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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 9 of 9 Research Studies DisplayedGrowdon ME, Gan S, Yaffe K
New psychotropic medication use among Medicare beneficiaries with dementia after hospital discharge.
Hospital stays often trigger behavioral shifts in people with dementia (PWD), potentially leading to the prescription of psychotropic drugs despite their limited effectiveness and potential for harmful side-effects. The purpose of this study was to ascertain the prevalence of new psychotropic drug prescriptions in PWD living in the community after their discharge from the hospital, and within these new users, the percentage who continued their use for an extended duration. The researchers conducted a retrospective cohort study, utilizing a random selection of Medicare claims from 2017. The study included PWD hospital patients who were 68 years or older and covered by traditional and Part D Medicare. The primary outcome was the event of prescribing at the time of discharge psychotropic drugs including antipsychotics, sedative-hypnotics, antiepileptics, and antidepressants. The initiation was characterized as new prescriptions (from classes not utilized in the 180 days preceding admission) filled within a week of discharge from the hospital or skilled nursing facility. Extended use was defined as the percentage of new users who continued to refill the newly prescribed medications for more than 90 days post-discharge. The study population consisted of 117,022 hospitalized PWD with an average age of 81 years, with 63% being female. The study found that prior to admission, 63% were already using at least one psychotropic drug; 10% were using drugs from three or more psychotropic classes. These classes included antidepressants (44% pre-admission), antiepileptics (29%), sedative-hypnotics (21%), and antipsychotics (11%). The percentage of PWD discharged with new psychotropic prescriptions ranged from 1.9% (antipsychotics) to 2.9% (antiepileptics); 6.6% had at least one new class initiated. Among these new users, prolonged use varied from 36% (sedative-hypnotics) to 63% (antidepressants); across drug classes, prolonged use was observed in 51%. Factors associated with the initiation of new psychotropics included duration of hospital stay and delirium.
AHRQ-funded; HS026383.
Citation: Growdon ME, Gan S, Yaffe K .
New psychotropic medication use among Medicare beneficiaries with dementia after hospital discharge.
J Am Geriatr Soc 2023 Apr; 71(4):1134-44. doi: 10.1111/jgs.18161..
Keywords: Elderly, Medication, Medicare, Dementia, Neurological Disorders, Hospitalization
Thomson J, Richardson T, Auger KA
Impact of the COVID-19 pandemic on hospitalizations of children with neurologic impairment.
The purpose of this multicenter retrospective cohort study was to explore the effect of the early COVID-19 pandemic on hospital utilization for children with neurologic impairment (NI). The study found that compared with the pre-COVID period, there was a 14.4% decrease in the weekly median number of hospitalizations in the early-COVID era. Hospitalizations decreased for both noninfectious and infectious illnesses in the early-COVID era. Researchers reported that the decrease was the largest in spring 2020 and continued throughout 2020.
AHRQ-funded; HS024735; HS025138; HS026763.
Citation: Thomson J, Richardson T, Auger KA .
Impact of the COVID-19 pandemic on hospitalizations of children with neurologic impairment.
J Hosp Med 2023 Jan; 18(1):33-42. doi: 10.1002/jhm.13021..
Keywords: Children/Adolescents, COVID-19, Neurological Disorders, Hospitalization
Poppert Cordts KM, Hall TA, Hartman ME
Sleep measure validation in a pediatric neurocritical care acquired brain injury population.
Lingering morbidities including physical, cognitive, emotional, and psychosocial sequelae, termed the Post-Intensive Care Syndrome, persist years after pediatric neurocritical care (PNCC) hospitalization. Sleep disturbances impact other Post-Intensive Care Syndrome domains and are under-evaluated to date due to a lack of appropriate measurement tools. The present study evaluated the validity of the Sleep Disturbance Scale for Children (SDSC) to address the growing need for assessing sleep problems after PNCC.
AHRQ-funded; HS022981.
Citation: Poppert Cordts KM, Hall TA, Hartman ME .
Sleep measure validation in a pediatric neurocritical care acquired brain injury population.
Neurocrit Care 2020 Aug;33(1):196-206. doi: 10.1007/s12028-019-00883-5..
Keywords: Children/Adolescents, Sleep Problems, Neurological Disorders, Intensive Care Unit (ICU), Hospitalization, Quality of Life
Oh ES, Needham DM, Nikooie R
Antipsychotics for preventing delirium in hospitalized adults: a systematic review.
The purpose of this study was to conduct a systematic review evaluating the benefits and harms of antipsychotics to treat delirium in adults. Results showed that there was little evidence demonstrating neurologic harms associated with short-term use of antipsychotics for treating delirium in adult inpatients, but potentially harmful cardiac effects tended to occur more frequently. Current evidence does not support routine use of haloperidol or second-generation antipsychotics to treat delirium in adult inpatients.
AHRQ-funded; 290201500006I.
Citation: Oh ES, Needham DM, Nikooie R .
Antipsychotics for preventing delirium in hospitalized adults: a systematic review.
Ann Intern Med 2019 Oct 1;171(7):474-84. doi: 10.7326/m19-1859..
Keywords: Neurological Disorders, Medication, Hospitalization, Inpatient Care, Patient-Centered Outcomes Research, Outcomes, Evidence-Based Practice, Comparative Effectiveness, Behavioral Health, Prevention
Nikooie R, Neufeld KJ, Oh ES
Antipsychotics for treating delirium in hospitalized adults: a systematic review.
The purpose of this study was to conduct a systematic review evaluating the benefits and harms of antipsychotics to treat delirium in adults. Results showed that there was little evidence demonstrating neurologic harms associated with short-term use of antipsychotics for treating delirium in adult inpatients, but potentially harmful cardiac effects tended to occur more frequently. Current evidence does not support routine use of haloperidol or second-generation antipsychotics to treat delirium in adult inpatients.
AHRQ-funded; 290201500006I.
Citation: Nikooie R, Neufeld KJ, Oh ES .
Antipsychotics for treating delirium in hospitalized adults: a systematic review.
Ann Intern Med 2019 Oct 1;171(7):485-95. doi: 10.7326/m19-1860.
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Keywords: Neurological Disorders, Medication, Hospitalization, Inpatient Care, Patient-Centered Outcomes Research, Outcomes, Evidence-Based Practice, Comparative Effectiveness, Behavioral Health
Spears CC, Besharat A, Monari EH
Causes and outcomes of hospitalization in Lewy body dementia: a retrospective cohort study.
Understanding hospitalization in Lewy body dementia (LBD) is a known knowledge gap. In this study, the authors aimed to identify common causes, medication profiles, complications, and outcomes of hospitalization in LBD. The investigators concluded that the most common reasons for hospitalization in LBD are potentially modifiable. They indicated that opportunities for improved care include increased involvement of neurological and psychiatric services, delirium prevention strategies, and reduced antipsychotic use.
AHRQ-funded; HS024159.
Citation: Spears CC, Besharat A, Monari EH .
Causes and outcomes of hospitalization in Lewy body dementia: a retrospective cohort study.
Parkinsonism Relat Disord 2019 Jul;64:106-11. doi: 10.1016/j.parkreldis.2019.03.014..
Keywords: Dementia, Neurological Disorders, Hospitalization
Heslin KC, Owens PL, Simpson LA
AHRQ Author: Heslin KC Owens PL
Annual report on health care for children and youth in the united states: focus on 30-day unplanned inpatient readmissions, 2009 to 2014.
The authors describe trends in unplanned 30-day all-condition hospital readmissions for children aged 1 to 17 years between 2009 and 2014. Using HCUP data, they found that the rate of readmission was essentially stable between 2009 and 2014. In 2009, the most common reason for readmission was sickle cell anemia, whereas in 2014 the most common reason was epilepsy. Pneumonia fell from the second to the sixth most common reason for readmission over this period. The authors suggest that their study provides a baseline assessment for examining trends in 30-day unplanned pediatric readmissions, an important quality metric as the provisions of the Children's Health Insurance Program Reauthorization Act and the Affordable Care Act are changed and implemented in the future.
AHRQ-authored.
Citation: Heslin KC, Owens PL, Simpson LA .
Annual report on health care for children and youth in the united states: focus on 30-day unplanned inpatient readmissions, 2009 to 2014.
Acad Pediatr 2018 Nov - Dec;18(8):857-72. doi: 10.1016/j.acap.2018.06.006..
Keywords: Healthcare Cost and Utilization Project (HCUP), Children/Adolescents, Hospital Readmissions, Hospitalization, Hospitals, Sickle Cell Disease, Pneumonia, Neurological Disorders
Sterling MR, Safford MM, Goggins K
Numeracy, health literacy, cognition, and 30-day readmissions among patients with heart failure.
Numeracy, health literacy, and cognition are important for chronic disease management. Prior studies have found them to be associated with poorer selfcare and worse clinical outcomes, but limited data exists in the context of heart failure (HF), a condition that requires patients to monitor their weight, fluid intake, and dietary salt, especially in the post hospitalization period. The purpose of this study was to examine the relationship between numeracy, health literacy, and cognition with 30-day readmissions among patients hospitalized for acute decompensated HF (ADHF).
AHRQ-funded; HS000066.
Citation: Sterling MR, Safford MM, Goggins K .
Numeracy, health literacy, cognition, and 30-day readmissions among patients with heart failure.
J Hosp Med 2018 Mar;13(3):145-51. doi: 10.12788/jhm.2932..
Keywords: Health Literacy, Hospital Readmissions, Hospitalization, Heart Disease and Health, Cardiovascular Conditions, Neurological Disorders, Risk
Gavinski K, Carnahan R, Weckmann M
Validation of the delirium observation screening scale in a hospitalized older population.
The authors studied the accuracy of the Delirium Observation Screening Scale (DOS) as a screening tool in hospitalized patients over age 64. They also investigated the user-friendliness of the tool. They determined that DOS is an accurate and easy way to screen for delirium in older inpatients.
AHRQ-funded; HS022666.
Citation: Gavinski K, Carnahan R, Weckmann M .
Validation of the delirium observation screening scale in a hospitalized older population.
J Hosp Med 2016 Jul;11(7):494-7. doi: 10.1002/jhm.2580.
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Keywords: Elderly, Hospitalization, Neurological Disorders, Screening