AHRQ Child & Adolescent Health Digest
Agency for Healthcare Research and Quality (AHRQ) sent this bulletin at 07/01/2013 11:49 AM EDTVolume 14, No. 25, July 1, 2013
- Second Evaluation Highlight of CHIPRA Quality Demonstration Grant Program
- Disparities Continue in Well-Child Visits
- More Research Needed into Benefits of Migraine Therapy in Children
- Primary Care Interventions to Prevent Child Maltreatment
- Patient Safety Primer Offers Strategies to Prevent Medication Errors
Second Evaluation Highlight of CHIPRA Quality Demonstration Grant Program
AHRQ has published the second Evaluation Highlight of the CHIPRA Quality Demonstration Grant Program, titled How are States and evaluators measuring medical homeness in the CHIPRA Quality Demonstration Grant Program? The new Evaluation Highlight examines the measurement of medical homes in selected demonstration States. It also describes the development of the Medical Home Index-Revised Short Form, an adaptation of the Medical Home Index, which is being used to evaluate the demonstration projects. Additional reports and resources are available on the national evaluation Web page.
Disparities Continue in Well-Child Visits
Children from families in the two lowest-income brackets in the United States had approximately half the number of recommended well-child visits in 2007-2008, compared with average adherence of nearly three-quarters among those in the highest-income bracket, according to a new AHRQ study. The gap has not narrowed significantly since 1996-1998. The study, by AHRQ researchers Thomas Selden and Salam Abdus, also analyzed adherence with well-child visit recommendations by whether the children had a usual source of care and insurance coverage, as well as by race or ethnicity, parent education, and other factors. They found 63 percent adherence among the children who had a usual source of care in 2007-2008, compared with 24 percent adherence among those who did not. Similarly, adherence was 64 percent among privately insured children and 57 percent for publicly insured children in 2007-2008, compared with 32 percent among uninsured children.
More Research Needed into Benefits of Migraine Therapy in Children
Limited evidence is available on the benefits and harms of therapies to prevent headaches in children because the quality of studies involving children is poor and the studies lack detailed information, a new research review from AHRQ’s Effective Health Care Program finds. Migraines significantly affect children’s physical, psychological, and social well-being, and have been shown to significantly impair learning and school productivity. Low strength evidence suggests that the beta blocker propranololthan is more effective than a placebo for preventing migraine in children, with no negative effects that could lead to treatment discontinuation. However, non-drug treatments such as stress management demonstrated better benefit-to-harm ratios than drug treatments in randomly controlled trials. More research is needed on the comparative effectiveness of multimodal drug and disease management approaches; the long-term benefits, safety, and adherence with preventive treatments; and the effects and risks of off-label drug use for migraine prevention. Select to access the full review, Migraine in Children: Preventive Pharmacologic Treatments.
Go to: http://www.effectivehealthcare.ahrq.gov/
Primary Care Interventions to Prevent Child Maltreatment
The U.S. Preventive Services Task Force released its final Recommendation Statement on primary care interventions to prevent child maltreatment. A fact sheet that explains the final recommendation in plain language is also available.
Patient Safety Primer Offers Strategies to Prevent Medication Errors
A growing evidence base supports specific strategies to prevent adverse drug events (ADEs), according to a patient safety primer posted online on AHRQ’s Patient Safety Network (PSNet). The primer outlines strategies providers can use at each stage of the medication use pathway – prescribing, transcribing, dispensing, administration – to prevent ADEs. These strategies range from computerized provider order entry and clinical decision support to minimizing nurse disruption and providing better patient education and medication labeling. The primer also identifies known risk factors for ADEs, including health literacy, patient characteristics, high alert medications and transitions in care.
Go to: http://psnet.ahrq.gov/primer.aspx?primerID=23
Go to: http://psnet.ahrq.gov/primer.aspx?primerID=23
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