National Healthcare Quality and Disparities Report
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Search All Research Studies
Topics
- Adverse Drug Events (ADE) (1)
- Adverse Events (1)
- Alcohol Use (8)
- Ambulatory Care and Surgery (2)
- Behavioral Health (4)
- Case Study (1)
- Children/Adolescents (2)
- COVID-19 (1)
- Diagnostic Safety and Quality (1)
- Emergency Department (1)
- Evidence-Based Practice (2)
- Guidelines (1)
- Healthcare Costs (1)
- Health Information Technology (HIT) (1)
- Hospitalization (2)
- Hospital Readmissions (1)
- Human Immunodeficiency Virus (HIV) (1)
- Implementation (2)
- Inpatient Care (1)
- Intensive Care Unit (ICU) (1)
- Lifestyle Changes (1)
- Medication (3)
- Medication: Safety (1)
- Obesity (1)
- Opioids (5)
- Patient-Centered Healthcare (1)
- Practice Patterns (2)
- Prevention (4)
- Primary Care (7)
- Public Health (1)
- Risk (1)
- (-) Screening (16)
- (-) Substance Abuse (16)
- Telehealth (1)
- Tobacco Use (1)
- Tobacco Use: Smoking Cessation (1)
- U.S. Preventive Services Task Force (USPSTF) (2)
- Vulnerable Populations (1)
AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 16 of 16 Research Studies DisplayedMiller-Rosales C, Busch SH, Meara ER
Internal and environmental predictors of physician practice use of screening and medications for opioid use disorders.
This study examined the extent of screening for opioid use and availability of medications for opioid use disorder (MOUD) in a national cross-section of multi-physician primary care and multispecialty practices. The authors found that a total of 26.2% of practices offered MOUD, while 69.4% of practices screened for opioid use. Offering of MOUD in a practice was associated with having advanced HIT functionality, while access to on-site behavioral clinicians was positively associated with offering MOUD in adjusted models.
AHRQ-funded; HS024075.
Citation: Miller-Rosales C, Busch SH, Meara ER .
Internal and environmental predictors of physician practice use of screening and medications for opioid use disorders.
Med Care Res Rev 2023 Aug; 80(4):410-22. doi: 10.1177/10775587231162681..
Keywords: Opioids, Substance Abuse, Behavioral Health, Screening, Medication, Practice Patterns
Bunting AM, Schwartz RP, Wu LT
A brief screening and assessment tool for opioid use in adults: results from a validation study of the Tobacco, Alcohol, Prescription Medication, and Other Substances Tool.
The objective of this secondary analysis was to evaluate opioid-specific validation results of the Tobacco, Alcohol, Prescription Medication, and Other Substances (TAPS) tool for screening in primary care The findings showed that TAPS opioid items could be used in primary care settings for a spectrum of unhealthy opioid use; however, self-disclosure remains an issue in primary care settings. The researchers noted that further testing in a larger population sample might be warranted, given the brevity, simplicity, and accuracy of self-administration.
AHRQ-funded; HS026120.
Citation: Bunting AM, Schwartz RP, Wu LT .
A brief screening and assessment tool for opioid use in adults: results from a validation study of the Tobacco, Alcohol, Prescription Medication, and Other Substances Tool.
J Addict Med 2023 Jul-Aug; 17(4):471-73. doi: 10.1097/adm.0000000000001139..
Keywords: Opioids, Screening, Substance Abuse, Behavioral Health, Primary Care
Jonas DE, Barclay C, Grammer D
The STUN (STop UNhealthy) Alcohol Use Now trial: study protocol for an adaptive randomized trial on dissemination and implementation of screening and management of unhealthy alcohol use in primary care.
This paper describes a randomized, controlled trial to evaluate the effect of primary care practice facilitation and telehealth services on evidence-based screening, counseling, and pharmacotherapy for unhealthy alcohol use in primary care practices in North Carolina with 10 or fewer providers. The study will produce important evidence about the effect of practice facilitation on uptake of evidence-based screening, counseling, and pharmacotherapy for unhealthy alcohol use when delivered on a large scale to small and medium-sized practices. The results of this rigorously conducted evaluation are expected to have a positive impact by accelerating the dissemination and implementation of evidence related to unhealthy alcohol use into primary care practices.
AHRQ-funded; HS027078.
Citation: Jonas DE, Barclay C, Grammer D .
The STUN (STop UNhealthy) Alcohol Use Now trial: study protocol for an adaptive randomized trial on dissemination and implementation of screening and management of unhealthy alcohol use in primary care.
Trials 2021 Nov 16;22(1):810. doi: 10.1186/s13063-021-05641-7..
Keywords: Alcohol Use, Substance Abuse, Behavioral Health, Primary Care, Screening, Implementation
Zubiago J, Murphy M, Guardado R
Increased HIV testing in people who use drugs hospitalized in the first wave of the COVID-19 pandemic.
During the COVID-19 pandemic, due to lapses in harm reduction services, several public health experts forecasted subsequent increases in diagnosis of HIV in PWUD. As many inpatient hospitals reworked patient flow during the COVID-19 surge, the investigators hypothesized that HIV testing in PWUD would decrease. To answer this question, they compiled a deidentified list of hospitalized patients with electronic medical record indicators of substance use-a positive urine toxicology screen, prescribed medications to treat opioid use disorder, a positive CIWA score, or a positive CAGE score-admitted between January, 2020 and August, 2020.
AHRQ-funded; HS026008.
Citation: Zubiago J, Murphy M, Guardado R .
Increased HIV testing in people who use drugs hospitalized in the first wave of the COVID-19 pandemic.
J Subst Abuse Treat 2021 May;124:108266. doi: 10.1016/j.jsat.2020.108266..
Keywords: Human Immunodeficiency Virus (HIV), Opioids, Substance Abuse, Alcohol Use, Hospitalization, COVID-19, Public Health, Screening
Afshar M, Sharma B, Bhalla S
External validation of an opioid misuse machine learning classifier in hospitalized adult patients.
This study looks at new methods to make opioid misuse screening in hospitals less resource-intensive, which causes it to occur rarely. The objective of this study is to externally validate the author’s previously published and open-source machine learning classifier by implementing it a different hospital to identify cases of opioid misuse. An observational cohort of 56,227 adult hospitalizations from October 2017 to December 2019 was used during a hospital-wide substance use screening program with manual screening. A manually completed Drug Abuse Screening Test served as the reference standard to validate a convolutional neural network (CNN) classified with coded word embedding features to capture electronic health record (EHR) clinical notes. Manual screening was completed in 67.8% of patients with 1.1% identified with opioid misuse. The opioid misuse classifier had good discrimination during external validation and may help overcome manual screening barriers.
AHRQ-funded; HS026385.
Citation: Afshar M, Sharma B, Bhalla S .
External validation of an opioid misuse machine learning classifier in hospitalized adult patients.
Addict Sci Clin Pract 2021 Mar 17;16(1):19. doi: 10.1186/s13722-021-00229-7..
Keywords: Opioids, Medication, Substance Abuse, Screening, Hospitalization
Dir AL, Clifton RL
Patterns of drug screen results and court-ordered substance use treatment referrals and completion among justice-involved youth
This study examined court records of drug screens among youth to explore patterns of substance use as well as rates of court-ordered referral to substance use treatment and treatment completion. Of the studied youth with a positive oral drug screen, 96% tested positive for cannabis and 9.8% for opioids at least once; 48.5% were court-ordered to substance use treatment. Of those referred, 67% had history of completing at least one treatment episode. These results underscore the need to utilize objective measures as well as validated self-reports of substance use history in both research and justice system decision-making to aid in identifying youth in need of services.
AHRQ-funded; HS022681; HS023318.
Citation: Dir AL, Clifton RL .
Patterns of drug screen results and court-ordered substance use treatment referrals and completion among justice-involved youth
J Subst Abuse Treat 2020 Nov;118:108095. doi: 10.1016/j.jsat.2020.108095..
Keywords: Children/Adolescents, Substance Abuse, Screening, Vulnerable Populations
Patnode CD, Perdue LA, Rushkin M
Screening for unhealthy drug use: updated evidence report and systematic review for the US Preventive Services Task Force.
Illicit drug use is among the most common causes of preventable morbidity and mortality in the US. The objective of this study was to conduct a systematic review of the literature on screening and interventions for drug use to inform the US Preventive Services Task Force. The investigators concluded that several screening instruments with acceptable sensitivity and specificity are available to screen for drug use, although there is no direct evidence on the benefits or harms of screening.
AHRQ-funded; 290201500007I.
Citation: Patnode CD, Perdue LA, Rushkin M .
Screening for unhealthy drug use: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2020 Jun 9;323(22):2310-28. doi: 10.1001/jama.2019.21381..
Keywords: U.S. Preventive Services Task Force (USPSTF), Substance Abuse, Screening, Evidence-Based Practice, Guidelines, Primary Care, Prevention
Burner E, Zhang M, Terp S
Feasibility and acceptability of a text message-based intervention to reduce overuse of alcohol in emergency department patients: controlled proof-of-concept trial.
The objective of this study was to assess the feasibility of and patient satisfaction with a text-based mHealth extension of an emergency department (ED) screening program to reduce risky alcohol use in low-income, urban patients. A case-control study was designed using a SMS text message-capable phones to receive mROAD (mobilizing to Reduce Overuse of Alcohol in the ED), an SMS text message-based extension of the ED screening program. mROAD is a 7-day program of twice-daily SMS text messages based on the NIH Health Rethinking Drinking campaign. Of 1028 patients screened, 9.2% exhibited risky alcohol use based on the Alcohol Use Disorders Identification Test (AUDIT) in the ED. Almost a quarter of the patients did not have an SMS text-messaging capable phone, leaving 76% eligible patients. Changes in behavior were similar between the two groups. The number of drinking days reported in the prior 30 days decreased by 5 and the number of heavy drinking days decreased by 4.1. Patients reported an 11-point increase in motivation to change alcohol use via the Change Questionnaire.
AHRQ-funded; HS022402.
Citation: Burner E, Zhang M, Terp S .
Feasibility and acceptability of a text message-based intervention to reduce overuse of alcohol in emergency department patients: controlled proof-of-concept trial.
JMIR Mhealth Uhealth 2020 Jun 4;8(6):e17557. doi: 10.2196/17557..
Keywords: Alcohol Use, Substance Abuse, Emergency Department, Telehealth, Health Information Technology (HIT), Screening, Prevention
Kuhns LM, Carlino B, Greeley K
A chart review of substance use screening and related documentation among adolescents in outpatient pediatric clinics: implications for practice.
This study looked at rates of substance use screening and related documentation among adolescents aged 12-17 in outpatient pediatric clinics in a large academic medical center. The authors abstracted a random sample of 127 records and coded clinical notes to describe screening cases and related characteristics. They then analyzed descriptive patterns within the data to calculate screening rates, characteristics of screening, and identify related factors. Rates of screening by providers was 72% for each common substance and a total of 6% of patients reported substance use during screening.
AHRQ-funded; HS026385.
Citation: Kuhns LM, Carlino B, Greeley K .
A chart review of substance use screening and related documentation among adolescents in outpatient pediatric clinics: implications for practice.
Subst Abuse Treat Prev Policy 2020 May 25;15(1):36. doi: 10.1186/s13011-020-00276-4..
Keywords: Children/Adolescents, Substance Abuse, Screening, Ambulatory Care and Surgery, Alcohol Use, Practice Patterns, Primary Care
Richards JE, Bobb JF, Lee AK
Integration of screening, assessment, and treatment for cannabis and other drug use disorders in primary care: an evaluation in three pilot sites.
This pilot study examined whether integrating evidence-based implementation strategies to implement Behavioral Health Integration (BHI) into primary care to increase diagnosis and treatment of substance use disorders (SUDs). Three pilot sites were used and patients were given annual screening for past-year cannabis and drug use, a Symptom Checklist for DSM-5 SUDs, and shared decision-making about different treatment options. Out of 39,599 eligible patients, almost 60% were screened for cannabis and other drug use. Daily cannabis use was reported with 2% of patients, and other drug use 1%. Of those patients, 51% and 37% completed an SUD Symptom Checklist. There was a higher proportion of patients diagnosed with cannabis use disorder (CUD) but not drug use disorder. However, the reverse was true for patients receiving treatment for drug-use disorders.
AHRQ-funded; HS023173.
Citation: Richards JE, Bobb JF, Lee AK .
Integration of screening, assessment, and treatment for cannabis and other drug use disorders in primary care: an evaluation in three pilot sites.
Drug Alcohol Depend 2019 Aug 1;201:134-41. doi: 10.1016/j.drugalcdep.2019.04.015..
Keywords: Substance Abuse, Behavioral Health, Evidence-Based Practice, Primary Care, Patient-Centered Healthcare, Screening, Diagnostic Safety and Quality
Mabry-Hernandez I, Scoulios N
AHRQ Author: Mabry-Hernandez I
Screening and behavioral counseling interventions to reduce unhealthy alcohol use in adolescents and adults.
This case study concerns a 20-year-old male university student with a history of exercise-induced asthma presenting for his yearly physical. He expresses that he occasionally misses classes in the morning because he is tired.
AHRQ-authored.
Citation: Mabry-Hernandez I, Scoulios N .
Screening and behavioral counseling interventions to reduce unhealthy alcohol use in adolescents and adults.
Am Fam Physician 2019 Jun 15;99(12):771-72..
Keywords: U.S. Preventive Services Task Force (USPSTF), Alcohol Use, Substance Abuse, Screening, Prevention, Primary Care, Case Study
Shafer PR, Borsky A, Ngo-Metzger Q
AHRQ Author: Shafer PR, Borsky A, Ngo-Metzger Q, Miller T, Meyers D
The practice gap: national estimates of screening and counseling for alcohol, tobacco, and obesity.
The authors of this study estimated screening and counseling rates for tobacco and alcohol use, and obesity by using a nationally representative sample of adults aged 35 years and older. Receipt of the recommended level of services ranged from nearly two-thirds for obesity and tobacco use to less than half for alcohol misuse. The authors conclude that care delivery shows significant room for improvement, but primary care practices may need additional resources to raise their screening and counseling rates.
AHRQ-authored.
Citation: Shafer PR, Borsky A, Ngo-Metzger Q .
The practice gap: national estimates of screening and counseling for alcohol, tobacco, and obesity.
Ann Fam Med 2019 Mar;17(2):161-63. doi: 10.1370/afm.2363..
Keywords: Alcohol Use, Lifestyle Changes, Obesity, Prevention, Primary Care, Screening, Substance Abuse, Tobacco Use
Cartmell KB, Dismuke CE, Dooley M
Effect of an evidence-based inpatient tobacco dependence treatment service on 1-year postdischarge health care costs.
In 2014, the Medical University of South Carolina (MUSC) implemented a Tobacco Dependence Treatment Service (TDTS) consistent with the Joint Commission (JC) standards recommending that hospitals screen patients for smoking, provide cessation support, and follow-up contact for relapse prevention within 1 month of discharge. This paper examined whether exposure to the TDTS influenced downstream health care charges 12 months after patients were discharged from the hospital.
AHRQ-funded; HS023863.
Citation: Cartmell KB, Dismuke CE, Dooley M .
Effect of an evidence-based inpatient tobacco dependence treatment service on 1-year postdischarge health care costs.
Med Care 2018 Oct;56(10):883-89. doi: 10.1097/mlr.0000000000000979..
Keywords: Healthcare Costs, Inpatient Care, Screening, Substance Abuse, Tobacco Use: Smoking Cessation
Clark BJ, Rubinsky AD, Ho PM
Alcohol screening scores and the risk of intensive care unit admission and hospital readmission.
This study sought to determine whether alcohol misuse was associated with admission to an intensive care unit (ICU) among patients receiving outpatient care. Among 486,115 veterans receiving outpatient care, the adjusted probability of ICU admission within 1 year was 2.0 percent for abstinent patients, 1.6 percent for patients with lower-risk alcohol use, 1.8 percent for patients with moderate alcohol misuse, and 2.5 percent for patients with severe alcohol misuse.
AHRQ-funded; HS022800.
Citation: Clark BJ, Rubinsky AD, Ho PM .
Alcohol screening scores and the risk of intensive care unit admission and hospital readmission.
Subst Abus 2016 Jul-Sep;37(3):466-73. doi: 10.1080/08897077.2015.1137259.
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Keywords: Alcohol Use, Hospital Readmissions, Intensive Care Unit (ICU), Ambulatory Care and Surgery, Screening, Substance Abuse
Lapham GT, Rubinsky AD, Williams EC
Decreasing sensitivity of clinical alcohol screening with the AUDIT-C after repeated negative screens in VA clinics.
The purpose of this study was to evaluate the performance of repeat annual clinical alcohol screening in 4 samples of VA outpatients with 1–4 prior consecutive negative annual screens. It found that among patients with repeated negative clinical alcohol screens, the proportion who subsequently screened positive a year later was low and decreased as patients had more prior negative screens.
AHRQ-funded; HS022800.
Citation: Lapham GT, Rubinsky AD, Williams EC .
Decreasing sensitivity of clinical alcohol screening with the AUDIT-C after repeated negative screens in VA clinics.
Drug Alcohol Depend 2014 Sep 1;142:209-15. doi: 10.1016/j.drugalcdep.2014.06.017..
Keywords: Screening, Alcohol Use, Substance Abuse
Katz DF, Sun J, Khatri V
QTc interval screening in an opioid treatment program.
This pilot study supports the feasibility of implementing a population-based electrocardiographic monitoring program in order to decrease the QTc interval in high-risk patients undergoing methadone maintenance in an opioid treatment program. Clinical characteristics alone were inadequate to identify patients in need of electrocardiographic screening.
AHRQ-funded; HS021138
Citation: Katz DF, Sun J, Khatri V .
QTc interval screening in an opioid treatment program.
Am J Cardiol. 2013 Oct 1;112(7):1013-8. doi: 10.1016/j.amjcard.2013.05.037..
Keywords: Opioids, Medication, Substance Abuse, Screening, Adverse Drug Events (ADE), Adverse Events, Medication: Safety, Risk, Implementation