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December 3, 2004, Issue No. 154
AHRQ News and Numbers
Prescription medicine expenses accounted for 18.5 percent of total health care spending in 2001, and the average expense for these medicines among those with expenses was $730. [Source: Agency for Healthcare Research and Quality, MEPS Statistical Brief #56: National Health Care Expenses in the U.S. Community Population, 2001 (PDF File, 846 KB; PDF Help).]
- New AHRQ consumer tool puts quit plan in a smoker's hands
- Call for more public comments on HCAHPS®—deadline January 18
- Second volume of "Closing the Quality Gap" is available
- New research abstracts available through Grants On-Line Database
- State of the Science Conference on End-of-Life Care
- New evidence report on congestive heart failure available
- Coming soon—new AHRQ Bioterrorism Preparedness LISTSERV®
- National Guideline Clearinghouse™ features patient safety-related guidelines
- AHRQ in the professional literature
1. New AHRQ Consumer Tool Puts Quit Plan in a Smoker's Hands
AHRQ released a new consumer tool for Palm™ and Pocket PCs to help smokers who want to quit. Quit Smoking: Consumer Interactive Tool is drawn from the evidence-based recommendations of the Public Health Service guideline, Treating Tobacco Use and Dependence, and helps smokers set up a program tailored to their individual needs. To use the application, the smoker plugs in the date he or she wants to quit, and the program counts back 5 days leading up to the quit date. It then offers a 5-day countdown of daily practical steps to help the smoker quit, such as identifying reasons to quit smoking; talking to the doctor about medications, including the nicotine patch or gum; and getting support from family and friends. The AHRQ Palm™ and Pocket PC applications are available as a free download. Select to read our press release and visit the AHRQ Web site for more information about quitting smoking.
2. Call for More Public Comments on HCAHPS®—Deadline January 18
The Centers for Medicare & Medicaid Services (CMS) is requesting public comments on the proposed collection of the AHRQ-developed Hospital CAHPS® (HCAHPS®) data and other data collection activities. HCAHPS® is an effort to provide comparative performance information on hospitals to the public and is part of the Hospital Quality Alliance. The goal of HCAHPS® is to offer consumers choice and create incentives for hospitals to improve performance in areas that are important to patients. AHRQ, in partnership with CMS, developed, tested, and modified the current questionnaire and implementation strategy to reflect public input. Select to read the November 19 Federal Register notice. Written comments are due January 18, 2005.
3. Second Volume of "Closing the Quality Gap" Is Available
The second volume in the series of AHRQ Evidence-based Practice Center Technical Reviews, titled Closing the Quality Gap: A Critical Analysis of Quality Improvement Strategies, Volume 2: Diabetes Mellitus Care, is now available. The reports explore the human and organizational factors influencing quality improvement strategies and evaluate nine quality improvement strategies, tools, or processes aimed at reducing the quality gap. Volume 2 examines strategies for improving the quality of care for adults with type 2 diabetes through changes in provider behavior, patient behavior, and modifications to the organization of care. Outpatient care for diabetes exemplifies the challenges of, and opportunities for, chronic disease management. Select to download Volume 2 as a set of (PDF Files, or send an E-mail to AHRQPubs@ahrq.hhs.gov for a print copy. Select to download Volume 1; Volume 3, which will focus on improving the treatment of patients suffering from hypertension, will be available soon.
4. New Research Abstracts Available Through Grants On-Line Database
AHRQ is now making abstracts of research conducted by AHRQ staff available online. The Grants On-Line Database (GOLD), a searchable database of grants funded by AHRQ, now contains information on staff research as well. Choose "Advanced Search" from the GOLD Web page. Also available on this site is a series of working papers based on staff research. Currently, seven working papers and more than 130 abstracts are available.
5. State of the Science Conference on End-of-Life Care
NIH will hold a State of the Science Conference on Improving End-of-Life Care on December 6-8 at the Natcher Conference Center on the NIH campus in Bethesda, MD. AHRQ has been actively involved in planning and organizing this conference. Evidence will be presented by national experts, including those from AHRQ's Southern California Evidence-based Practice Center—RAND, which developed the systematic review and analysis that will serve as a reference for the consensus panel and for discussion at the conference. Select for registration information. Select to access the End-of-Life Care summary and report. A print copy of the summary and the full report are available by sending an E-mail to AHRQPubs@ahrq.hhs.gov.
6. New Evidence Report on Congestive Heart Failure Available
AHRQ announced the availability of a new evidence report on cardiac resynchronization therapy (CRT) for congestive heart failure. AHRQ's University of Alberta Evidence-based Practice Center conducted this systematic review to examine the success rate and safety of biventricular pacemaker implantation and the efficacy of CRT in patients with heart failure. In addition, the researchers conducted a decision analysis to evaluate the incremental cost-effectiveness of CRT versus medical therapy alone. The researchers concluded that when added to medical therapy in certain patients with symptomatic heart failure, CRT reduces all-cause mortality by 25 percent and heart failure hospitalizations by 32 percent. These benefits are particularly significant in heart failure patients who are at higher risk. Select to read the summary. A print copy of the summary and the report are available by sending an E-mail to AHRQPubs@ahrq.hhs.gov.
7. Coming Soon—New AHRQ Bioterrorism Preparedness Listserv®
AHRQ is launching a new Bioterrorism Preparedness Listserv®. We will send items of interest to listserv subscribers periodically about the results of AHRQ's bioterrorism preparedness research, planning, and response projects. AHRQ's bioterrorism research portfolio aims to assess and improve the U.S. healthcare system's capacity to respond to possible incidents of bioterrorism. The portfolio focuses on surge capacity, clinical preparedness, training, and the ability of front-line medical staff—including primary care providers, emergency departments, and hospitals—to detect and respond to a bioterrorist threat. The new listserv will feature concise descriptions of new AHRQ reports and tools along with Web links to the products themselves.
8. National Guideline Clearinghouse™ Features Patient Safety-Related Guidelines
Nearly 250 of the more than 1,400 guidelines included in the National Guideline Clearinghouse™ (NGC) have been categorized in the Institute of Medicine's domain of "safety." The NGC team catalogues a guideline as patient safety-related when it provides recommendations on how care should be given. Traditionally, guideline recommendations assist in decision-making on what care should be given, when, to whom, where, and why. With the increasing emphasis on the need to reduce medical errors and improve patient safety, guideline developers may purposefully include statements about how that care should be given, such as checking patient identification before dispensing medication, and by whom. To find these safety-related evidence-based guidelines, use the detailed search feature (scroll approximately two-thirds down, select "safety" in the IOM Domain field box, scroll to the bottom of page, and select Search).
9. AHRQ in the Professional Literature
We are providing the following hyperlinks to journal abstracts through PubMed® for your convenience. Unfortunately, some of you may not be able to access the abstracts because of firewalls or specific settings on your individual computer systems. If you are having problems, you should ask your technical support staff for possible remedies.
Curtis LH, Ostbye T, Sendersky V, et al. Inappropriate prescribing for elderly Americans in a large outpatient population. Arch Intern Med 2004 Aug 9-23; 164(5):1621-5. Select to access the abstract on PubMed®.
Egede LE. Patterns and correlates of emergency department use by individuals with diabetes. Diabetes Care 2004 Jul; 27(7):1748-50. Select to access the abstract on PubMed®.
Meara E, Landrum MB, Ayanian JZ, et al. The effect of managed care market share on appropriate use of coronary angiography among traditional Medicare beneficiaries. Inquiry 2004 Summer; 41(2):144-58. Select to access the abstract on PubMed®.
Hitcho EB, Krauss MJ, Birge S, et al. Characteristics and circumstances of falls in a hospital setting: a prospective analysis. J Gen Intern Med 2004 Jul; 19(7):732-9. Select to access the abstract on PubMed®.
Borders TF. Rural community-dwelling elders' reports of access to care: are there Hispanic versus non-Hispanic white disparities? J Rural Health 2004 Summer; 20(3):210-0. Select to access the abstract on PubMed®.
Zaoutis TE, Greves HM, Lautenbach E, et al. Risk factors for disseminated candidiasis in children with candidemia. Pediatr Infect Dis J 2004 Jul; 23(7):635-41. Select to access the abstract on PubMed®.
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Current as of December 2004