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
151 to 175 of 231 Research Studies DisplayedHartung DM, Hall J, Haverly SN
Pharmacists' role in opioid safety: a focus group investigation.
This qualitative study explores the pharmacist's role in promoting opioid safety from the perspective of pharmacists and patients. Using focus groups, results showed that pharmacists expressed discomfort filling potentially high-risk opioid prescriptions and noted barriers such as lack of clinical information and discomfort policing high-risk prescribing; and that patients were concerned about pharmacists potentially overstepping their professional responsibilities by interfering with prescribers' clinical decisions.
AHRQ-funded; HS024227.
AHRQ-funded; HS024227.
AHRQ-funded; HS024227.
Citation: Hartung DM, Hall J, Haverly SN .
Pharmacists' role in opioid safety: a focus group investigation.
Pain Med 2018 Sep;19(9):1799-806. doi: 10.1093/pm/pnx139..
Keywords: Provider: Pharmacist, Opioids, Medication: Safety, Medication, Patient Safety
Wong A, Plasek JM, Montecalvo SP
Natural language processing and its implications for the future of medication safety: a narrative review of recent advances and challenges.
This review illustrates the fundamentals of natural language processing (NLP) and discusses the application the NLPs to medication safety in four data sources: electronic health records, Internet-based data, published literature, and reporting systems. The benefit of NLP is its time-saving features in association with the automation of medication safety tasks, as well as the potential for near real-time identification of adverse events, such as incidents posted on social media that might otherwise go unanalyzed. However, NLP is limited by a lack of data sharing between health care organizations, which inhibits wider adverse event monitoring across populations. The authors anticipate that future work on NLPs will focus on integrating of data sources from different domains to more quickly identify potential adverse events and to improve clinical decision support regarding patients’ estimated risks for specific adverse events.
AHRQ-funded; HS022728; HS024264; HS025375.
Citation: Wong A, Plasek JM, Montecalvo SP .
Natural language processing and its implications for the future of medication safety: a narrative review of recent advances and challenges.
Pharmacotherapy 2018 Aug;38(8):822-41. doi: 10.1002/phar.2151..
Keywords: Adverse Drug Events (ADE), Adverse Events, Electronic Health Records (EHRs), Health Information Technology (HIT), Medication, Medication: Safety, Patient Safety
Trivedi LU, Alvarez CA, Mansi IA
Association of statin therapy with risk of epilepsy in 2 propensity score-matched cohorts.
The objective of this study was to examine the association between statin use and epilepsy risk in a general population and in a healthy population (individuals with no severe comorbidities). The study did not demonstrate a significant beneficial or deleterious effect of statin use on risk of being diagnosed with epilepsy. The authors assert that clinicians should not withhold statins, whenever indicated, in patients with epilepsy.
AHRQ-funded; HS022418.
Citation: Trivedi LU, Alvarez CA, Mansi IA .
Association of statin therapy with risk of epilepsy in 2 propensity score-matched cohorts.
Ann Pharmacother 2018 Jun;52(6):546-53. doi: 10.1177/1060028018756650..
Keywords: Medication, Medication: Safety, Adverse Drug Events (ADE), Adverse Events, Cardiovascular Conditions, Neurological Disorders, Risk
Wang J, Ali E, Gong Y
An information enhanced framework for reporting medication events.
In this article, the authors describe a proposed framework to discover supportive information from the FDA Adverse Event Reporting System (FAERS), an open data source, to enhance the reporting of insulin-use events. The framework represents a paradigm for developing an information enhanced electronic reporting system.
AHRQ-funded; HS022895.
Citation: Wang J, Ali E, Gong Y .
An information enhanced framework for reporting medication events.
Stud Health Technol Inform 2018;250:169-73..
Keywords: Adverse Drug Events (ADE), Adverse Events, Medical Errors, Medication, Medication: Safety, Patient Safety
Kannampallil TG, Manning JD, Chestek DW
Effect of number of open charts on intercepted wrong-patient medication orders in an emergency department.
The authors examined the effect of number of open charts on intercepted wrong-patient medication orders in an emergency department using an interrupted time series analysis of intercepted wrong-patient medication orders in an emergency department during 2010-2016.
AHRQ-funded; HS024945.
Citation: Kannampallil TG, Manning JD, Chestek DW .
Effect of number of open charts on intercepted wrong-patient medication orders in an emergency department.
J Am Med Inform Assoc 2018 Jun;25(6):739-43. doi: 10.1093/jamia/ocx099..
Keywords: Adverse Drug Events (ADE), Emergency Department, Medical Errors, Medication, Medication: Safety, Patient Safety
Kron K, Myers S, Volk L
Incorporating medication indications into the prescribing process.
Investigators looked into the challenges of incorporating patient-specific drug indications into a computerized prescriber order-entry (CPOE) system. Six expert stakeholder panels were convened to provide input. Findings are summarized including rationale, literature findings, potential benefits, and challenges of incorporating indications into the prescribing process. The findings have identified design requirements for a new CPOE interface and workflow.
AHRQ-funded; HS023694.
Citation: Kron K, Myers S, Volk L .
Incorporating medication indications into the prescribing process.
Am J Health Syst Pharm 2018 Jun 1;75(11):774-83. doi: 10.2146/ajhp170346..
Keywords: Health Information Technology (HIT), Medication, Medication: Safety
Lee JL, Dy SM, Gurses AP
Towards a more patient-centered approach to medication safety.
In this perspective, the authors focus their discussion on a patient-centered approach to measurement and describe commonly used health system–oriented medication safety measures for evaluating interventions. They also discuss measures that reflect patient-centeredness in medication safety.
AHRQ-funded; HS024436.
Citation: Lee JL, Dy SM, Gurses AP .
Towards a more patient-centered approach to medication safety.
J Patient Exp 2018 Jun;5(2):83-87. doi: 10.1177/2374373517727532..
Keywords: Adverse Drug Events (ADE), Patient-Centered Healthcare, Patient Safety, Medication: Safety, Medication
Zhou S, Kang H, Yao B
Unveiling originated stages of medication errors: an automated pipeline approach.
Medication error reports collected by Patient Safety Organizations provide an opportunity to analyze and learn from previous cases. However, the current process of analyzing the reports is labor-intensive and time-consuming. To improve the efficiency, the investigators used automated text classification techniques to develop a pipeline for medication error report pre-analysis.
AHRQ-funded; HS022895.
Citation: Zhou S, Kang H, Yao B .
Unveiling originated stages of medication errors: an automated pipeline approach.
Stud Health Technol Inform 2018;250:182-86..
Keywords: Adverse Drug Events (ADE), Adverse Events, Medical Errors, Medication, Medication: Safety, Patient Safety
Smith JC, Chen Q, Denny JC
Evaluation of a novel system to enhance clinicians' recognition of preadmission adverse drug reactions.
This study evaluated whether an automated system, the Adverse Drug Effect Recognizer (ADER), could assist clinicians in detecting and addressing inpatients' ongoing preadmission adverse drug reactions (ADRs). The investigators found that their results indicated that ADER helped physicians recognize ADRs and reduced ordering of suspected ADR-causing medications. They suggest that in hospitals using EHRs, ADER-like systems could improve clinicians' recognition and elimination of ongoing ADRs.
AHRQ-funded; HS023485.
Citation: Smith JC, Chen Q, Denny JC .
Evaluation of a novel system to enhance clinicians' recognition of preadmission adverse drug reactions.
Appl Clin Inform 2018 Apr;9(2):313-25. doi: 10.1055/s-0038-1646963..
Keywords: Adverse Drug Events (ADE), Adverse Events, Medication: Safety, Medication, Patient Safety, Health Information Technology (HIT)
Rangachari P, Dellsperger KC, Fallaw D
Creating a foundation for implementing an electronic health records (EHR)-integrated Social Knowledge Networking (SKN) system on medication reconciliation.
Augusta University received a two-year grant from AHRQ, to implement a Social Knowledge Networking (SKN) system for enabling its health system, AU-Health, to progress from "limited use" of EHR Medication Reconciliation (MedRec) Technology, to "meaningful use." Phase 1 sought to identify a comprehensive set of issues related to EHR MedRec encountered by practitioners at AU-Health. The purpose of this paper is to describe the methods and results of Phase 1.
AHRQ-funded; HS024335.
Citation: Rangachari P, Dellsperger KC, Fallaw D .
Creating a foundation for implementing an electronic health records (EHR)-integrated Social Knowledge Networking (SKN) system on medication reconciliation.
J Hosp Adm 2018 Apr;7(2):36-49. doi: 10.5430/jha.v7n2p36.
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Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Medication: Safety, Medication, Patient Safety
Wong A, Seger DL, Slight SP
Evaluation of 'definite' anaphylaxis drug allergy alert overrides in inpatient and outpatient settings.
The aim of this study was to determine the rate of anaphylaxis overrides, the reasons for these overrides, whether the overrides were appropriate, and if harm occurred from overrides. Overrides of 'definite' anaphylaxis drug-allergy interactions were common and often appropriate. Most overrides were due to desensitizations.
AHRQ-funded; HS021094.
Citation: Wong A, Seger DL, Slight SP .
Evaluation of 'definite' anaphylaxis drug allergy alert overrides in inpatient and outpatient settings.
Drug Saf 2018 Mar;41(3):297-302. doi: 10.1007/s40264-017-0615-1.
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Keywords: Adverse Drug Events (ADE), Clinical Decision Support (CDS), Electronic Health Records (EHRs), Medication: Safety, Medication
Cornu P, Phansalkar S, Seger DL
High-priority and low-priority drug-drug interactions in different international electronic health record systems: a comparative study.
The purpose of this comparative retrospective study was to investigate whether alert warnings for high-priority and low-priority drug-drug interactions were present in five international electronic health record systems, to compare and contrast the severity level assigned to them, and to establish the proportion of alerts that were overridden.
AHRQ-funded; HS021094.
Citation: Cornu P, Phansalkar S, Seger DL .
High-priority and low-priority drug-drug interactions in different international electronic health record systems: a comparative study.
Int J Med Inform 2018 Mar;111:165-71. doi: 10.1016/j.ijmedinf.2017.12.027..
Keywords: Adverse Drug Events (ADE), Electronic Health Records (EHRs), Health Information Technology (HIT), Medication, Medication: Safety
Kerstenetzky L, Birschbach MJ, Beach KF
Improving medication information transfer between hospitals, skilled-nursing facilities, and long-term-care pharmacies for hospital discharge transitions of care: a targeted needs assessment using the Intervention Mapping framework.
The authors of this study report on the development of a logic model that will be used to explore methods for minimizing patient care medication delays and errors while further improving handoff communication to skilled nurse facilities and long term care pharmacy staff.
AHRQ-funded; HS021984.
Citation: Kerstenetzky L, Birschbach MJ, Beach KF .
Improving medication information transfer between hospitals, skilled-nursing facilities, and long-term-care pharmacies for hospital discharge transitions of care: a targeted needs assessment using the Intervention Mapping framework.
Res Social Adm Pharm 2018 Feb;14(2):138-45. doi: 10.1016/j.sapharm.2016.12.013..
Keywords: Adverse Drug Events (ADE), Hospital Discharge, Hospitals, Long-Term Care, Medical Errors, Medication, Medication: Safety, Nursing Homes, Patient Safety, Transitions of Care
Gray SL, Hart LA, Perera S
Meta-analysis of interventions to reduce adverse drug reactions in older adults.
This review examined the effect of interventions to optimize medication use on adverse drug reactions (ADRs) in older adults. Thirteen randomized controlled trials involving 6,198 older adults were included in the review. It concluded that interventions designed to optimize medication use reduced the risk of any and serious ADRs in older adults.
AHRQ-funded; HS023779.
Citation: Gray SL, Hart LA, Perera S .
Meta-analysis of interventions to reduce adverse drug reactions in older adults.
J Am Geriatr Soc 2018 Feb;66(2):282-88. doi: 10.1111/jgs.15195.
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Keywords: Adverse Drug Events (ADE), Elderly, Medication: Safety, Medication, Patient Safety
Zullo AR, Gray SL, Holmes HM
Screening for medication appropriateness in older adults.
Older adults are at high risk for inappropriate medication use given their myriad medical conditions and medications. Screening efforts may seem overwhelming, but starting with a focused approach and leveraging a team-based strategy can help practicing clinicians gain initial momentum. Future research is needed to strengthen the evidence base for medication use in older adults and to elucidate effective and scalable interventions to improve medication safety.
AHRQ-funded; HS022998.
Citation: Zullo AR, Gray SL, Holmes HM .
Screening for medication appropriateness in older adults.
Clin Geriatr Med 2018 Feb;34(1):39-54. doi: 10.1016/j.cger.2017.09.003.
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Keywords: Elderly, Medication: Safety, Medication, Patient Safety
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
George MD, Baker JF, Hsu JY
Perioperative timing of infliximab and the risk of serious infection after elective hip and knee arthroplasty.
The purpose of this retrospective cohort study was to evaluate the association between infliximab timing and serious infection after elective hip or knee arthroplasty. The investigators concluded that administering infliximab within 4 weeks of elective knee or hip arthroplasty was not associated with a higher risk of short- or long-term serious infection compared to withholding infliximab for longer time periods. They also concluded that glucocorticoid use, especially >10 mg/day, was associated with an increased infection risk.
AHRQ-funded; HS018517.
Citation: George MD, Baker JF, Hsu JY .
Perioperative timing of infliximab and the risk of serious infection after elective hip and knee arthroplasty.
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Keywords: Adverse Drug Events (ADE), Adverse Events, Medication, Medication: Safety, Orthopedics, Patient Safety, Surgery
Zhou M, Wang SV, Leonard CE
Sentinel modular program for propensity score-matched cohort analyses: application to glyburide, glipizide, and serious hypoglycemia.
Sentinel is a program sponsored by the US Food and Drug Administration to monitor the safety of medical products. This cohort assessment was conducted to evaluate the ability of the Sentinel Propensity Score Matching Tool to reproduce, in an expedited fashion, the known association between glyburide (vs. glipizide) and serious hypoglycemia. The study’s findings were consistent with the literature, and demonstrated the ability of the tool to reproduce this known association in an expedited.
AHRQ-funded; HS022193.
Citation: Zhou M, Wang SV, Leonard CE .
Sentinel modular program for propensity score-matched cohort analyses: application to glyburide, glipizide, and serious hypoglycemia.
Epidemiology 2017 Nov;28(6):838-46. doi: 10.1097/ede.0000000000000709..
Keywords: Adverse Drug Events (ADE), Diabetes, Medication: Safety, Medication, Patient Safety
Boyce RD, Jao J, Miller T
Automated screening of emergency department notes for drug-associated bleeding adverse events occurring in older adults.
The purpose of this study was to conduct research to show the value of text mining for automatically identifying suspected bleeding adverse drug events (ADEs) in the emergency department (ED). The investigators found that both models they examined, accurately identify bleeding ADEs using the presence or absence of certain clinical concepts in ED admission notes for older adult patients.
AHRQ-funded; HS024208.
Citation: Boyce RD, Jao J, Miller T .
Automated screening of emergency department notes for drug-associated bleeding adverse events occurring in older adults.
Appl Clin Inform 2017 Oct;8(4):1022-30. doi: 10.4338/aci-2017-02-ra-0036..
Keywords: Adverse Drug Events (ADE), Elderly, Emergency Department, Medication, Medication: Safety
Balbale SN, Trivedi I, O'Dwyer LC
Strategies to identify and reduce opioid misuse among patients with gastrointestinal disorders: a systematic scoping review.
In this study, the investigators conducted a systematic scoping review to describe published scientific literature on strategies to identify and reduce opioid misuse among patients with gastrointestinal (GI) symptoms and disorders. They concluded that prescription drug monitoring and self-management interventions may be promising strategies to identify and reduce opioid misuse in GI care. They suggest that rigorous, empirical research is needed to evaluate the longer-term impact of these strategies.
AHRQ-funded; HS000084.
Citation: Balbale SN, Trivedi I, O'Dwyer LC .
Strategies to identify and reduce opioid misuse among patients with gastrointestinal disorders: a systematic scoping review.
Dig Dis Sci 2017 Oct;62(10):2668-85. doi: 10.1007/s10620-017-4705-9..
Keywords: Behavioral Health, Chronic Conditions, Digestive Disease and Health, Medication, Medication: Safety, Opioids, Patient Self-Management, Prevention, Substance Abuse
Nothelle SK, Sharma R, Oakes AH
Determinants of potentially inappropriate medication use in long-term and acute care settings: a systematic review.
The authors searched for studies conducted in the United States that described determinants of Potentially inappropriate medications (PIMs) use in adults >/=60 years of age in a nursing home or residential care facility, in the emergency department (ED), or in the hospital. They concluded that among older adults, those who are on many medications are at increased risk for PIM use across multiple settings.
AHRQ-funded; HS000029.
Citation: Nothelle SK, Sharma R, Oakes AH .
Determinants of potentially inappropriate medication use in long-term and acute care settings: a systematic review.
J Am Med Dir Assoc 2017 Sep;18(9):806.e1-06.e17. doi: 10.1016/j.jamda.2017.06.005.
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Keywords: Medication, Medication: Safety, Long-Term Care, Critical Care, Elderly
Chui MA, Stone JA, Holden RJ
Improving over-the-counter medication safety for older adults: a study protocol for a demonstration and dissemination study.
This study proposes to evaluate the effectiveness of the intervention for preventing misuse of high-risk OTC medications by older adults; and to evaluate the implementation of the intervention in community pharmacies. The primary outcome will be a comparison of proportion of older adults who misuse OTC medication from baseline to post-intervention.
AHRQ-funded; HS024490.
Citation: Chui MA, Stone JA, Holden RJ .
Improving over-the-counter medication safety for older adults: a study protocol for a demonstration and dissemination study.
Res Social Adm Pharm 2017 Sep - Oct;13(5):930-37. doi: 10.1016/j.sapharm.2016.11.006.
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Keywords: Adverse Drug Events (ADE), Elderly, Medication: Safety, Medication, Provider: Pharmacist
Miller GE, Sarpong EM, Davidoff AJ
AHRQ Author: Miller GE, Sarpong EM
Determinants of potentially inappropriate medication use among community-dwelling older adults.
The researchers examined the determinants of potentially inappropriate medication (PIM) use. The multivariate results suggest that poor health status and high-PIM-risk conditions were associated with increased PIM use, while increasing age and educational attainment were associated with lower PIM use. Contrary to expectations, lack of a usual care source of care or supplemental insurance was associated with lower PIM use
AHRQ-authored.
Citation: Miller GE, Sarpong EM, Davidoff AJ .
Determinants of potentially inappropriate medication use among community-dwelling older adults.
Health Serv Res 2017 Aug;52(4):1534-49. doi: 10.1111/1475-6773.12562.
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Keywords: Medication, Elderly, Medication: Safety, Adverse Drug Events (ADE), Medical Errors
Koronkowski MJ, Semla TP, Schmader KE
Recent literature update on medication risk in older adults, 2015-2016.
Medications can pose considerable risk in older adults. This article intended to provide a narrative review of key publications in medication safety for clinicians and researchers committed to improving medication safety in older adults. It annotates four articles addressing this concern from 2016.
AHRQ-funded; HS023779.
Citation: Koronkowski MJ, Semla TP, Schmader KE .
Recent literature update on medication risk in older adults, 2015-2016.
J Am Geriatr Soc 2017 Jul;65(7):1401-05. doi: 10.1111/jgs.14887.
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Keywords: Elderly, Medication, Medication: Safety, Adverse Drug Events (ADE), Adverse Events, Patient Safety
Schroeder SR, Salomon MM, Galanter WL
Cognitive tests predict real-world errors: the relationship between drug name confusion rates in laboratory-based memory and perception tests and corresponding error rates in large pharmacy chains.
The researchers conducted a study to assess the association between error rates in laboratory-based tests of drug name memory and perception and real-world drug name confusion error rates. They found that across two distinct pharmacy chains, there is a strong and significant association between drug name confusion error rates observed in the real world and those observed in laboratory-based tests of memory and perception.
AHRQ-funded; HS021093.
Citation: Schroeder SR, Salomon MM, Galanter WL .
Cognitive tests predict real-world errors: the relationship between drug name confusion rates in laboratory-based memory and perception tests and corresponding error rates in large pharmacy chains.
BMJ Qual Saf 2017 May;26(5):395-407. doi: 10.1136/bmjqs-2015-005099.
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Keywords: Adverse Drug Events (ADE), Medical Errors, Medication: Safety, Medication, Provider: Pharmacist