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January 28, 2005, Issue No. 158
AHRQ News and Numbers
As many as 5 million admissions to U.S. hospitals (or nearly 15 percent of hospital stays) could have been prevented with high-quality primary and preventive care, according to AHRQ data. These potentially preventable hospitalizations resulted in a cost of more than $26.5 billion in 2000. [Source: Agency for Healthcare Research and Quality, HCUP Fact Book No. 5: Preventable Hospitalizations: A Window Into Primary and Preventive Care, 2000.]
- New study finds harmful drug-drug and drug-disease interactions among the elderly
- AHRQ finds potentially inappropriate prescription drug use in nursing homes associated with deaths of elderly residents
- Telephone briefing on hospital patient safety culture survey set for February 15
- Different way of treating adolescent depression pays off
- New study finds that some prostate cancer drugs involve risks
- Spending for prescription drugs to treat mental health disorders increased 20 percent
- Professional nursing associations urged to play a role in emergency preparedness
- New evidence report on end-of-life care available
- AHRQ in the professional literature
1. New Study Finds Harmful Drug-drug and Drug-disease Interactions Among the Elderly
A new AHRQ study found that elderly patients were prescribed at least one medication that could have caused a harmful drug-disease interaction in more than 2.5 percent of outpatient visits. The likelihood that a patient was prescribed a medication that had the potential for a harmful drug-drug interaction was slightly less than 1 percent in visits that involved two or more prescriptions. Using data from 1995 to 2000, researchers assessed the likelihood that a patient would receive a prescription for a medication that could have a harmful drug-drug or drug-disease interaction. They studied six drug-drug and 50 drug-disease combinations considered to be harmful to the elderly. The study, "Suboptimal Prescribing in Elderly Outpatients: Potentially Harmful Drug-Drug and Drug-Disease Combinations," was published in the February issue of the Journal of the American Geriatrics Society. Select to access the abstract in PubMed®. A print copy of the article is available by sending an E-mail to AHRQPubs@ahrq.hhs.gov.
2. AHRQ Finds Potentially Inappropriate Prescription Drug Use in Nursing Homes Associated With Deaths of Elderly Residents
Another AHRQ study shows that elderly nursing home residents given potentially inappropriate drugs intermittently over a 3-month period had an almost 90 percent greater likelihood of dying during the last month of that period than similar residents not administered possibly inappropriate medications. In a separate analysis, the researchers found that over a 2-month period, residents who took potentially inappropriate medications during the last month of that period had an 80 percent greater chance of being hospitalized the following month than residents not exposed to the medications. The study, "Hospitalization and Death Associated with Potentially Inappropriate Medication Prescriptions among Elderly Nursing Home Residents," was based on 1996 data from AHRQ's Medical Expenditure Panel Survey, which are the latest available MEPS data for nursing home residents. The study was published in the January 10 issue of Archives of Internal Medicine. A print copy is available by sending an E-mail to AHRQPubs@ahrq.hhs.gov.
3. Telephone Briefing on Hospital Patient Safety Culture Survey Set for February 15
On February 15, from 2:00 p.m. to 3:30 p.m., EST, AHRQ, in partnership with Premier, Inc., the Department of Defense, the American Hospital Association, and Westat will host the first in a series of technical assistance telephone briefings on AHRQ's Hospital Survey on Patient Safety Culture. The purpose of the briefing is to provide hospital leaders interested in adopting this tool with tips and techniques for administering the survey. This toll-free conference call will include the faculty responsible for the development of the survey and feature the experiences of users who have successfully implemented it. The survey is currently available online. Print copies may be ordered by sending an E-mail to AHRQPubs@ahrq.hhs.gov.
4. Different Way of Treating Adolescent Depression Pays Off
An AHRQ-funded model program for diagnosing and treating depression in adolescents who use primary care clinics versus standard care settings helped to lower rates of severe depressive symptoms (31 percent vs. 42 percent) in just 6 months. In addition, there was increased use of psychotherapy or counseling, 32 percent vs. 21 percent, and a slightly lower rate of medication treatment, 13 percent vs. 16 percent. The study, "Effectiveness of a Quality Improvement Intervention for Adolescent Depression in Primary Care Clinics," led by Joan Asarnow, Ph.D., at the UCLA Neuropsychiatric Institute, was published in the January 19 issue of JAMA. Select to access the abstract in PubMed®.
5. New Study Finds That Some Prostate Cancer Drugs Involve Risks
Hormone-suppressing drugs increasingly used to treat prostate cancer make men so prone to broken bones that the risks of the treatment may outweigh the benefits in those whose cancer was caught early, according to a new AHRQ-funded study. Researchers at the University of Texas Medical Branch at Galveston found that in the 5 years after prostate cancer was diagnosed, men taking such drugs had a 20 percent risk of fracture versus 13 percent among those not getting the treatment. The study, "Risk of Fracture After Androgen Deprivation for Prostate Cancer," led by Dr. Vakahn Shahinian, was published in the January 13 issue of the New England Journal of Medicine. Select to access the abstract in PubMed®.
6. Spending for Prescription Drugs to Treat Mental Health Disorders Increased 20 Percent
Total spending for drugs to treat mental health disorders rose from $27.6 billion in 1996 (adjusted for inflation) to $35.2 billion in 2001, an increase of 5 percent each year, according to a new AHRQ analysis. During that same time, expenditures just for prescription drugs to treat these disorders more than doubled, rising from $5.9 billion to $14.7 billion (in 2001 dollars), which represents an increase of almost 20 percent each year. AHRQ's Samuel H. Zuvekas, Ph.D., analyzed Medical Expenditure Panel Survey data for the years 1996 through 2001 and found that about the same percentage of Americans not living in institutions or serving in the military received ambulatory treatment for mental health and substance abuse problems in both years. However, in 2001, 34 percent of people with mental health and substance abuse disorders were treated solely with medication, compared with 26 percent in 1996, or a little more than 7 million more people. The study, "Prescription Drugs and the Changing Patterns of Treatment for Mental Disorders, 1996-2001," was published in the January/February issue of Health Affairs. Select to access the abstract in PubMed®.
7. Professional Nursing Associations Urged To Play a Role in Emergency Preparedness
Nursing associations should get involved in helping the nation better prepare strategically for public health emergencies, according to an article by Sally Phillips, R.N., Ph.D, Director of AHRQ's Bioterrorism Preparedness Research Program, and Roberta Lavin, R.N., M.S., CAPT, U.S. Public Health Service, Office of the Assistant Secretary for Public Health Emergency Preparedness. The article, "Readiness and Response to Public Health Emergencies: Help Needed Now From Professional Nursing Associations" was published in the September/October 2004 issue of the Journal of Professional Nursing. Select to access the article.
8. New Evidence Report on End-of-Life Care Available
A new evidence review on end-of-life care and outcomes identified a very large and diverse body of literature reflecting the tremendous growth and importance of the field of end-of-life care that has emerged in the past 20 years. In a new evidence report prepared by AHRQ's Southern California Evidence-based Practice Center, the reviewers identified evidence to support the effectiveness of interventions to improve satisfaction, ameliorate cancer pain, relieve depression in cancer patients, provide non-pharmacologic interventions for behavioral problems in dementia, and foster continuity in cancer and congestive heart failure care. More evidence is needed to support management of non-cancer pain and symptoms, provide effective advance care planning, understand and address the needs of informal caregivers, and understand disparities by gender, race/ethnicity, and having a non-cancer, life-limiting disease. Select to access the summary and full report. Print copies of the summary and report are available by sending an E-mail to AHRQPubs@ahrq.hhs.gov.
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.
Bundorf MK, Singer SJ, Wagner TH, et al. Consumers' use of the Internet for health insurance. Am J Manag Care 2004 Sep;10(9):609-16. Select to access the abstract on PubMed®.
Guadagnoli E, Normand SL, DiSalvo TG, et al. Effects of treatment recommendations and specialist intervention on care provided by primary care physicians to patients with myocardial infarction or heart failure. Am J Med 2004 Sept 15;117(6):371-9. Select to access the abstract on PubMed®.
Hughes R, Stone P. The perils of shift work; evening shift, night shift and rotating shifts: are they for you? Am J Nurs 2004 Sep;104(9):60-3. Select to access the abstract on PubMed®.
Handa VL, Harvey L, Cundiff GW, et al. Sexual function among women with urinary incontinence and pelvic organ prolapse. Am J Obstet Gynecol 2004 Sep;191(3):998-1003. Select to access the abstract on PubMed®.
He XZ, Baker DW. Body mass index, physical activity, and the risk of decline in overall health and physical functioning in late middle age. Am J Public Health 2004 Sep;94(9):1567-73. Select to access the abstract on PubMed®.
Rhodes KV, Vieth T, Het, et al. Resuscitating the physician-patient relationship: emergency department communication in an academic medical center. Ann Emerg Med 2004 Sep;44(3):262-7. Select to access the abstract on PubMed®.
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Current as of January 2005