National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Access to Care (1)
- Adverse Drug Events (ADE) (3)
- Adverse Events (1)
- Antibiotics (1)
- Arthritis (1)
- Cancer (6)
- (-) Cancer: Breast Cancer (17)
- Cancer: Lung Cancer (1)
- Case Study (1)
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- (-) Medication (17)
- Medication: Safety (1)
- Opioids (2)
- Pain (1)
- Patient-Centered Outcomes Research (2)
- Patient Adherence/Compliance (3)
- Patient Safety (2)
- Policy (1)
- Practice Patterns (2)
- Prevention (3)
- Primary Care (1)
- Racial and Ethnic Minorities (1)
- Risk (3)
- Social Determinants of Health (1)
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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 17 of 17 Research Studies DisplayedWarren DK, Peacock KM, Nickel KB
Postdischarge prophylactic antibiotics following mastectomy with and without breast reconstruction.
The authors investigated factors associated with post-discharge prophylactic antibiotic use after mastectomy with and without immediate reconstruction and the impact on surgical-site infection (SSI). They found that anti-methicillin-sensitive Staphylococcus aureus antibiotics were associated with decreased risk of SSI for patients who had mastectomy only and those who had mastectomy with immediate reconstruction. They concluded that the high numbers needed to treat suggest that potential benefits of post-discharge antibiotics should be weighed against potential harms associated with antibiotic overuse.
AHRQ-funded; HS019455.
Citation: Warren DK, Peacock KM, Nickel KB .
Postdischarge prophylactic antibiotics following mastectomy with and without breast reconstruction.
Infect Control Hosp Epidemiol 2022 Oct;43(10):1382-88. doi: 10.1017/ice.2021.400..
Keywords: Antibiotics, Cancer: Breast Cancer, Cancer, Medication, Surgery, Healthcare-Associated Infections (HAIs), Prevention, Women, Practice Patterns
Eyrich NW, Sloss KR, Howard RA
Opioid prescribing exceeds consumption following common surgical oncology procedures.
Researchers aimed to compare opioid prescribing to opioid consumption for common surgical oncology procedures. They found that the median quantity of opioid prescribed was significantly larger than consumed following breast biopsy, lumpectomy, and mastectomy or wide local excision. The majority of patients reported receiving education on taking opioids, but only 27% received instructions on proper disposal; 82% of prescriptions filled resulted in unused opioids, and only 11% of these patients safely disposed of them. They concluded that their study demonstrated that opioid prescribing exceeds consumption following common surgical oncology procedures, thus indicating the potential for reductions in prescribing.
AHRQ-funded; HS023313.
Citation: Eyrich NW, Sloss KR, Howard RA .
Opioid prescribing exceeds consumption following common surgical oncology procedures.
J Surg Oncol 2021 Jan;123(1):352-56. doi: 10.1002/jso.26272..
Keywords: Opioids, Medication, Surgery, Cancer: Breast Cancer, Cancer, Practice Patterns, Pain
Maclean JC, Halpern MT, Hill SC
AHRQ Author: Hill SC
The effect of Medicaid expansion on prescriptions for breast cancer hormonal therapy medications.
The purpose of this study was to quantify the effects of the Affordable Care Act Medicaid expansion on prescriptions for effective breast cancer hormonal therapies (tamoxifen and aromatase inhibitors) among Medicaid enrollees. Data from the Medicaid State Drug Utilization Database was used. Findings showed that Medicaid expansion may have had a meaningful impact on the ability of lower-income women to access effective hormonal therapies used to treat breast cancer.
AHRQ-authored.
Citation: Maclean JC, Halpern MT, Hill SC .
The effect of Medicaid expansion on prescriptions for breast cancer hormonal therapy medications.
Health Serv Res 2020 Jun;55(3):399-410. doi: 10.1111/1475-6773.13289..
Keywords: Medicaid, Cancer: Breast Cancer, Cancer, Medication, Policy, Women, Healthcare Utilization, Access to Care, Health Insurance
Gibson DC, Chou LN, Raji MA
Opioid prescribing trends in women following mastectomy or breast-conserving surgery before and after the 2014 federal reclassification of hydrocodone.
This study compares changes in opioid prescribing among surgical breast cancer patients following the 2014 federal reclassification of hydrocodone. Data from 2009 to 2017 was used from a large nationally representative commercial insurance health program. Women aged 18 years and older who were diagnosed with carcinoma in-situ or malignant breast cancer and received breast-conserving surgery or a mastectomy from 2010 to 2016 were included. Patients in 2015 or 2016 who had surgery were less likely to receive a greater than 1-day supply of opioid prescriptions or 30 days or more supply than in 2013. However, only in 2016 were surgical breast cancer patients less likely to receive a 90-day supply than in 2013.
AHRQ-funded; HS026133.
Citation: Gibson DC, Chou LN, Raji MA .
Opioid prescribing trends in women following mastectomy or breast-conserving surgery before and after the 2014 federal reclassification of hydrocodone.
Oncologist 2020 Apr;25(4):281-89. doi: 10.1634/theoncologist.2019-0758..
Keywords: Opioids, Medication, Surgery, Cancer: Breast Cancer, Cancer, Women
Fan T, Fakolade A
AHRQ Author: Fan T
Medication use to reduce risk of breast cancer.
In this case study, a 40-year-old woman comes to her doctor’s office for a routine gynecologic visit. She is not taking any medications and is generally healthy. She is sexually active, and her last menstrual period started 10 days ago. She states that her mother was diagnosed with bilateral breast cancer at 49 years of age and that she would like to discuss her options for reducing the risk of breast cancer. Three questions are posed about risk-reducing medications.
AHRQ-authored
Citation: Fan T, Fakolade A .
Medication use to reduce risk of breast cancer.
Am Fam Physician 2020 Mar 15;101(6):373-74..
Keywords: U.S. Preventive Services Task Force (USPSTF), Cancer: Breast Cancer, Cancer, Medication, Risk, Prevention, Case Study, Women
Nelson HD, Fu R, Zakher B
Medication use for the risk reduction of primary breast cancer in women: updated evidence report and systematic review for the US Preventive Services Task Force.
The purpose of this paper was to update the 2013 US Preventive Services Task Force systematic review on medications to reduce risk of primary (first diagnosis) invasive breast cancer in women. Investigators abstracted data on methods, participant characteristics, eligibility criteria, outcome ascertainment, and follow-up; individual trial results were combined using a profile likelihood random-effects model. Results showed that tamoxifen, raloxifene, and aromatase inhibitors were associated with lower risk of primary invasive breast cancer in women but also were associated with adverse effects that differed between medications. Risk stratification methods to identify patients with increased breast cancer risk demonstrated low accuracy.
AHRQ-funded; 290201500009I.
Citation: Nelson HD, Fu R, Zakher B .
Medication use for the risk reduction of primary breast cancer in women: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2019 Sep 3;322(9):868-86. doi: 10.1001/jama.2019.5780..
Keywords: Cancer: Breast Cancer, Cancer, Medication, U.S. Preventive Services Task Force (USPSTF), Evidence-Based Practice, Guidelines, Prevention, Primary Care
Sun D, Simon GJ, Skube S
Causal phenotyping for susceptibility to cardiotoxicity from antineoplastic breast cancer medications.
Cardiotoxicity is a relatively common and particularly important adverse event caused by chemotherapy for breast cancer patients. The authors of this study propose three phenotyping algorithms to assess breast cancer patients' susceptibility to cardiotoxicity caused by five first-line antineoplastic drugs. The study demonstrates the potential utility of causal phenotyping.
AHRQ-funded; HS022085.
Citation: Sun D, Simon GJ, Skube S .
Causal phenotyping for susceptibility to cardiotoxicity from antineoplastic breast cancer medications.
AMIA Annu Symp Proc 2018 Apr 16;2017:1655-64..
Keywords: Adverse Drug Events (ADE), Cancer: Breast Cancer, Medication, Risk
Milata JL, Otte JL, Carpenter JS
Oral endocrine therapy nonadherence, adverse effects, decisional support, and decisional needs in women with breast cancer.
Adverse effects contribute to breast cancer survivors’ decisions to stop oral endocrine therapy (OET), yet there has been little investigation of the process through which that occurs. This review serves as a call to action for providers to provide support to breast cancer survivors experiencing OET adverse effects and facing decisions related to nonadherence.
AHRQ-funded; HS024241.
Citation: Milata JL, Otte JL, Carpenter JS .
Oral endocrine therapy nonadherence, adverse effects, decisional support, and decisional needs in women with breast cancer.
Cancer Nurs 2018 Jan/Feb;41(1):E9-E18. doi: 10.1097/ncc.0000000000000430..
Keywords: Adverse Events, Cancer: Breast Cancer, Decision Making, Medication, Patient Adherence/Compliance
Sun D, Sarda G, Skube SJ
Phenotyping and visualizing infusion-related reactions for breast cancer patients.
Researchers developed and evaluated a phenotyping algorithm to detect Infusion-related reactions (IRRs) for breast cancer patients. They also designed a visualization prototype to render IRR patients' medications, lab tests and vital signs over time. By comparing with the 42 randomly selected doses that are manually labeled by a domain expert, the sensitivity, positive predictive value, specificity, and negative predictive value of the algorithms are 69 percent, 60 percent, 79 percent, and 85 percent, respectively.
AHRQ-funded; HS022085.
Citation: Sun D, Sarda G, Skube SJ .
Phenotyping and visualizing infusion-related reactions for breast cancer patients.
Stud Health Technol Inform 2017;245:599-603.
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Keywords: Adverse Drug Events (ADE), Cancer: Breast Cancer, Medication, Medication: Safety, Patient Safety
Kao CJ, Wurz GT, Lin YC
Repurposing ospemifene for potentiating an antigen-specific immune response.
The overall objective of the present series of preclinical studies was to evaluate the immunomodulatory activity of ospemifene in combination with a peptide cancer vaccine. The authors concluded that, taken together, ospemifene's dose response and schedule-dependent immune modulating activity offers a method of tailoring and augmenting the efficacy of previously failed antigen-specific cancer vaccines for a wide range of malignancies.
AHRQ-funded; HS022236.
Citation: Kao CJ, Wurz GT, Lin YC .
Repurposing ospemifene for potentiating an antigen-specific immune response.
Menopause 2017 Apr;24(4):437-51. doi: 10.1097/gme.0000000000000776.
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Keywords: Cancer: Breast Cancer, Cancer: Lung Cancer, Medication, Vaccination
Mamtani R, Clark AS, Scott FI
Association between breast cancer recurrence and immunosuppression in rheumatoid arthritis and inflammatory bowel disease: a cohort study.
The researchers examined the rates of breast cancer recurrence in patients with immune-mediated disease and treated breast cancer who received therapy with methotrexate, thiopurines, or anti-tumor necrosis factor (anti-TNF). They found that the risk of breast cancer recurrence in patients who received methotrexate, thiopurine, or anti-TNF therapy was not statistically significantly increased, although they did not rule out a 2-fold or greater increased risk in those treated with thiopurines.
AHRQ-funded; HS021110; HS018517.
Citation: Mamtani R, Clark AS, Scott FI .
Association between breast cancer recurrence and immunosuppression in rheumatoid arthritis and inflammatory bowel disease: a cohort study.
Arthritis Rheumatol 2016 Oct;68(10):2403-11. doi: 10.1002/art.39738.
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Keywords: Cancer: Breast Cancer, Digestive Disease and Health, Medication, Patient-Centered Outcomes Research, Arthritis
Du XL, Zhang Y, Hardy D
Temporal and geographic variations in the receipt of colony-stimulating factors and Erythropoiesis-stimulating agents in a large retrospective cohort of older women with breast cancer from 2000 to 2009.
The purpose of this study was to use the most recent national data for a large cohort of patients diagnosed with breast cancer to evaluate temporal trend of receiving hematopoietic growth factors and to examine significant factors associated with increasing trends and geographic variations. The receipt of colony-stimulationg factors continued to increase throughout the study period, and pegfilgrastim started to replace filgrastim since 2003. The receipt of erythropoiesis-stimulating agents increased at first, then declined substantially due to the black box warning. There were substantial geographic variations in the use of these hematopoietic growth factors.
AHRQ-funded; HS018956.
Citation: Du XL, Zhang Y, Hardy D .
Temporal and geographic variations in the receipt of colony-stimulating factors and Erythropoiesis-stimulating agents in a large retrospective cohort of older women with breast cancer from 2000 to 2009.
Am J Ther 2016 Mar-Apr;23(2):e411-21. doi: 10.1097/mjt.0000000000000182.
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Keywords: Cancer: Breast Cancer, Medication, Elderly
Roberts MC, Bryson A, Weinberger M
Oncologists' barriers and facilitators for oncotype DX use: qualitative study.
The purpose of this paper was to understand better the U.S. oncologists' oncotype DX (ODX) uptake and how they use ODX during adjuvant chemotherapy decision making. This study identified multi-level factors that influence ODX uptake, including organizational factors, interpersonal factors, and intrapersonal factors.
AHRQ-funded; HS022189.
Citation: Roberts MC, Bryson A, Weinberger M .
Oncologists' barriers and facilitators for oncotype DX use: qualitative study.
Int J Technol Assess Health Care 2016 Jan;32(5):355-61. doi: 10.1017/s026646231600060x.
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Keywords: Cancer: Breast Cancer, Treatments, Decision Making, Genetics, Medication
Rosenberg SM, Partridge AH
New insights into nonadherence with adjuvant endocrine therapy among young women with breast cancer.
This editorial described endocrine therapy and reasons for nonadherence in young women with breast cancer, including side effects and fertility concerns.
AHRQ-funded; HS023680.
Citation: Rosenberg SM, Partridge AH .
New insights into nonadherence with adjuvant endocrine therapy among young women with breast cancer.
J Natl Cancer Inst 2015 Oct;107(10). doi: 10.1093/jnci/djv245.
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Keywords: Adverse Drug Events (ADE), Cancer: Breast Cancer, Medication, Patient Adherence/Compliance
Roberts MC, Wheeler SB, Reeder-Hayes K
Racial/Ethnic and socioeconomic disparities in endocrine therapy adherence in breast cancer: a systematic review.
The authors sought to understand factors that influence endocrine therapy (ET) adherence among racial/ethnic and socioeconomic subpopulations of breast cancer patients. They found significant underuse of ET among minority and low-income women. They further noted that both race/ethnicity and socioeconomic status are associated with ET use in most settings.
AHRQ-funded; HS021282.
Citation: Roberts MC, Wheeler SB, Reeder-Hayes K .
Racial/Ethnic and socioeconomic disparities in endocrine therapy adherence in breast cancer: a systematic review.
Am J Public Health 2015 Jul;105 Suppl 3:e4-e15. doi: 10.2105/ajph.2014.302490.
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Keywords: Cancer: Breast Cancer, Medication, Patient Adherence/Compliance, Racial and Ethnic Minorities, Social Determinants of Health
Wheeler SB, Kohler RE, Reeder-Hayes KE
Endocrine therapy initiation among Medicaid-insured breast cancer survivors with hormone receptor-positive tumors.
The researchers sought to characterize endocrine therapy (ET) use in a low-income Medicaid-insured population in North Carolina. They found that, of 222 women meeting the inclusion criteria, only 50 percent filled a prescription for ET. Results suggest substantial underutilization of ET in this population.
AHRQ-funded; HS019468.
Citation: Wheeler SB, Kohler RE, Reeder-Hayes KE .
Endocrine therapy initiation among Medicaid-insured breast cancer survivors with hormone receptor-positive tumors.
J Cancer Surviv 2014 Dec;8(4):603-10. doi: 10.1007/s11764-014-0365-3..
Keywords: Cancer: Breast Cancer, Healthcare Utilization, Medicaid, Medication, Patient-Centered Outcomes Research
Ezaz G, Long JB, Gross CP
Risk prediction model for heart failure and cardiomyopathy after adjuvant trastuzumab therapy for breast cancer.
The investigators sought to develop a clinical risk score that identifies older women with breast cancer who are at higher risk of heart failure or cardiomyopathy after trastuzumab. That found that a 7-factor risk score was able to stratify 3-year risk of heart failure/cardiomyopathy after trastuzumab between the lowest and highest risk groups by more than 2-fold in a Medicare population.
AHRQ-funded; HS018781.
Citation: Ezaz G, Long JB, Gross CP .
Risk prediction model for heart failure and cardiomyopathy after adjuvant trastuzumab therapy for breast cancer.
J Am Heart Assoc 2014 Feb;3(1):e000472. doi: 10.1161/jaha.113.000472.
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Keywords: Cancer: Breast Cancer, Heart Disease and Health, Medication, Patient Safety, Risk