National Healthcare Quality and Disparities Report
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Topics
- Adverse Drug Events (ADE) (1)
- Adverse Events (1)
- Antibiotics (2)
- Antimicrobial Stewardship (1)
- Arthritis (1)
- Behavioral Health (2)
- Blood Thinners (1)
- Cancer: Lung Cancer (1)
- Cardiovascular Conditions (2)
- Care Management (2)
- Case Study (2)
- Catheter-Associated Urinary Tract Infection (CAUTI) (1)
- Chronic Conditions (2)
- Comparative Effectiveness (6)
- COVID-19 (1)
- Decision Making (1)
- Dementia (7)
- Depression (1)
- Diabetes (1)
- Diagnostic Safety and Quality (2)
- Dialysis (1)
- Domestic Violence (1)
- Education: Continuing Medical Education (2)
- (-) Elderly (30)
- (-) Evidence-Based Practice (30)
- Falls (1)
- Guidelines (8)
- Healthcare-Associated Infections (HAIs) (1)
- Healthcare Delivery (1)
- Healthcare Utilization (1)
- Heart Disease and Health (3)
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- Imaging (1)
- Implementation (2)
- Infectious Diseases (1)
- Inpatient Care (1)
- Kidney Disease and Health (1)
- Long-Term Care (7)
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- Mortality (1)
- Neurological Disorders (7)
- Nursing Homes (8)
- Opioids (1)
- Orthopedics (1)
- Outcomes (8)
- Pain (2)
- Patient-Centered Healthcare (1)
- Patient-Centered Outcomes Research (10)
- Patient Safety (2)
- Practice Patterns (1)
- Prevention (6)
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- Provider (1)
- Provider: Clinician (1)
- Provider: Health Personnel (1)
- Provider: Physician (1)
- Quality Improvement (2)
- Quality Measures (1)
- Quality of Care (2)
- Racial and Ethnic Minorities (1)
- Screening (4)
- Sex Factors (2)
- Surgery (3)
- Training (1)
- Transitions of Care (2)
- Treatments (2)
- U.S. Preventive Services Task Force (USPSTF) (4)
- Urinary Tract Infection (UTI) (1)
- Vulnerable Populations (1)
- Women (1)
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 30 Research Studies DisplayedLeland NE, Lekovitch C, Martínez J
Optimizing post-acute care patient safety: a scoping review of multifactorial fall prevention interventions for older adults.
The purpose of this scoping review was to describe the evidence for multifactorial post-acute care (PAC) fall prevention interventions for older patients. The researchers included 33 studies and characterized common intervention domains including: evaluating patient-specific fall risk factors, developing an individualized risk profile and treatment plan that targets each patient's fall risk factors, and implementing facility-based strategies such as staff education. There was not consensus across studies in how the domains were addressed and to what extent. The researchers concluded that health system efforts to prevent accidental falls in PAC should consider a patient-centered multifactorial approach.
AHRQ-funded; HS022907.
Citation: Leland NE, Lekovitch C, Martínez J .
Optimizing post-acute care patient safety: a scoping review of multifactorial fall prevention interventions for older adults.
J Appl Gerontol 2022 Oct;41(10):2187-96. doi: 10.1177/07334648221104375..
Keywords: Elderly, Falls, Prevention, Patient Safety, Evidence-Based Practice
Baughman AW, Renton M, Wehbi NK
Building community and resilience in Massachusetts nursing homes during the COVID-19 pandemic.
Researchers discuss the partnership of the Massachusetts Senior Care Association and Hebrew SeniorLife with AHRQ ECHO National Nursing Home COVID-19 Action Network (the Network). This educational program provided 16 weeks of free weekly virtual sessions to 295 eligible nursing homes. The Network weekly meetings were a source of connection, emotional support, and validation and may be a valuable mechanism to support resilience and wellbeing for nursing home staff.
AHRQ-funded; 75Q80120C00003.
Citation: Baughman AW, Renton M, Wehbi NK .
Building community and resilience in Massachusetts nursing homes during the COVID-19 pandemic.
J Am Geriatr Soc 2021 Oct;69(10):2716-21. doi: 10.1111/jgs.17389..
Keywords: COVID-19, Elderly, Nursing Homes, Evidence-Based Practice, Provider: Health Personnel, Education: Continuing Medical Education, Training
Feltner C, Wallace IF, Kistler CE
Screening for hearing loss in older adults: updated evidence report and systematic review for the US Preventive Services Task Force.
The purpose of this study was to update the evidence review on screening for hearing loss in adults 50 years or older to inform the US Preventive Services Task Force. Findings showed that several screening tests can adequately detect hearing loss in older adults, while no studies reported on the harms of screening or treatment. Further, evidence showing benefit from hearing aids on hearing-related function among adults with screen-detected or newly detected hearing loss is limited to studies enrolling veterans.
AHRQ-funded; 290201500011I.
Citation: Feltner C, Wallace IF, Kistler CE .
Screening for hearing loss in older adults: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2021 Mar 23;325(12):1202-15. doi: 10.1001/jama.2020.24855..
Keywords: U.S. Preventive Services Task Force (USPSTF), Elderly, Screening, Guidelines, Evidence-Based Practice, Prevention
Dworsky JQ, Shenoy R, Childers CP
Older veterans undergoing inpatient surgery: what is the compliance with best practice guidelines?
This study’s objective was to determine the documented compliance with best practice guidelines for optimal perioperative care for the older adult surgical patient that were created by the American College of Surgeons Quality Improvement Program and the American Geriatrics Society. The guidelines include 38 measures. A retrospective chart review was conducted on 86 older adults undergoing elective inpatient coronary artery bypass graft, prostatectomy, or colectomy over a 2-year period at a single Veterans Affairs hospital. Mean reported compliance across measures was 41% ± 4%. Of the 38 analyzed measures, 10 measures were achieved for 0 patients, and only 1 patient for 7 measures. Future work is needed to understand barriers for implementation.
AHRQ-funded; HS000046.
Citation: Dworsky JQ, Shenoy R, Childers CP .
Older veterans undergoing inpatient surgery: what is the compliance with best practice guidelines?
Surgery 2021 Feb;169(2):356-61. doi: 10.1016/j.surg.2020.08.033..
Keywords: Elderly, Surgery, Guidelines, Evidence-Based Practice, Quality Improvement, Quality of Care, Quality Measures
Makam AN, Nguyen OK, Miller ME
Comparative effectiveness of long-term acute care hospital versus skilled nursing facility transfer.
This study compared the effectiveness of long-term acute care hospital (LTACH) use versus skilled nursing facility (SNF) transfer after hospitalization. Medicare claims linked to electronic health record (EHR) data from six Texas hospitals between 2009 and 2010 were used to conduct a retrospective cohort study of hospitalized patients transferred to either an LTACH or SNF and followed for one year. Out of 3505 patients, 18% were transferred to an LTACH and overall were younger, less likely to be female, and white, but sicker than transfers to an SNF. Patients transferred to an LTACH were less likely to survive (59 vs. 65%) or recover (62.5 vs 66%). Adjusting for demographic and clinical confounders found in Medicare claims and EHR data, transfer location was not significantly associated with differences in mortality but was associated with greater Medicare spending.
AHRQ-funded; HS022418.
Citation: Makam AN, Nguyen OK, Miller ME .
Comparative effectiveness of long-term acute care hospital versus skilled nursing facility transfer.
BMC Health Serv Res 2020 Nov 11;20(1):1032. doi: 10.1186/s12913-020-05847-6..
Keywords: Comparative Effectiveness, Evidence-Based Practice, Long-Term Care, Elderly, Medicare, Transitions of Care, Nursing Homes, Hospitals
Zimmerman S, Wretman CJ, Ward K
Fidelity and sustainability of Mouth Care Without a Battle and lessons for other innovations in care.
This project examined the fidelity and sustainability of Mouth Care Without a Battle (MCWB), an evidence-based program conducted in a two-year cluster randomized trial in 14 nursing homes. The investigators found that results that triangulated two sources of data indicated that fidelity decreased after the first year; results provided guidance to promote fidelity and sustainability of this and other new care practices in nursing homes, including ongoing education, coaching, evaluation, feedback, and sufficient resources.
AHRQ-funded; HS022298.
Citation: Zimmerman S, Wretman CJ, Ward K .
Fidelity and sustainability of Mouth Care Without a Battle and lessons for other innovations in care.
Geriatr Nurs 2020 Nov-Dec;41(6):878-84. doi: 10.1016/j.gerinurse.2020.06.002..
Keywords: Elderly, Nursing Homes, Long-Term Care, Evidence-Based Practice
Zullo AR, Riester MR, Erqou S
Comparative effectiveness of angiotensin II receptor blockers and angiotensin-converting enzyme inhibitors in older nursing home residents after myocardial infarction: a retrospective cohort study.
Evidence regarding differences in outcomes between angiotensin II receptor blockers (ARBs) and angiotensin-converting enzyme inhibitors (ACEIs) among older nursing home (NH) residents after acute myocardial infarction (AMI) is limited. The purpose of this study was to estimate the post-AMI effects of ARBs versus ACEIs on mortality, rehospitalization, and functional decline outcomes in this important population.
AHRQ-funded; HS022998.
Citation: Zullo AR, Riester MR, Erqou S .
Comparative effectiveness of angiotensin II receptor blockers and angiotensin-converting enzyme inhibitors in older nursing home residents after myocardial infarction: a retrospective cohort study.
Drugs Aging 2020 Oct;37(10):755-66. doi: 10.1007/s40266-020-00791-w..
Keywords: Elderly, Nursing Homes, Heart Disease and Health, Medication, Evidence-Based Practice, Comparative Effectiveness, Patient-Centered Outcomes Research, Outcomes
H H, Caton Gilstrap L
AHRQ Author: Tracer H
Screening for cognitive impairment in older adults.
This evidence-based approach paper focuses on putting prevention into action. It discusses screening for cognitive impairment in older adults. It provides case study, case study questions and a discussion.
AHRQ-authored.
Citation: H H, Caton Gilstrap L .
Screening for cognitive impairment in older adults.
Am Fam Physician 2020 Jun 15;101(12):753-54..
Keywords: U.S. Preventive Services Task Force (USPSTF), Dementia, Neurological Disorders, Elderly, Screening, Prevention, Case Study, Evidence-Based Practice, Guidelines
Fink HA, Linskens EJ, Silverman PC
Accuracy of biomarker testing for neuropathologically defined Alzheimer disease in older adults with dementia
This study is a systematic review of biomarker and test accuracy for identification of Alzheimer Disease (AD) in older adults. Studies with low or medium risk of bias were analyzed, and two reviewers rated risk of bias. Fifteen brain imaging studies and 9 cerebrospinal fluid (CSF) studies met analysis criteria and were included. The meta-analysis found that in methodologically heterogeneous studies of uncertain applicability to typical clinical settings, the biomarkers amyloid PET, 18F-FDG proton emission tomography (PET), and magnetic resonance imaging (MRI) were highly sensitive for neuropathologic AD. Single studies suggested that adding amyloid PET, 18F-FDG PET, and CSF test combinations may add accuracy to clinical evaluation.
AHRQ-funded; 290201500008I.
Citation: Fink HA, Linskens EJ, Silverman PC .
Accuracy of biomarker testing for neuropathologically defined Alzheimer disease in older adults with dementia
Ann Intern Med 2020 May 19;172(10):669-77. doi: 10.7326/m19-3888..
Keywords: Elderly, Dementia, Neurological Disorders, Imaging, Diagnostic Safety and Quality, Patient-Centered Outcomes Research, Evidence-Based Practice
Fink HA, Linskens EJ, MacDonald R
Benefits and harms of prescription drugs and supplements for treatment of clinical Alzheimer-type dementia
This is a systematic review and meta-analysis of the benefits and harms of prescription drugs and supplements for treatment of clinical Alzheimer-type dementia (CATD). Studies with low or medium risk of bias (ROB) were analyzed and rated. The analysis concluded there was a slight reduction in short-term cognitive decline with cholinesterase inhibitors and memantime, and cholinesterase inhibitors slightly reduced reported functional decline. There was mostly insufficient evidence on drug treatment of behavioral and psychological symptoms of dementia and on supplements for all outcomes.
AHRQ-funded; 290201500008I.
Citation: Fink HA, Linskens EJ, MacDonald R .
Benefits and harms of prescription drugs and supplements for treatment of clinical Alzheimer-type dementia
Ann Intern Med 2020 May 19;172(10):656-68. doi: 10.7326/m19-3887..
Keywords: Elderly, Dementia, Neurological Disorders, Medication, Patient-Centered Outcomes Research, Evidence-Based Practice, Outcomes, Adverse Drug Events (ADE), Adverse Events, Treatments
Hemmy LS, Linskens EJ, Silverman PC
Brief cognitive tests for distinguishing clinical Alzheimer-type dementia from mild cognitive impairment or normal cognition in older adults with suspected cognitive impairment.
Researchers summarized evidence on accuracy and harms of brief cognitive tests for clinical Alzheimer-type dementia (CATD) in older adults with suspected cognitive impairment. They encountered the following limitations: small studies, few test metrics being evaluated by multiple studies, and few studies directly comparing different tests, scores, cut points, or test combinations. They concluded that many brief, single cognitive tests accurately distinguish CATD from normal cognition in older adults but are less accurate in distinguishing mild CATD from normal cognition or CATD from mild cognitive impairment.
AHRQ-funded; 290201500008I.
Citation: Hemmy LS, Linskens EJ, Silverman PC .
Brief cognitive tests for distinguishing clinical Alzheimer-type dementia from mild cognitive impairment or normal cognition in older adults with suspected cognitive impairment.
Ann Intern Med 2020 May 19;172(10):678-87. doi: 10.7326/m19-3889..
Keywords: Dementia, Neurological Disorders, Diagnostic Safety and Quality, Elderly, Evidence-Based Practice, Patient-Centered Outcomes Research
Zullo AR, Ofori-Asenso R, Wood M
Effects of statins for secondary prevention on functioning and other outcomes among nursing home residents.
Studies examining the effects of statins after acute myocardial infarction (AMI) excluded frail older adults, especially nursing home (NH) residents, and few examined functional outcomes. Older NH residents may benefit less from statins and be particularly susceptible to adverse drug events like myopathy-related functional decline. In this retrospective cohort study, the investigators evaluated the effects of statins on 1-year functional decline, rehospitalization, and death in NH residents.
AHRQ-funded; HS022998.
Citation: Zullo AR, Ofori-Asenso R, Wood M .
Effects of statins for secondary prevention on functioning and other outcomes among nursing home residents.
J Am Med Dir Assoc 2020 Apr;21(4):500-07.e8. doi: 10.1016/j.jamda.2020.01.102..
Keywords: Elderly, Nursing Homes, Long-Term Care, Medication, Prevention, Outcomes, Evidence-Based Practice, Patient-Centered Outcomes Research
Patnode CD, Perdue LA, Rossom RC
Screening for cognitive impairment in older adults: updated evidence report and systematic review for the US Preventive Services Task Force.
The purpose of this study was to systematically review the test accuracy of cognitive screening instruments and benefits and harms of interventions to treat cognitive impairment in older adults (>/=65 years) to inform the US Preventive Services Task Force. The investigators concluded that screening instruments could adequately detect cognitive impairment. They indicated that there was no empirical evidence, however, that screening for cognitive impairment improved patient or caregiver outcomes or causes harm.
AHRQ-funded; 290201500007I.
Citation: Patnode CD, Perdue LA, Rossom RC .
Screening for cognitive impairment in older adults: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2020 Feb 25;323(8):764-85. doi: 10.1001/jama.2019.22258..
Keywords: U.S. Preventive Services Task Force (USPSTF), Dementia, Neurological Disorders, Elderly, Guidelines, Screening, Prevention, Evidence-Based Practice
Ochs-Ross R, Daly EJ, Zhang Y
Efficacy and safety of esketamine nasal spray plus an oral antidepressant in elderly patients with treatment-resistant depression-TRANSFORM-3.
This phase 3 double-blind study randomized patients with treatment-resistant depression age 65 or older to flexibly-dosed esketamine nasal spray and new oral antidepressant (esketamine/antidepressant) or new oral antidepressant and placebo nasal spray (antidepressant/placebo). The primary endpoint was change in the Montgomery-Asberg Depression Rating Scale (MADRS) over 28 days from baseline. Results showed that esketamine/antidepressant did not achieve statistical significance for patients ages 75 and older; however, greater differences were seen for patients ages 65-74 and patients with earlier onset of depression younger than age 55.
AHRQ-funded; HS023000.
Citation: Ochs-Ross R, Daly EJ, Zhang Y .
Efficacy and safety of esketamine nasal spray plus an oral antidepressant in elderly patients with treatment-resistant depression-TRANSFORM-3.
Am J Geriatr Psychiatry 2020 Feb;28(2):121-41. doi: 10.1016/j.jagp.2019.10.008..
Keywords: Medication, Depression, Behavioral Health, Elderly, Comparative Effectiveness, Treatments, Evidence-Based Practice
Kim SC, Jin Y, Lee YC
Association of preoperative opioid use with mortality and short-term safety outcomes after total knee replacement.
The purpose of this study was to determine the association of preoperative opioid use among patients 65 years and older with mortality and other complications at 30 days post-total knee replacement (TKR). Findings show that continuous opioid users had a higher risk of revision operations, vertebral fractures, and opioid overdose at 30 days post-TKR but not of in-hospital or 30-day mortality, compared with opioid-naive patients. Highlights include the need for better understanding of patient characteristics associated with chronic opioid use to optimize preoperative assessment of overall risk after TKR.
AHRQ-funded; HS018910.
Citation: Kim SC, Jin Y, Lee YC .
Association of preoperative opioid use with mortality and short-term safety outcomes after total knee replacement.
JAMA Netw Open 2019 Jul 3;2(7):e198061. doi: 10.1001/jamanetworkopen.2019.8061..
Keywords: Opioids, Medication, Surgery, Orthopedics, Elderly, Patient-Centered Outcomes Research, Mortality, Outcomes, Arthritis, Evidence-Based Practice
Borsky AE, Zhang E
AHRQ Author: Borsky AE
Screening for intimate partner violence, elder abuse, and abuse of vulnerable adults.
This Putting Prevention into Practice case study demonstrates how a U.S. Preventive Services Task Force (USPSTF) recommendation can used by clinicians. This case study uses the Screening for Intimate Partner Violence, Elder Abuse, and Abuse of Vulnerable Adults recommendation as an example. Three quiz questions are given which directly link to the recommendations. The questions involve screening guidelines, screening instruments, and follow-up if there is a positive screening and detailed answers are provided.
AHRQ-authored.
Citation: Borsky AE, Zhang E .
Screening for intimate partner violence, elder abuse, and abuse of vulnerable adults.
Am Fam Physician 2019 May 15;99(10):649-50..
Keywords: Case Study, Domestic Violence, Elderly, Evidence-Based Practice, Screening, U.S. Preventive Services Task Force (USPSTF), Vulnerable Populations
Hanlon JT, Perera S, Drinka PJ
The IOU consensus recommendations for empirical therapy of cystitis in nursing home residents.
A 19-member panel of clinical pharmacists was convened for the Improving Outcomes of UTI Management in Long-Term Care Project (IOU) funded by the Agency for Healthcare Research and Quality. The objective is to reach consensus on a set of recommendations for the empirical treatment of cystitis in older nursing home residents with oral anti-infective medications. A comprehensive literature search was conducted and out of that 31 recommendations were created. There were two Delphi Survey rounds conducted and those recommendations were rated on a 5-point Likert scale. In the first round three recommendations reached consensus and in the second round an additional eight recommendations were agreed on.
AHRQ-funded; HS023779.
Citation: Hanlon JT, Perera S, Drinka PJ .
The IOU consensus recommendations for empirical therapy of cystitis in nursing home residents.
J Am Geriatr Soc 2019 Mar;67(3):539-45. doi: 10.1111/jgs.15726..
Keywords: Elderly, Nursing Homes, Long-Term Care, Medication, Quality Improvement, Quality of Care, Evidence-Based Practice
Carnahan RM, Daly JM, Minion S
A needs assessment of family physicians to inform development of educational resources on antipsychotic use in dementia.
The authors assessed the needs and preferred resources of Iowa physicians to inform the development of educational resources for best practice dementia care and compared the responses of nursing home medical directors with nonmedical directors. They found that medical directors and nonmedical directors had similar preferences for resources used and information needs, with preference for online resources, pocket guides, a handbook, consulting pharmacists, and facility in-services being the most commonly preferred sources of new information. Medical directors were significantly more aware of the FDA warning on antipsychotic use in dementia and treated more nursing home patients. No differences were observed between groups related to confidence in and use of nondrug strategies instead of antipsychotics to manage behavioral symptoms of dementia.
AHRQ-funded; HS019355.
Citation: Carnahan RM, Daly JM, Minion S .
A needs assessment of family physicians to inform development of educational resources on antipsychotic use in dementia.
J Prim Care Community Health 2019 Jan-Dec;10:2150132719840113. doi: 10.1177/2150132719840113..
Keywords: Education: Continuing Medical Education, Medication, Dementia, Neurological Disorders, Elderly, Evidence-Based Practice, Guidelines, Long-Term Care
Shuman CJ, Xie XJ, Herr KA
Sustainability of evidence-based acute pain management practices for hospitalized older adults.
This article reported on the sustainability of evidence-based acute pain management practices in hospitalized older adults following testing of a multifaceted Translating Research Into Practice (TRIP) implementation intervention. Results revealed most evidence-based acute pain management practices were sustained for 18 months following implementation.
AHRQ-funded; HS010482.
Citation: Shuman CJ, Xie XJ, Herr KA .
Sustainability of evidence-based acute pain management practices for hospitalized older adults.
West J Nurs Res 2018 Dec;40(12):1749-64. doi: 10.1177/0193945917738781..
Keywords: Care Management, Elderly, Evidence-Based Practice, Inpatient Care, Pain, Implementation
Lee T, Qian J, Thamer M
Tradeoffs in vascular access selection in elderly patients initiating hemodialysis with a catheter.
In this study the investigators evaluated clinically relevant vascular access outcomes in elderly patients receiving an arteriovenous fistulas (AVF) or arteriovenous grafts AVG after hemodialysis therapy initiation. The investigators found that in elderly hemodialysis patients initiating hemodialysis therapy with a catheter, the optimal vascular access selection depended on tradeoffs between shorter catheter dependence and less frequent interventions to make the vascular access (AVG) functional versus longer access patency and fewer interventions after successful use of the vascular access (AVF).
AHRQ-funded; HS022931; HS021229.
Citation: Lee T, Qian J, Thamer M .
Tradeoffs in vascular access selection in elderly patients initiating hemodialysis with a catheter.
Am J Kidney Dis 2018 Oct;72(4):509-18. doi: 10.1053/j.ajkd.2018.03.023..
Keywords: Dialysis, Kidney Disease and Health, Elderly, Evidence-Based Practice, Patient-Centered Outcomes Research, Outcomes
Naylor MD, Hirschman KB, Toles MP
Adaptations of the evidence-based Transitional Care Model in the U.S.
The goal of this study was to describe and classify common local adaptations of the evidence-based intervention Transitional Care Model (TCM); this model is comprised of 10 components that have been proven in multiple clinical trials to improve care and outcomes for chronically ill older adults who are transitioning home from hospitals. 582 U.S.-based transitional care clinicians in health systems and community-based organizations were asked to complete a survey, then researchers interviewed a subset of survey respondents regarding implementation of TCM in their distinct organizations. The results suggest hypotheses that can be used to guide rigorous examination of the association between adaptations of TCM components and desired outcomes, and reinforce a need for investment in adaptation science.
AHRQ-funded; HS022406.
Citation: Naylor MD, Hirschman KB, Toles MP .
Adaptations of the evidence-based Transitional Care Model in the U.S.
Soc Sci Med 2018 Sep;213:28-36. doi: 10.1016/j.socscimed.2018.07.023..
Keywords: Elderly, Chronic Conditions, Evidence-Based Practice, Transitions of Care
Angraal S, Khera R, Wang Y
Sex and race differences in the utilization and outcomes of coronary artery bypass grafting among Medicare beneficiaries, 1999-2014.
The authors sought to evaluate how the use of coronary artery bypass grafting (CABG) and its outcomes have evolved in different sex and racial subgroups. Using Medicare data, they found that women and black patients had persistently higher CABG mortality than men and white patients, respectively, despite greater declines over the time period. The authors conclude that these findings indicate progress, but further progress is needed.
AHRQ-funded; HS023000.
Citation: Angraal S, Khera R, Wang Y .
Sex and race differences in the utilization and outcomes of coronary artery bypass grafting among Medicare beneficiaries, 1999-2014.
J Am Heart Assoc 2018 Jul 12;7(14). doi: 10.1161/jaha.118.009014..
Keywords: Cardiovascular Conditions, Elderly, Evidence-Based Practice, Heart Disease and Health, Healthcare Utilization, Medicare, Outcomes, Patient-Centered Outcomes Research, Racial and Ethnic Minorities, Sex Factors
Callahan CM, Bateman DR, Wang S
State of science: bridging the science-practice gap in aging, dementia and mental health.
This article describes why new models of care in aging, dementia, and mental health diffuse inadequately into the healthcare systems and communities where they might benefit older adults. The investigators review a general framework for the diffusion of innovations and highlight the importance of other features of innovations that deter or facilitate diffusion.
AHRQ-funded; HS024384.
Citation: Callahan CM, Bateman DR, Wang S .
State of science: bridging the science-practice gap in aging, dementia and mental health.
J Am Geriatr Soc 2018 Apr;66(Suppl 1):S28-s35. doi: 10.1111/jgs.15320..
Keywords: Elderly, Dementia, Behavioral Health, Healthcare Delivery, Neurological Disorders, Implementation, Evidence-Based Practice
Jump RLP, Crnich CJ, Mody L
Infectious diseases in older adults of long-term care facilities: update on approach to diagnosis and management.
The diagnosis, treatment, and prevention of infectious diseases in older adults in long-term care facilities (LTCFs), particularly nursing facilities, remains a challenge for all health providers who care for this population. This review provides updated information on the currently most important challenges of infectious diseases in LTCFs. With the increasing prescribing of antibiotics in older adults, particularly in LTCFs, the topic of antibiotic stewardship is presented in this review.
AHRQ-funded; HS022465.
Citation: Jump RLP, Crnich CJ, Mody L .
Infectious diseases in older adults of long-term care facilities: update on approach to diagnosis and management.
J Am Geriatr Soc 2018 Apr;66(4):789-803. doi: 10.1111/jgs.15248.
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Keywords: Elderly, Healthcare-Associated Infections (HAIs), Infectious Diseases, Nursing Homes, Long-Term Care, Antimicrobial Stewardship, Antibiotics, Medication, Evidence-Based Practice, Guidelines
McCreedy EM, Kane RL, Gollust SE
Patient-centered guidelines for geriatric diabetes care: potential missed opportunities to avoid harm.
Clinicians strive to deliver individualized, patient-centered care. However, these intentions are understudied. This research explored how patient characteristics associated with a high risk-to-benefit ratio with hypoglycemia medications affected decision making by primary care clinicians. The investigators found that primary care clinicians often chose to intensify glycemic control despite individual patient factors that warranted higher glycemic targets based on existing guidelines.
AHRQ-funded; HS000011.
Citation: McCreedy EM, Kane RL, Gollust SE .
Patient-centered guidelines for geriatric diabetes care: potential missed opportunities to avoid harm.
J Am Board Fam Med 2018 Mar-Apr;31(2):192-200. doi: 10.3122/jabfm.2018.02.170141..
Keywords: Diabetes, Elderly, Patient-Centered Healthcare, Guidelines, Evidence-Based Practice, Decision Making, Medication, Primary Care, Practice Patterns, Provider: Physician, Provider: Clinician, Provider