a unique model in which hospitals can access ASP implementation expertise to support long-term program growth.
AHRQ-funded; HS023866.
Citation: Moehring RW, Yarrington ME, Davis AE .
Effects of a collaborative, community hospital network for antimicrobial stewardship program implementation.
Clin Infect Dis 2021 Nov 2;73(9):1656-63. doi: 10.1093/cid/ciab356..
Keywords: Antimicrobial Stewardship, Antibiotics, Hospitals, Implementation, Medication
Desai SM, McWilliams JM
340B Drug Pricing Program and hospital provision of uncompensated care.
This study evaluated whether hospital entry into the 340B Drug Pricing Program is associated with changes in hospital provision of uncompensated care. The authors analyzed secondary data on 340B participation and uncompensated care provision among general acute care hospitals and critical access hospitals from 2003 to 2015. They constructed an annual, hospital-level data set on hospital 340B participation and on uncompensated care provision. They did not find evidence that hospitals increased provision of uncompensated care after entry into the 340B program differentially more than hospitals that never entered or had not yet entered the program.
AHRQ-funded; HS026980; HS024072.
Citation: Desai SM, McWilliams JM .
340B Drug Pricing Program and hospital provision of uncompensated care.
Am J Manag Care 2021 Oct;27(10):432-37. doi: 10.37765/ajmc.2021.88761..
Keywords: Hospitals, Healthcare Costs, Medication
Herzig SJ, Rothberg MB, Moss CR
Risk of in-hospital falls among medications commonly used for insomnia in hospitalized patients.
This study investigated the risk of in-hospital falls among patients receiving medications commonly used for insomnia. This retrospective cohort study was conducted at a large academic medical center from January 2007 to July 2013. Adults admitted for a primary psychiatric disorder were excluded. Medications of interest included benzodiazepines, non-benzodiazepine benzodiazepine receptor agonists, trazodone, atypical antipsychotics, and diphenhydramine. Among 225,498 hospitalizations, 37.7% had exposure to at least one of the medication classes of interest with benzodiazepines being the most commonly prescribed. A fall occurred in 1.1% (2,427) of hospitalizations. The rate of falls per 1,000 hospital days was greater among patients with exposure to each of the medications of interest compared to unexposed patients.
AHRQ-funded; HS026215.
Citation: Herzig SJ, Rothberg MB, Moss CR .
Risk of in-hospital falls among medications commonly used for insomnia in hospitalized patients.
Sleep 2021 Sep 13;44(9):zsab064. doi: 10.1093/sleep/zsab064..
Keywords: Falls, Medication, Adverse Events, Risk, Hospitals
Goodman KE, Cosgrove SE, Pineles L
Significant regional differences in antibiotic use across 576 US hospitals
This study’s objective was to examine adult antibiotic use across 576 hospitals and nearly 12 million encounters in 2016-2017. Findings showed that adult inpatient antibiotic use remained high, driven predominantly by broad-spectrum agents. Recommendations included better understanding of the reasons for interhospital usage differences, including by region and teaching status, in order to inform efforts to reduce inappropriate antibiotic prescribing.
AHRQ-funded; HS026205.
Citation: Goodman KE, Cosgrove SE, Pineles L .
Significant regional differences in antibiotic use across 576 US hospitals
Significant regional differences in antibiotic use across 576 US hospitals and 11 701 326 adult admissions, 2016-2017..
Keywords: Antimicrobial Stewardship, Antibiotics, Medication, Hospitals
Tamma PD, Miller MA, Dullabh P
AHRQ Author: Miller MA
Association of a safety program for improving antibiotic use with antibiotic use and hospital-onset Clostridioides difficile infection rates among US hospitals.
Regulatory agencies and professional organizations recommend antibiotic stewardship programs (ASPs) in US hospitals. The optimal approach to establish robust, sustainable ASPs across diverse hospitals is unknown. The purpose of this study was to assess whether the Agency for Healthcare Research and Quality (AHRQ) Safety Program for Improving Antibiotic Use was associated with reductions in antibiotic use across US hospitals. The investigators concluded that AHRQ Safety Program appeared to enable diverse hospitals to establish ASPs and teach frontline clinicians to self-steward their antibiotic use.
AHRQ-authored; AHRQ-funded; 233201500020I.
Citation: Tamma PD, Miller MA, Dullabh P .
Association of a safety program for improving antibiotic use with antibiotic use and hospital-onset Clostridioides difficile infection rates among US hospitals.
JAMA Netw Open 2021 Feb;4(2):e210235. doi: 10.1001/jamanetworkopen.2021.0235..
Keywords: Antimicrobial Stewardship, Antibiotics, Medication, Decision Making, Clostridium difficile Infections, Patient Safety, Quality Improvement, Quality of Care, Hospitals
Eaton EF, Lee RA, Westfall AO
An integrated hospital protocol for persons with injection-related infections may increase medications for opioid use disorder use but challenges remain.
This study looked at whether a hospital-based protocol would increase the use of medications for opioid use disorder (MOUD) for persons who are hospitalized for infectious complications. Participants who received care for an infection at the University of Alabama at Birmingham Hospital from 2015 to 2018 were included. The protocol included use of an intravenous antibiotic and addiction team (IVAT) consultation and a 9-item risk assessment. The percentage of patients with OUD receiving MOUD increased significantly with IVAT (29% to 37%) and MOUD use was higher in “high risk” participants (62%). However, the uptake of MOUD remains suboptimal at less than 50%.
AHRQ-funded; HS023009.
Citation: Eaton EF, Lee RA, Westfall AO .
An integrated hospital protocol for persons with injection-related infections may increase medications for opioid use disorder use but challenges remain.
J Infect Dis 2020 Sep 2;222(Suppl 5):S499-s505. doi: 10.1093/infdis/jiaa005..
Keywords: Opioids, Substance Abuse, Medication, Infectious Diseases, Hospitals
Co Z, Holmgren AJ, Classen DC
The tradeoffs between safety and alert fatigue: data from a national evaluation of hospital medication-related clinical decision support.
This study evaluated the overall performance of hospitals that used the Computerized Physician Order Entry Evaluation Tool in 2017 and 2018 and compared performances for fatal orders and nuisance orders each year. The authors evaluated 1599 hospitals that took the test by using their overall percentage scores along with the percentage of fatal orders appropriately alerted on and the percentage of nuisance orders incorrectly alerted on. Overall hospital scores improved from 58.1% in 2017 to 66.2% in 2018. Fatal order performance improved slightly from 78.8% to 83.0%, but there no very little change in nuisance order performance (89.0% to 89.7%). Conclusions were that perhaps hospitals are not targeting the deadliest orders first and some hospitals may be achieving higher scores by over-alerting. This has the potential to cause clinician burnout and even worsen patient safety.
AHRQ-funded; HS023696.
Citation: Co Z, Holmgren AJ, Classen DC .
The tradeoffs between safety and alert fatigue: data from a national evaluation of hospital medication-related clinical decision support.
J Am Med Inform Assoc 2020 Aug;27(8):1252-58. doi: 10.1093/jamia/ocaa098..
Keywords: Medication: Safety, Medication, Patient Safety, Clinical Decision Support (CDS), Decision Making, Burnout, Hospitals, Health Information Technology (HIT), Quality of Care
Stolldorf DP, Mixon AS, Auerbach AD
Implementation and sustainability of a medication reconciliation toolkit: a mixed methods evaluation.
MARQUIS (Multi-Center Medication Reconciliation Quality Improvement Study) provided participating hospitals with a toolkit to assist in developing robust medication reconciliation programs. Here the investigators described hospitals' implementation of the MARQUIS toolkit, barriers and facilitators, and important factors that may enhance the spread and sustainability of the toolkit.
AHRQ-funded; HS025486.
Citation: Stolldorf DP, Mixon AS, Auerbach AD .
Implementation and sustainability of a medication reconciliation toolkit: a mixed methods evaluation.
Am J Health Syst Pharm 2020 Jul 7;77(14):1135-43. doi: 10.1093/ajhp/zxaa136..
Keywords: Medication, Medication: Safety, Patient Safety, Hospitals, Tools & Toolkits
Basu J
AHRQ Author: Basu J
Multilevel risk factors for hospital readmission among patients with opioid use disorder in selected US States: role of socioeconomic characteristics of patients and their community.
This study examined the association of socioeconomic characteristics of individuals hospitalized with a principal diagnosis of opioid use disorder and their all-cause 30-day readmission risks. Discharge data from the 2014 HCUP Survey was used and was linked to community and hospital characteristics using data from HRSA and the American Hospital Association. Medicare is associated with the highest readmission risk followed by Medicaid covered patients. Self-pay or covered by other payers had a similar risk to private insurance coverage. Urban patients also had a higher readmission rate than rural patients.
AHRQ-authored.
Citation: Basu J .
Multilevel risk factors for hospital readmission among patients with opioid use disorder in selected US States: role of socioeconomic characteristics of patients and their community.
Health Serv Res Manag Epidemiol 2020 Jan-Dec;7:2333392820904240. doi: 10.1177/2333392820904240..
Keywords: Healthcare Cost and Utilization Project (HCUP), Opioids, Medication, Substance Abuse, Hospital Readmissions, Hospitals, Social Determinants of Health
Stolldorf DP, Schnipper JL, Mixon AS
Organisational context of hospitals that participated in a multi-site mentored medication reconciliation quality improvement project (MARQUIS2): a cross-sectional observational study.
Medication reconciliation (MedRec) is an important patient safety strategy and is widespread in US hospitals and globally. Nevertheless, high quality MedRec has been difficult to implement. As part of a larger study investigating MedRec interventions, the investigators evaluated and compared organisational contextual factors and team cohesion by hospital characteristics and implementation team members' profession to better understand the environmental context and its correlates during a multi-site quality improvement (QI) initiative.
AHRQ-funded; HS025486.
Citation: Stolldorf DP, Schnipper JL, Mixon AS .
Organisational context of hospitals that participated in a multi-site mentored medication reconciliation quality improvement project (MARQUIS2): a cross-sectional observational study.
BMJ Open 2019 Nov 2;9(11):e030834. doi: 10.1136/bmjopen-2019-030834.
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Keywords: Medication, Quality Improvement, Hospitals, Medication: Safety, Patient Safety, Adverse Drug Events (ADE), Adverse Events, Medical Errors, Implementation
Yarrington ME, Anderson DJ, Dodds Ashley E
Impact of FDA black box warning on fluoroquinolone and alternative antibiotic use in southeastern US hospitals.
This study’s objective was the quantify the effect of the 2016 FDA “black box” update on the use of fluoroquinolone antibiotics among a cohort of southeastern US hospitals. Fluoroquinolone was given a black box warning after many serious adverse events were reported. Antibiotic use data from 29 southeastern US hospitals over a 5-year period was analyzed. Fluoroquinolone use declined both and before after the FDA advisory update in 2016.
AHRQ-funded; HS023866.
Citation: Yarrington ME, Anderson DJ, Dodds Ashley E .
Impact of FDA black box warning on fluoroquinolone and alternative antibiotic use in southeastern US hospitals.
Infect Control Hosp Epidemiol 2019 Nov;40(11):1297-300. doi: 10.1017/ice.2019.247..
Keywords: Antibiotics, Medication, Practice Patterns, Healthcare Utilization, Hospitals, Adverse Drug Events (ADE), Adverse Events
Mixon AS, Kripalani S, Stein J
An on-treatment analysis of the MARQUIS study: interventions to improve inpatient medication reconciliation.
This paper examined evidence-based interventions implemented in five US hospitals to improve inpatient medication reconciliation. The sites implemented one to seven interventions in 791 patients during a 25-month implementation period. Three interventions were associated with significant decreases in potentially harmful reconciliation rates while two interventions were associated with significant increases. The positive interventions included: defining clinical roles and responsibilities, training, and hiring staff to perform discharge medication reconciliation. The negative interventions were training staff to take medication histories and implementing a new electronic health record (EHR) system.
AHRQ-funded; HS019598.
Citation: Mixon AS, Kripalani S, Stein J .
An on-treatment analysis of the MARQUIS study: interventions to improve inpatient medication reconciliation.
J Hosp Med 2019 Oct;14(10):614-17. doi: 10.12788/jhm.3308..
Keywords: Medication, Evidence-Based Practice, Adverse Drug Events (ADE), Adverse Events, Medical Errors, Patient Safety, Hospitals, Healthcare Delivery, Inpatient Care
Anderson DJ, Watson S, Moehring RW
Feasibility of core antimicrobial stewardship interventions in community hospitals.
The purpose of this study was to determine the feasibility and results of implementing 2 core stewardship intervention strategies in community hospitals. The two antimicrobial stewardship strategies targeted vancomycin hydrochloride, piperacillin-tazobactam, and the antipseudomonal carbapenems on formulary at the study hospitals: (1) modified preauthorization (PA), in which the prescriber had to receive pharmacist approval for continued use of the antibiotic after the first dose, and (2) postprescription audit and review (PPR), in which the pharmacist would engage the prescriber about antibiotic appropriateness after 72 hours of therapy.
AHRQ-funded; HS023866.
Citation: Anderson DJ, Watson S, Moehring RW .
Feasibility of core antimicrobial stewardship interventions in community hospitals.
The purpose of this study was to determine the feasibility and results of implementing 2 core stewardship intervention strategies in community hospitals. The two antimicrobial stewardship strategies targeted vancomycin hydrochloride, piperacillin-tazobactam, and the antipseudomonal carbapenems on formulary at the study hospitals: (1) modified preauthorization (PA), in which the prescriber had to receive pharmacist approval for continued use of the antibiotic after the first dose, and (2) postprescription audit and review (PPR), in which the pharmacist would engage the prescriber about antibiotic appropriateness after 72 hours of therapy..
Keywords: Antibiotics, Antimicrobial Stewardship, Healthcare-Associated Infections (HAIs), Hospitals, Infectious Diseases, Medication, Patient Safety
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
Nolan K, Zullo AR, Bosco E
Controlled substance diversion in health systems: a failure modes and effects analysis for prevention.
This study’s purpose was to demonstrate the utility of failure modes and effects analysis (FMEA) to identify potential sources of controlled substance diversion and developing solutions in an academic health system. A cross-functional team of 18 members was developed from the department of pharmacy. Scoring criteria was developed and ways were identified in which step of the medication supply there could be failure and result in diversion of controlled substances. Failure was indicated with a vulnerability score of 48 or 64. A total of 10 major steps and 30 substeps in the supply process was identified. From this 103 potential failure modes were identified, with 24 modes (23%) considered failing. Notable failure included controlled substance activity under temporary patients and discrepancy trends. Expanded use of cameras in high-risk areas and added verification checks were implemented after the analysis.
AHRQ-funded; HS022998.
Citation: Nolan K, Zullo AR, Bosco E .
Controlled substance diversion in health systems: a failure modes and effects analysis for prevention.
Am J Health Syst Pharm 2019 Jul 18;76(15):1158-64. doi: 10.1093/ajhp/zxz116..
Keywords: Medication, Provider: Pharmacist, Hospitals, Quality Improvement, Quality of Care
Goldstein E, MacFadden DR, Karaca Z
AHRQ Author: Karaca Z Steiner CA
Antimicrobial resistance prevalence, rates of hospitalization with septicemia and rates of mortality with sepsis in adults in different US states.
Researchers studied the relation between the prevalence of resistance to various antibiotics in different bacteria and rates of sepsis-related outcomes. They found that, among the different combinations of antibiotics/bacteria, prevalence of resistance to fluoroquinolones in E. coli had the strongest association with septicemia hospitalization rates for individuals aged over 50 years, and with sepsis mortality rates for individuals aged 18-84 years. They also found a number of positive correlations between prevalence of resistance for different combinations of antibiotics/bacteria and septicemia hospitalization/sepsis mortality rates in adults.
AHRQ-authored.
Citation: Goldstein E, MacFadden DR, Karaca Z .
Antimicrobial resistance prevalence, rates of hospitalization with septicemia and rates of mortality with sepsis in adults in different US states.
Int J Antimicrob Agents 2019 Jul;54(1):23-34. doi: 10.1016/j.ijantimicag.2019.03.004..
Keywords: Antibiotics, Antimicrobial Stewardship, Healthcare Cost and Utilization Project (HCUP), Hospitals, Hospitalization, Medication, Mortality, Sepsis
Vijay A, Rhee TG, Ross JS
U.S. prescribing trends of fentanyl, opioids, and other pain medications in outpatient and emergency department visits from 2006 to 2015.
This retrospective study tracked US prescribing trends of fentanyl, opioids, and other pain medications in outpatient and emergency department (ED) visits from 2006 to 2015. Data from the 2006-2015 National Ambulatory Medical Care Surveys and National Hospital Ambulatory Medical Care Surveys was used. During that time period, 17.4% of office-based outpatient visits and 45% of ED visits listed a pain medication prescription. There was an increase of about 5% from 2006-2007 to 2014-2015 for outpatient visits in which any pain medication was prescribed. Fentanyl prescription rates remained stable but doubled at EDs. There was also an increase in non-opioid pain medications in both settings.
AHRQ-funded; HS022882; HS025164.
Citation: Vijay A, Rhee TG, Ross JS .
U.S. prescribing trends of fentanyl, opioids, and other pain medications in outpatient and emergency department visits from 2006 to 2015.
Prev Med 2019 Jun;123:123-29. doi: 10.1016/j.ypmed.2019.03.022..
Keywords: Ambulatory Care and Surgery, Emergency Department, Hospitals, Medication, Opioids, Pain, Practice Patterns
Schnipper JL, Mixon A, Stein J
Effects of a multifaceted medication reconciliation quality improvement intervention on patient safety: final results of the MARQUIS study.
The authors of this paper conducted a pragmatic quality improvement (QI) study at five US hospitals, two of which included concurrent controls. The investigators found that a mentored implementation of a multifaceted medication reconciliation QI initiative was associated with a reduction in total, but not potentially harmful, medication discrepancies. They suggest that the effect of EHR implementation on medication discrepancies warrants further study.
AHRQ-funded; HS019598.
Citation: Schnipper JL, Mixon A, Stein J .
Effects of a multifaceted medication reconciliation quality improvement intervention on patient safety: final results of the MARQUIS study.
BMJ Qual Saf 2018 Dec;27(12):954-64. doi: 10.1136/bmjqs-2018-008233..
Keywords: Hospitals, Medication, Medication: Safety, Patient Safety, Quality Improvement
Prey JE, Polubriaginof F, Grossman LV
Engaging hospital patients in the medication reconciliation process using tablet computers.
Researchers conducted a pilot study to determine whether patients’ use of an electronic home medication review tool on a table computer could improve medication safety before or after hospitalization. Patients were randomized to the tool and out of 76 patients approached, 65 participated. About three-quarters (74%) made changes to their home medication list. Out of that total, 74% of the changes identified had a significant or greater potential severity, and 49% had a greater than 50-50 chance of harm. This medication reconciliation tool showed great potential to improve medication safety during and after hospitalization.
AHRQ-funded; HS021816.
Citation: Prey JE, Polubriaginof F, Grossman LV .
Engaging hospital patients in the medication reconciliation process using tablet computers.
J Am Med Inform Assoc 2018 Nov;25(11):1460-69. doi: 10.1093/jamia/ocy115..
Keywords: Adverse Drug Events (ADE), Adverse Events, Electronic Health Records (EHRs), Health Information Technology (HIT), Hospitalization, Hospitals, Medication, Medication: Safety, Patient and Family Engagement, Patient Safety, Prevention
Hostler CJ, Moehring RW, Ashley ESD
Feasibility and value of developing a regional antibiogram for community hospitals.
The purpose of this study was to determine the feasibility and value of developing a regional antibiogram for community hospitals. The investigators concluded that small community hospitals frequently cannot develop an accurate antibiogram due to a paucity of local data. They suggest that a regional antibiogram is likely to provide clinically useful information to community hospitals for low-prevalence pathogens.
AHRQ-funded; HS023866.
Citation: Hostler CJ, Moehring RW, Ashley ESD .
Feasibility and value of developing a regional antibiogram for community hospitals.
Infect Control Hosp Epidemiol 2018 Jun;39(6):718-22. doi: 10.1017/ice.2018.71..
Keywords: Antibiotics, Hospitals, Medication