jueves, 24 de mayo de 2018

AHRQ Research Studies | Agency for Healthcare Research & Quality

AHRQ Research Studies | Agency for Healthcare Research & Quality

AHRQ News Now

Updated Database Provides Access to Full Inventory of AHRQ-Funded Research Findings

A recently updated AHRQ Research Studies database provides links to nearly 4,000 AHRQ-funded studies published since 2014 on research topics ranging from opioid misuse to prevention of healthcare-associated infections. The studies, searchable by keyword, showcase the breadth of the agency’s research endeavors and the diversity of academic journals that have published AHRQ-sponsored research findings. Each database entry includes a title, a brief summary of the research and a link to an abstract on the National Library of Medicine website
AHRQ--Agency for Healthcare Research and Quality: Advancing Excellence in Health Care

de Cordova PB
Excess mortality associated with weekend hospital admissions may be due to patient-level differences, rather than reduced staffing or services.
The author comments on a study by Walker that explained the weekend effect as arising from differences in patient characteristics among patients who present to the emergency department on the weekend. For staffing, Walker used a proxy measure because staffing information was not available. The author cautions that, although a clear rationale was provided, there should be acknowledgement that use of a proxy, whether for illness severity or staffing, may alter results.
Evid Based Nurs 2018 Apr;21(2):49. doi: 10.1136/eb-2017-102779. 
AHRQ-funded; HS024339. 
View abstract on the National Library of Medicine site.
Keywords: health care delivery, Health Services Research (HSR), Hospitalization, Mortality, Staffing
Crossman MK, Warfield ME, Kotelchuck M
Associations between early intervention home visits, family relationships and competence for mothers of children with developmental disabilities.
The researchers examined the association between intensity of home visits in early intervention (EI), perceived helpfulness of home visits in EI, and positive family relationships as predictors of maternal competence at age 3, as well as moderating effects of predictors, controlling for child characteristics, family demographics, and negative life events. They found that the intensity of home visits was not significantly associated with maternal competence at age 3.
Matern Child Health J 2018 Apr;22(4):599-607. doi: 10.1007/s10995-018-2429-x. 
AHRQ-funded; HS000063. 
View abstract on the National Library of Medicine site.
Keywords: Children, Disabilities, Family Health and History, Patient & Family Engagement, Prevention and Care Management
Costa DK, Valley TS, Miller MA
ICU team composition and its association with ABCDE implementation in a quality collaborative.
Awakening, Breathing Coordination, Delirium, and Early Mobility bundle (ABCDE) should involve an interprofessional team, yet no studies describe what team composition supports implementation. This study found that ABCDE implementation was associated with frequent involvement of team members, suggesting a need for role articulation and coordination.
J Crit Care 2018 Apr;44:1-6. doi: 10.1016/j.jcrc.2017.09.180. 
AHRQ-authored; AHRQ-funded; HS024552. 
View abstract on the National Library of Medicine site.
Keywords: Critical Care, Intensive Care Unit (ICU), Patient Safety, Quality Improvement, Team Work
AHRQ Author: Miller MA
Blaz JW, Doig AK, Cloyes KG
The symbolic functions of nurses' cognitive artifacts on a medical oncology unit.
Acute care nurses continue to rely on personally created paper-based tools-their "paper brains"-to support work during a shift, although standardized handoff tools are recommended. This interpretive descriptive study examines the functions these paper brains serve beyond handoff in the medical oncology unit at a cancer specialty hospital.
West J Nurs Res 2018 Apr;40(4):520-36. doi: 10.1177/0193945916683683.
AHRQ-funded; HS022183. 
View abstract on the National Library of Medicine site.
Keywords: Acute Care, Cancer, Nursing, Organization and Administration, Prevention and Care Management
Buys DR, Kennedy RE, Williams CP
Social and demographic predictors of nutritional risk: cross-sectional analyses from the UAB Study of Aging II.
Social factors may disparately affect access to food and nutritional risk among older adults by race and gender. This study assesses these associations using the Mini Nutritional Assessment among 414 community-dwelling persons 75+ years of age in Alabama. Multivariable analyses indicated that social factors affect nutritional risk differently by race and gender. Nutritional risk interventions are warranted for older adults.
Fam Community Health 2018 Apr/Jun;41 Suppl 2 Suppl, Food Insecurity and Obesity:S33-s45. doi: 10.1097/fch.0000000000000180. 
AHRQ-funded; HS013852. 
View abstract on the National Library of Medicine site.
Keywords: Elderly, Nutrition, Obesity, Risk Factors, Socioeconomic Factors
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.
Drug Saf 2018 Mar;41(3):297-302. doi: 10.1007/s40264-017-0615-1. 
AHRQ-funded; HS021094. 
View abstract on the National Library of Medicine site.
Keywords: Adverse Drug Events, Clinical Decision Support (CDS), Electronic Health Records, Medication Safety, Medications
Thomas HN, Hamm M, Hess R
Changes in sexual function among midlife women: "I'm older... and I'm wiser".
Researchers conducted 20 individual interviews and three focus groups among sexually active women aged 45 to 60 years (total n = 39) to explore how sexual function changes during midlife. Women described experiencing both positive and negative changes in sexual function during midlife. When negative changes occurred, women often adapted behaviorally and psychologically.
Menopause 2018 Mar;25(3):286-92. doi: 10.1097/gme.0000000000000988.
AHRQ-funded; HS022989. 
View abstract on the National Library of Medicine site.
Keywords: Aging, Sexual Health, Women's Health
Sorkin DH, Amin A, Weimer DL
Hospital discharge and selecting a skilled nursing facility: a comparison of experiences and perspectives of patients and their families.
This article seeks to examine and compare the experiences and perspectives of patients and others involved in the selection of the nursing home (predominately adult children and spouses). It found that patients were the primary decision makers about 23 percent of the time but were often involved in the decision even when family members/involved others were primarily making decisions in the discharge process.
Prof Case Manag 2018 Mar/Apr;23(2):50-59. doi: 10.1097/ncm.0000000000000252. 
AHRQ-funded; HS021844. 
View abstracton the National Library of Medicine site.
Keywords: Decisionmaking, Hospital Discharge, Long-Term Care, Nursing Homes, Patient Experience
Ng X, dosReis S, Beardsley R
Understanding systemic lupus erythematosus patients' desired outcomes and their perceptions of the risks and benefits of using corticosteroids.
This qualitative study examined systemic lupus erythematosus (SLE) patients' most desired outcomes and their concerns with corticosteroid use in SLE treatment. The SLE patients' most desired outcomes: reduction in flares, maintenance of normal activities, minimization of treatment side effects, prevention of future organ damage, and finding a cure. The patients’ primary concerns with the adverse effects of corticosteroids: weight gain, organ damage, mood swings/irritability, sleep disturbances, and dental issues.
Lupus 2018 Mar;27(3):475-83. doi: 10.1177/0961203317726375. 
AHRQ-funded; HS022135. 
View abstract on the National Library of Medicine site.
Keywords: Adverse Drug Events, Medications, Patient-Centered Outcomes Research
DuGoff EH, Walden E, Ronk K
Can claims data algorithms identify the physician of record?
This study sought to determine the agreement of the primary care physician (PCP) identified by claims algorithms with the PCP of record in electronic health record data. It concluded that researchers may be more likely to identify a patient's PCP when focusing on primary care visits only; however, these algorithms perform less well among vulnerable populations and those experiencing fragmented care.
Med Care 2018 Mar;56(3):e16-e20. doi: 10.1097/mlr.0000000000000709.
AHRQ-funded; HS021899. 
View abstract on the National Library of Medicine site.
Keywords: Diabetes, Elderly, Electronic Health Records, Primary Care
Berry JG, Gay JC, Joynt Maddox K
Age trends in 30 day hospital readmissions: US national retrospective analysis.
This study assessed trends in and risk factors for readmission to hospital across the age continuum. It concluded that the likelihood of readmission was elevated for children transitioning to adulthood, children and younger adults with mental health disorders, and patients of all ages with multiple chronic conditions.
BMJ 2018 Feb 27;360:k497. doi: 10.1136/bmj.k497. 
AHRQ-funded; HS023092. 
View abstract on the National Library of Medicine site.
Keywords: Aging, Healthcare Cost and Utilization Project (HCUP), Readmissions, Risk Factors
Agimi Y, Albert SM, Youk AO
Dementia and motor vehicle crash hospitalizations: role of physician reporting laws.
This study sought to determine the effect of physician reporting laws and state licensing requirements on crash hospitalizations among drivers with dementia. It concluded that physician reporting laws, mandated or legally protected, were not associated with a lower likelihood of dementia among crash hospitalized drivers. Vision testing at in-person renewal and in-person renewal requirements were significantly related with a lower prevalence of dementia in hospitalized older drivers.
Neurology 2018 Feb 27;90(9):e808-e13. doi: 10.1212/wnl.0000000000005022. 
View abstract on the National Library of Medicine site.
Keywords: Dementia, Elderly, Healthcare Cost and Utilization Project (HCUP), Hospitalization, Legislation/Regulations
AHRQ Author: Steiner CA
Deans KJ, Minneci PC, Nacion KM
Health care quality measures for children and adolescents in foster care: feasibility testing in electronic records.
The objective of the study is to identify healthcare quality measures for young children and adolescents in foster care and to test whether the data required to calculate these measures can be feasibly extracted and interpreted within an electronic health records or within the Statewide Automated Child Welfare Information System. It found that electronic health records and the Statewide System data frequently lacked important information on foster care youth essential for calculating the measures.
BMC Pediatr 2018 Feb 22;18(1):79. doi: 10.1186/s12887-018-1064-4. 
AHRQ-funded; HS020503. 
View abstract on the National Library of Medicine site.
Keywords: Adolescents, Children, Electronic Health Records, Quality Measures, Vulnerable Populations
Baggett TP, Berkowitz SA, Fung V
Prevalence of housing problems among community health center patients.
This study used data from a national survey to assess the prevalence and health-related correlates of housing problems among community health center patients. It found that, compared with those without housing problems, participants with housing problems were more likely to report health problems, emergency department use, and delays in care.
JAMA 2018 Feb 20;319(7):717-19. doi: 10.1001/jama.2017.19869. 
AHRQ-funded; HS025378. 
View abstract on the National Library of Medicine site.
Keywords: Community-Based Medicine, Health Services Research (HSR), Vulnerable Populations
Shah MP, Lopman BA, Tate JE
Use of Internet search data to monitor rotavirus vaccine impact in the United States, United Kingdom, and Mexico.
In this study, researchers aimed to study the correlation between internet query searches (IQS) for "rotavirus" and rotavirus disease activity in the United States, United Kingdom, and Mexico before and after introduction of rotavirus vaccine. They found positive correlation between the rotavirus IQS and laboratory reports in the United States and United Kingdom and between the rotavirus IQS and acute gastroenteritis hospitalizations in the United States and Mexico for all correlations.
J Pediatric Infect Dis Soc 2018 Feb 19;7(1):56-63. doi: 10.1093/jpids/pix004.
View abstract on the National Library of Medicine site.
Keywords: Healthcare Cost and Utilization Project (HCUP), Vaccination, Web-Based
AHRQ Author: Steiner CA
Childers CP, Siletz AE, Singer ES
Surgical technical evidence review for elective total joint replacement conducted for the AHRQ Safety Program for Improving Surgical Care and Recovery.
AHRQ, the American College of Surgeons, and the Johns Hopkins Medicine Armstrong Institute for Patent Safety and Quality have developed the Safety Program for Improving Surgical Care and Recovery - a national effort to catalyze implementation of practices to improve perioperative care and enhance recovery of surgical patients. This review synthesizes evidence that can be used to develop a protocol for elective total knee arthroplasty and total hip arthroplasty.
Geriatr Orthop Surg Rehabil 2018 Feb 12;9:2151458518754451. doi: 10.1177/2151458518754451. 
AHRQ-funded; 233201500020I. 
View abstracton the National Library of Medicine site.
Keywords: Evidence-based Medicine, Orthopedics, Patient Safety, Surgery, Surgical Safety
Desai S, McWilliams JM
Consequences of the 340B drug pricing program.
Researchers used Medicare claims and a regression-discontinuity design, taking advantage of the threshold for program eligibility among general acute care hospitals to isolate the effects of the 340B Drug Pricing Program on hospital-physician consolidation and on the outpatient administration of parenteral drugs. They concluded that the Program has been associated with hospital-physician consolidation in hematology-oncology and with more hospital-based administration of parenteral drugs in hematology-oncology and ophthalmology.
N Engl J Med 2018 Feb 8;378(6):539-48. doi: 10.1056/NEJMsa1706475.
AHRQ-funded; HS024072. 
View abstract on the National Library of Medicine site.
Keywords: Health Care Costs, Health Care Payment, Hospitals, Medicare, Medications
Khan S, Biju A, Wang S
Mobile critical care recovery program (m-CCRP) for acute respiratory failure survivors: study protocol for a randomized controlled trial.
The Mobile Critical Care Recovery Program (m-CCRP) study is a two arm, randomized clinical trial. The researchers will randomize 620 patients admitted to the ICU with acute respiratory failure requiring mechanical ventilation to one of two arms - m-CCRP intervention versus attention control. Their primary aim is to assess the efficacy of m-CCRP in improving the quality of life of acute respiratory failure survivors at 12 months
Trials 2018 Feb 7;19(1):94. doi: 10.1186/s13063-018-2449-2. 
AHRQ-funded; HS024384. 
View abstract on the National Library of Medicine site.
Keywords: Critical Care, Intensive Care Unit (ICU), Quality of Life, Respiratory Care, Respiratory Conditions
Maciejewski ML, Hammill BG, Voils CI
Prescriber continuity and medication availability in older adults with cardiometabolic conditions.
Researchers examined whether the number of prescribers of essential medications was associated with the availability of medications, a surrogate for adherence, to manage diabetes, hypertension or dyslipidemia. They found that the number of prescribers was not significantly associated with availability of oral diabetes agents but having more prescribers is associated with increased medication availability in older Medicare beneficiaries with dyslipidemia or hypertension.
SAGE Open Med 2018 Feb 6;6:2050312118757388. doi: 10.1177/2050312118757388. 
AHRQ-funded; HS023085. 
View abstract on the National Library of Medicine site.
Keywords: Chronic Conditions, Elderly, Medicare, Medications, Patient Adherence
Adam GP, Di M, Cu-Uvin S
Strategies for improving the lives of US women aged 40 and above living with HIV/AIDS: an evidence map.
This work aims to identify and characterize empirical studies of strategies for the comprehensive management of women over 40, including transgender women, who live with HIV/AIDS. Few of the 37 eligible studies focused on women facing obvious challenges, such as immigrants, transgender, physically abused, or those recently released from prison. No studies focused on women caring for dependents, including children and grandchildren, or those diagnosed after age 40.
Syst Rev 2018 Feb 2;7(1):25. doi: 10.1186/s13643-018-0684-y. 
AHRQ-funded; 290201500002I. 
View abstract on the National Library of Medicine site.
Keywords: Evidence-based Medicine, Human Immunodeficiency Virus (HIV), Vulnerable Populations, Women's Health


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