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July 31, 2007, Issue No. 235


AHRQ News and Numbers

Orthopedic procedures—including knee reconstruction or replacement (knee arthroplasty), total and partial hip replacement, and spinal fusion—increased by nearly 25 percent between 1997 and 2005, climbing from 822,000 to 1.3 million. Medicare paid for hospital costs for nearly 60 percent of all knee surgeries and 64 percent of all hip replacements. (Source: Agency for Healthcare Research and Quality (AHRQ) HCUP Statistical Brief No. 34: Hospital Stays Involving Musculoskeletal Procedures, 1997-2005 (PDF File, 164 KB; PDF Help.)

Today's Headlines

1. AHRQ Resources Help Local Communities with Disaster Preparedness Involving Nursing Homes and Hospitals
2. AHRQ Guide Summarizes Evidence for Off-Label Use of Atypical Antipsychotics
3. Notice of Invitation To Submit Nominations for Effective Health Care Stakeholder Group
4. New Review of Consumer-Oriented Strategies for Improving Health Benefit Design is Available
5. Pediatric Emergency Department Health Information Technology Is Topic of Audiocast
6. Register Now for AHRQ Web Conference on Reducing Pressure Ulcers and Improving Quality in Long-Term Care
7. Register Now for AHRQ's Joint MEPS-HCUP Training Workshop
8. Highlights From Our Most Recent Monthly Newsletter
9. AHRQ in the Professional Literature

1. AHRQ Resources Help Local Communities with Disaster Preparedness Involving Nursing Homes and Hospitals

AHRQ has released the Emergency Preparedness Atlas: U.S. Nursing Home and Hospital Facilities, a guide that is intended to help local communities identify facilities that could be available and prepared to provide assistance under emergency conditions in their communities. The Emergency Preparedness Atlas includes six case studies in North Carolina, Oregon, Pennsylvania, Southern California, Washington, and Utah. Each includes a series of maps depicting the locations and capacity of nursing homes and hospitals as well as their geographic relationship to a variety of emergency management and bioterrorism preparedness regions, such as Hazardous Materials (HAZMAT) response regions, emergency management regions, and Red Cross chapters.

The Atlas includes maps for all 50 states with the location of hospitals and nursing homes, and it displays the locations relative to the distribution of the elderly population. Also published with the Atlas is a report, Nursing Homes in Public Health Emergencies, that presents the results of a series of focus groups convened to collect information about disaster- and bioterrorism-related planning activities among nursing homes in the same six States used in the Atlas case study series.

Emergency Preparedness Atlas: U.S. Nursing Home and Hospital Facilities and Nursing Homes in Public Health Emergencies were developed for AHRQ under contract with RTI International in Research Triangle Park, NC. Select to access the Atlas, or to access the report. Print copies of the Atlas and Nursing Homes in Public Health Emergencies are available by sending an E-mail to ahrqpubs@ahrq.hhs.gov.

2. AHRQ Guide Summarizes Evidence for Off-Label Use of Atypical Antipsychotics

AHRQ's new plain-language guide for clinicians and policymakers outlines the latest scientific evidence on the off-label use of atypical antipsychotic drugs. The guide summarizes the strength of evidence of effectiveness for five drugs commonly used off-label—aripiprazole (sold as Abilify®), olanzapine (Zyprexa®), quetiapine (Seroquel®), risperidone (Risperdal®), and ziprasidone (Geodon®)—and points out there is no strong evidence that these atypical antipsychotics work for any off-label uses.

The guide, which includes cost estimates, also emphasizes that some of the medications can increase the risks of stroke, tremors, and other serious side effects. Atypical antipsychotics are approved by the U.S. Food and Drug Administration for treating schizophrenia and bipolar disorder but are often used off-label for other conditions. Some studies show the drugs may help some patients with obsessive-compulsive disorder and dementia-related behavioral disturbances, and the medications are also used to treat agitation, anxiety, psychotic episodes, and obsessive behaviors.

The atypical antipsychotics guide is the newest in a series of publications from AHRQ's Effective Health Care program. The program has already published guides comparing pain medications for osteoarthritis and treatment options for patients with renal artery stenosis. Future guides will summarize evidence on second-generation antidepressants and oral diabetes medications. Available guides can be found on the AHRQ Effective Health Care site.

3. Notice of Invitation To Submit Nominations for Effective Health Care Stakeholder Group

AHRQ invites nominations from interested organizations and knowledgeable individuals for a stakeholder group to support the work of the Effective Health Care Program, funded under Section 1013 of the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) of 2003. The goals of this program are to develop evidence on the effectiveness and comparative effectiveness of different treatments and health care interventions of importance to the Medicare, Medicaid, and State Children's Health Insurance Program.

Members will serve as volunteers for a 2-year period from October 2007 through September 2009. The Stakeholder Group will be composed of up to 15 members, and will attend three to four meetings per year as part of this process. Meetings will be held in Rockville, MD, and Portland, Oregon. The first meeting will be held on October 26, in Rockville, MD.

Nominations for the Effective Health Care Stakeholder Group must be received by August 31 and sent by E-mail to EffectiveHealthCare@ahrq.gov. Select to sign up for E-mail updates and to be notified when items of interest become available for review or public comment from the Effective Health Care Program. You may choose to be notified about one or multiple conditions and/or products.

4. New Review of Consumer-Oriented Strategies for Improving Health Benefit Design is Available

AHRQ has released an exploratory review of consumer directed health plans (CDHPs), tiered provider networks, and efforts to collect and disseminate information about provider quality. Increasingly, employers and health plans are experimenting with a set of consumer-driven strategies that are designed to empower consumers as knowledgeable decisionmakers regarding their health and their health care choices. The goals of the report were to provide a framework for assessing the likely effects of these three strategies and to review available published peer reviewed literature. The report was prepared by AHRQ's Stanford University-University of California at San Francisco (UCSF) Evidence-based Practice Center. For more information, select to access Consumer-Oriented Strategies for Improving Health Benefit Design: An Overview. Print copies are available by sending an E-mail to ahrqpubs@ahrq.hhs.gov.

5. Pediatric Emergency Department Health Information Technology Is Topic of Audiocast

A pediatric emergency department might be the last place you'd expect to find parents using information technology to help clinicians treat their child. But that's what happened at Boston Children's and South Shore hospitals. In this week's audio Healthcare 411 Provider Insider, Stephen C. Porter, M.D., an emergency physician at Children's Hospital in Boston and the principal investigator on an AHRQ health IT grant, discusses how technology could go a long way to providing better care. Select to access the 11-minute program.

In addition, in AHRQ's Healthcare 411 Radiocast, Michael L. Dansinger, M.D., an obesity researcher with the Tufts-New England Medical Center, says that "even small, relatively short-term weight loss may have an important clinical effect." Select to access the 2-minute radio program on the EPC study "The Effect of Dietary Counseling for Weight Loss." You can listen to the audio program directly through your computer—if it has a sound card and speakers and can play MP3 audio files—or you can download it to a portable audio device. To access any of AHRQ's podcasts and special reports, or to sign up for a free subscription to the series and receive notice of all future AHRQ podcasts, visit our Healthcare 411 series main page.

6. Register Now for AHRQ Web Conference on Reducing Pressure Ulcers and Improving Quality in Long-Term Care

AHRQ will host a free 2-hour Web conference on reducing pressure ulcers on Wednesday, August 8 from 1:30-3:30 EDT. The Web conference will present an evidence-based, electronic, quality improvement tool called the "On Time Quality Improvement for Long-Term Care Program."

This Web conference is being planned specifically for New York state nursing homes eligible to compete for state funds being set aside to subsidize the cost of program implementation, but it is open to all health care providers and others. Long-term care facilities present a unique set of issues for an extremely vulnerable patient population, and the prevalence of pressure ulcers in individual facilities can range from 2.5 percent to 24 percent.

Developed by AHRQ, this program is innovative and designed to improve day-to-day practice in nursing homes, improve work flow, enrich work culture, and reduce pressure ulcers. This Web conference introduces a set of tools that can improve work experience and the quality of life experienced by nursing home residents. Continuing education credits are provided for New York Licensed Nursing Home Administrators only.

7. Register Now for AHRQ's Joint MEPS-HCUP Training Workshop

Register now for AHRQ's joint MEPS and HCUP Data Users Workshop to be held on September 19-20 at the Eisenberg Building in Rockville. The workshop is designed to facilitate the health services research community in using data from the two AHRQ data resources: the Medical Expenditure Panel Survey (MEPS) and the Healthcare Cost and Utilization Project (HCUP).

The workshop will provide researchers with an overview of the two data resources on the first day, and hands-on training on one of the data resources on the second day. Full details and registration information are available on the MEPS Web site. Registration is required, and the workshop spaces are limited and will fill quickly.

8. Highlights From Our Most Recent Monthly Newsletter

Among the key articles in the online issue of Research Activities:

Prophylactic antibiotics given to prevent surgical site infections are more timely if given in the operating room.
Patients who suffer from surgical site infections have twice the mortality, are 60 percent more likely to spend time in an intensive care unit, and are five times more likely to be readmitted to the hospital than patients without surgical site infections. Between 40 and 60 percent of surgical site infections are estimated to be preventable with the proper administration of prophylactic antibiotics. However, the practice of giving patients prophylactic antibiotics on the inpatient ward before operations is not as timely as prophylactic antibiotics given in the operating room.

Other articles include:

  • Parents prefer as much information as possible about the prognosis of their child's cancer.
  • A fall management program in nursing homes improves care and reduces use of physical restraints.
  • Certain medical education programs may reinforce physicians' goals to practice in disadvantaged communities.

Select to access these articles and more.

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.

Field TS, Mazor KM, Briesacher B, et al. Adverse drug events resulting from patient errors in older adults. J Am Geriatr Soc 2007 Mar;55(2):271-6. Select to access the abstract in PubMed®.

Han HR, Kang J, Kim KB, et al. Barriers to and strategies for recruiting Korean Americans for community-partnered health promotion research. J Immigr Minor Health 2007 Apr; 9(2):137-146. Select to access the abstract in PubMed®.

Talcott JA, Spain P, Clark JA, et al. Hidden barriers between knowledge and behavior: the North Carolina prostate cancer screening and treatment experience. Cancer 2007 Apr 15;109(8):1599-1606. Select to access the abstract in PubMed®.

Sequist TD, Cullen T, Hays H, et al. Implementation and use of an electronic health record within the Indian Health Service. J Am Med Inform Soc 2007 Mar-Apr;14(2):191-7. Select to access the abstract in PubMed®.

Fanjiang G, Russell GH, Katz AJ. Short- and long-term response to and weaning from infliximab therapy in pediatric ulcerative colitis. J Pediatr Gastroenterol Nutr 2007 Mar;44(3):312-7. Select to access the abstract in PubMed®.

If you are a new subscriber or would like to reference information in a previous issue, an archive of this newsletter can be found on AHRQ's Web site at http://www.ahrq.gov/news/newsletters/e-newsletter/index.html.

Contact Information

Please address comments and questions to Nancy Comfort at Nancy.Comfort@ahrq.hhs.gov or (301) 427-1866.

Current as of July 2007

 

The information on this page is archived and provided for reference purposes only.

 

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