Drugs, Pharmaceuticals, and Therapeutics

Research Findings

Research Activities, August 2008:
New Spanish-language consumer guide compares oral diabetes medications
More vigilance in disinfecting hospital surfaces is critical for reducing vancomycin-resistant infections
Some children are already experiencing drug resistance to a class of broad-spectrum antibiotics used in adults
Many pregnant women continue to be prescribed a class of antihypertensive medications dangerous to the fetus
Kegel exercises, bladder training, and some medications can resolve women's urinary incontinence
Studies elaborate on the potential use of health information technology to improve care delivery
E-prescribing will not greatly disrupt workflow in outpatient practices if carefully implemented
Direct-to-consumer advertising of antidepressants aims to increase pool of users
Long-term use of antibiotics appears safe to treat a large-scale exposure to anthrax in a bioterrorism attack
An antimicrobial stewardship program improves appropriate antimicrobial use among hospitalized children
Education campaign reduces antibiotic prescribing by emergency department physicians for upper respiratory tract infections
Nearly one in five patients with HIV infection continues to be treated by drugs to which their HIV has tested resistant
Treatment costs nearly double for hay fever and other allergies

Research Activities, July 2008:
AHRQ announces guide to help patients on Coumadin®/warfarin therapy
Studies examine racial/ethnic disparities and use patterns for nonsteroidal anti-inflammatory drugs
Multiple prescriptions are linked to preventable drug reactions in children
The Medicare Part D prescription drug benefit has modestly boosted drug use and reduced average out-of-pocket expenses
One in four disabled seniors use risky or ineffective medicines

Research Activities, June 2008:
Community-wide interventions prove modestly successful in reducing antibiotic use among Medicaid-insured children
Use of dementia treatments is similar in community and long-term care settings
Antidepressants and therapy may be cost-effective for patients with medically unexplained symptoms
More studies need to be done on potential risk of incident heart failure among certain patients taking TNF-alpha antagonists
FDA warnings appear to lead to appropriate prescriber action

Research Activities, May 2008:
Medication monitoring advice and feedback to physicians modestly improves outpatient medication safety
Use of a visual medication schedule and brief physician counseling can reduce time to anticoagulation control
New pill card helps patients take medications on time
Antidepressant use during pregnancy is linked to increases in preterm birth and potentially serious infant perinatal problems
Researchers examine the relationship of workarounds to technology implementation and medication safety in nursing homes
Staff education and performance feedback only slightly improve fracture prevention among nursing home residents
Worries about finances often prompt patients with HIV disease to skimp on their antiretroviral medication
Limited health literacy is a barrier to patients taking the correct prescribed medications
Poor literacy is linked to poor HIV medication adherence among blacks, and may contribute to HIV health disparities
Physician residents use personal digital assistants most for drug references and medical calculations
Physicians generally followed drug treatment guidelines for atrial fibrillation, but only one-third used warfarin
Coxibs and NSAIDs with gastroprotective agents offer better protection from ulcers than NSAIDs alone

Research Activities, April 2008:
White children are about twice as likely to use stimulants as black and Hispanic children
Maternal asthma is associated with lower birth weight
Doctors override automated alerts on potential drug interactions
Cost-effectiveness of primary care treatment of sinusitis depends on individual, societal, and payer's perspectives

Research Activities, March 2008:
Hospital incident reporting systems often miss physician high-risk procedure and prescribing errors
Care quality is not necessarily better with electronic health records
Few nursing home residents receive medications and supplements for osteoporosis
Studies examine emergency communication, use of defibrillators, and benefit of ED pharmacists
Rural emergency departments have a high rate of medication errors with the potential to harm children
Varied regional rates of chronic obstructive pulmonary disease episodes may be due to medical system factors

Research Activities, February 2008:
Pediatric outpatient medication errors are common and are often due to mistakes made at home
Blacks, Hispanics, and other minority groups are less likely to get strong pain medications in hospital emergency departments
Study of young Head Start children links overweight to worsened asthma
Medicare drug plans cover a good selection of drugs for nursing home residents, but plan vigilance should continue
Financial incentives to physicians and long-term care facilities may foster adoption of computerized drug systems
Doctors should remind patients about warfarin compliance, even those who claim to be taking the drug as directed
Three-tier formularies increase cost sharing for retirees in generous plans, with little effect on continued drug use
Managed care helps the elderly avoid preventable hospitalizations more than traditional Medicare

Research Activities, January 2008:
AHRQ releases toolkits to help providers and patients implement safer health care practices
Antibiotics to prevent children's recurrent urinary tract infections have unclear benefits and potential risks
Medicaid-insured parents could benefit from educational programs to promote more judicious use of antibiotics
Regulatory warnings led to decreased use of antidepressants in children and adolescents in 2004 and 2005
Some women with breast cancer do not receive adjuvant treatments recommended by guidelines
Use of antidepressants by low-income pregnant women has jumped more than twofold, raising questions about fetal risks
The link between vitamin B levels and subsequent cognitive function remains unclear
Studies examine pharmacy workload and medication errors and cost savings of hospital barcode medication systems
Following recommended guidelines to manage cardiovascular disease improves patient outcomes
Journal supplement explores alternative research approaches to test drug safety and effectiveness
Possible problematic drug interactions are not always reported in medical records
Nonsteroidal anti-inflammatory drugs do not appear to protect against development of lung cancer
New studies reveal the impact of drug copayment and coinsurance policies on statin and beta-blocker therapy after heart attack
Use of complementary and alternative medicine is common among persons who have been hospitalized for coronary artery disease
Combining medications is often the best strategy to battle rheumatoid arthritis

Research Activities, December 2007:
Common medications provide equal blood pressure control
Treatments for pediatric Crohn's disease cases vary widely in North America
Many seniors will pay double the monthly copay for angiotensin receptor blockers under the Medicare Part D drug plan compared with their previous plans
Prescribing antidepressants for elderly persons should not be affected by concern about drug-related pneumonia risk
A pharmacy alert system plus physician-pharmacist collaboration can reduce inappropriate drug prescribing among elderly outpatients
Adults with food allergies tend to have more severe asthma
Doctors should advise Latino families about the safety, low cost, and dental health benefits of drinking tap water
Both invasive and noninvasive strategies can reduce the cardiac risks of noncardiac surgery
Patients with HIV who share treatment decisions with their doctor have better outcomes
New AHRQ tools help pharmacies better serve patients with limited health literacy

Research Activities, November 2007:
AHRQ expands therapeutics education and research centers and adds new topics: Health IT, economics, and formularies
Study documents the health costs of being a woman
Nursing home report cards have prompted many nursing homes to improve care, especially those with poor scores
Postdischarge care management that integrates medical and social care can improve outcomes of the low-income elderly
Studies explore the use and functions of electronic health records
Implementing a basic electronic prescribing system may reduce nonclinical prescribing errors
Study confirms link between intravenous bisphosphonates and jaw infection or surgery
Insurers save with incentive-based formularies, but consumers pay more out of pocket
Studies examine prescribing of antibiotics for respiratory infections in hospital emergency departments

Research Activities, October 2007:
AHRQ and FDA to collaborate in the largest study ever of possible heart risks with ADHA medications
Studies examine dispensing of sample medications and preventing medication errors in primary care practices
Asian Pacific American ethnic groups vary in their adherence to antihypertensive drug therapy
Low blood levels of omega-3 fatty acids predicts increased risk for acute coronary syndrome
Studies examine medication adherence and group medical visits among persons with high blood pressure
Educational outreach to individual physicians to improve antihypertensive drug prescribing can reduce drug costs
One-third of patients with acute coronary syndrome and diabetes do not have their blood sugar assessed before hospital discharge

Research Activities, September 2007:
Medication errors are made during care for half of the children seen at rural California emergency departments
Women with coronary heart disease are less likely than men to use aspirin to prevent further problems
Outpatient medication errors are common among patients who have received liver, kidney, and/or pancreas transplants
Computerized drug-drug interaction alerts are useful, but can be improved
Studies examine the safety of prescribing antipsychotics, acetylcholinesterase inhibitors, and beta-blockers to older adults
Medications that relieve pain and anxiety in acute trauma patients hold promise for prevention of posttraumatic stress disorder
Medicare Part D provides coverage protection for mental health-related drugs, but certain drugs still may not be covered
Drug therapy has reduced hospitalization for HIV patients, but those hospitalized are getting older and sicker
Effectively treating other medical conditions in patients with HIV may reduce HIV's overall impact on functioning
Available and timely access to AZT for HIV-infected mothers giving birth needs to be improved in Illinois birthing hospitals

Research Activities, August 2007:
Many children treated at pediatric hospitals receive at least one "off-label" medication
More than one-third of hospitalized patients are concerned about medical errors, which they define more broadly than clinicians
Few of the safeguards routinely used for intravenous chemotherapy have been adopted for oral chemotherapy at U.S. cancer centers
Changes in workflow and tasks need to be assessed when introducing bar code medication administration into nurses' work
Pertussis vaccination in adults can be cost-effective depending on incidence rates
Medication therapy management programs varied widely after initial implementation of the Medicare Part D drug benefit
Despite prior-approval requirements of hospitals for certain antimicrobials, doctors still manage to "stealth dose"
Providing combination medication for elderly patients following a heart attack can save both lives and money

Research Activities, July 2007:
While most diabetes drugs provide similar glucose control, some offer important advantages
Infliximab is a safe and effective therapeutic option for children with sever ulcerative colitis
Certain resident and facility characteristics and medications increase the risk of fractures among nursing home residents
Urinary incontinence is common among residents of Southeastern nursing homes, especially among black residents
Studies examine the impact of rheumatic diseases on the ability to work

Research Activities, June 2007:
Medication errors are common among patients in psychiatric hospitals
Prophylactic antibiotics given to prevent surgical site infections are more timely if given in the operating room
Patients find it difficult to adhere to warfarin therapy even when monitored at anticoagulation clinics
Risk factors can help predict which patients with hospital-acquired urinary tract infections will develop blood infections

Research Activities, May 2007:
Report issued to Congress on electronic prescribing to cut errors and costs
Examining use of "rescue drugs" in a hospital can reveal previously unreported adverse drug events
Use of high-risk medications by pregnant women is not uncommon
Case management may improve adherence to antiviral therapy as well as outcomes of HIV-infected homeless persons
A study of one managed behavioral health care organization does not show a shift in treatment costs to drugs and primary care

Research Activities, April 2007:
Pulse oximetry and hospital observation can detect failure of amoxicillin treatment earlier in children with severe pneumonia
Automated piggyback infusion of intravenous drugs is neither simple nor safe
Poor communication between patients taking warfarin and their doctors may place them at risk for stroke and bleeding
High out-of-pocket costs for antiretroviral therapy are linked to more treatment failures among HIV-infected patients in Botswana
Updated pharmacy data can track whether HIV patients are maintaining enough adherence for treatment success
Prescription drug coverage does not assure long-term adherence to beta-blocker therapy following a heart attack
New webliography identifies reliable prescription medication Web sites for consumers
Prior use of fluoroquinolone antibiotics boosts the risk of fluoroquinolone-resistant infections

Research Activities, March 2007:
Studies highlight the interaction between managed care and market forces and their impact on quality of care
Barriers impede efforts to use a region-wide hospital medication error reporting system
Substantially delaying the first dose of hepatitis B vaccine may lead to underimmunization of children
Factors such as disease status and sex affect adherence to drug prescribing guidelines for hypertension
A color-coded tape helps EMTs calculate the correct epinephrine dose for children in cardiopulmonary arrest
Guidelines can help paramedics select which drugs to use to facilitate prehospital endotracheal intubation
Use of the pain reliever propoxyphene is associated with a higher risk of hip fracture among the elderly
Higher-than-recommended doses of antipsychotic medications may not benefit people with schizophrenia and may increase side effects

Research Activities, February 2007:
Shifting from a culture of blame to a culture of safety in nursing homes could help identify and prevent medical errors
Physician, patient, and pharmacy outreach reminders can improve recommended laboratory monitoring for certain medications
A small proportion of patients are prescribed a medication that can interact with the QT-prolonging medication they also take
Eleven medications account for one-third of medication errors that harm hospitalized children
Some pregnant women are still prescribed medications with the potential to harm the fetus
Computerized and age-specific drug alerts can reduce both inappropriate prescribing of drugs and unnecessary drug alerts
Evidence is lacking to support many off-label uses of atypical antipsychotic drugs
Newer class of antidepressants is similar in effectiveness, but side effects differ
A protocol for adjusting diabetes medications can improve diabetes management and patient blood-sugar levels
Medications can aid endotracheal intubation of critically ill or injured patients who are not in cardiac arrest
Employer-sponsored insurance coverage of smoking cessation treatments could save employers and insurers money

Research Activities, January 2007:
Antidepressants may increase children's and adolescents' risk of suicide attempts after hospitalization for depression
Management of emergency department information on children's medication allergies needs improvement
Depression worsens the health and quality of life of people with diabetes
New report finds little evidence to determine the usefulness of genetic tests in the treatment of depression
Overprescribing of lipid-lowering agents is associated with several physician and practice characteristics
National guidelines and clinical evidence only modestly influence prescribing of antihypertensive agents
A new classification scheme quantifies the risk of hemorrhage among atrial fibrillation patients taking anticoagulants
An enhanced pain assessment scale and feedback to hospital nurses can improve pain documentation and analgesic prescribing but not pain reduction
Increased use of prescription medicines is changing health care spending patterns

Research Activities, December 2006:
Longer anti-clotting treatment appears to lower the risk of death or a heart attack in patients with drug-eluting stents
A pain medication appropriateness scale reveals that many nursing home residents suffer from poorly controlled pain
Direct-to-consumer drug advertising on television may have led to increased prescribing of Vioxx® and Celebrex®

Research Activities, November 2006:
Computerized drug alerts when ordering medications reduce inappropriate prescribing for the elderly
Faxed pharmacy alerts to doctors when patients miss their antidepressant prescription refill does not improve compliance
States with long-standing opioid prescription monitoring programs have fewer outpatient prescriptions for opioid analgesics
Many outpatients taking drugs with a narrow therapeutic range do not receive drug concentration monitoring to prevent toxicity
More convenient HIV treatment can be as effective as more complex regimens

Research Activities, October 2006:
Teriparatide alone is less cost-effective than alendronate alone for the treatment of women with severe osteoporosis
Elderly patients whose physicians are white or have urban practices are more likely to use antidepressants
Prescription drug benefits limits for Medicare beneficiaries are associated with less use of prescription drugs, worse clinical outcomes, and higher hospitalization costs

Research Activities, September 2006:
Use of stimulant medications to treat attention deficit hyperactivity disorder in children has leveled off since 1997
Using handheld computers with specific prescribing software at the point of care can reduce unsafe NSAID prescribing

Research Activities, August 2006:
Pharmacists help identify patient safety and quality issues by clarifying prescriptions
Hospital pharmacy medication dispensing is highly accurate, but still inadequate
Studies examine the practice of prescribing medications to outpatients that can dangerously interact with one another
Studies highlight the value of the Medical Expenditure Panel Survey to inform trends in care costs, coverage, use, and access
Only half of older people with diabetes receive ACE inhibitors or angiotensin receptor blockers to prevent cardiac problems
Primary care physicians often prescribe antiviral medications inappropriately or fail to prescribe them when needed

Research Activities, July 2006:
Doctors often fail to order laboratory monitoring when elderly HMO outpatients begin cardiovascular medications
Medications to prevent blood clots after major orthopedic surgery are underused, especially in Japanese patients
Parental use of a kiosk in the emergency department has the potential to improve asthma care
Computerized prescribing may reduce some harmful medication errors, but can introduce new errors
Androgen deprivation therapy for prostate cancer causes only modest depression and other side effects
Primary care of patients with type 2 diabetes can be improved
Some adults with diabetes face high health care expenditures

Research Activities, June 2006:
Use of ACE inhibitors during the first trimester of pregnancy is related to an increased risk of birth defects
National survey of community pharmacies examines workload, available technology, and perceptions of drug alert systems
Antidepressant use doubled among adolescents from 1997 to 2002, with no change among children younger than 13 years
Menopausal hormone therapy declined after published WHI trial results
Medicaid spending on outpatient drugs more than doubled in recent years
Study finds no clinically significant difference in effectiveness of drugs for managing anemia in patients undergoing cancer treatment

Research Activities, May 2006
Electronic medication alerts reduce inappropriate prescribing of warfarin with interacting drugs
Many primary care doctors still do not use electronic antibiotic prescribing for acute infections
One of every five medications approved for certain diagnoses are prescribed by office-based physicians for other conditions
Primary care doctors often fail to prescribe "controller medications" for asthma patients after an emergency room visit
Physician compliance with medication black box warnings is mixed
The recommended dose of intravenous morphine does not control severe acute pain in patients presenting to the emergency department

Research Activities, April 2006
Over one-third of outpatients prescribed drugs for the first time do not receive recommended laboratory monitoring
Clinician recommendations for pneumonia vaccination play a key role in vaccination rates
Although inappropriate for use in older adults, propoxyphene was widely prescribed to elderly patients in the 1990s

Research Activities, March 2006
Frequent potential medication dosing errors occur during outpatient pediatric visits
Computerized medication alert systems may need to be more specific for home health care patients
Computerized alerts and professional collaboration improve laboratory monitoring of outpatients starting new medications

Research Activities, February 2006:
Audit/feedback and educational materials have little effect on monitoring patients for NSAID toxicity
The new Medicare drug bill encourages E-prescribing to improve patient safety and health, but advanced systems are key
Computerized physician order entry prevents drug errors, but can initially result in new errors in ICUs
Implementation of computerized order entry systems with clinical decision support in long-term care facilities is a challenge
Long-term antibiotic treatment for acne may be associated with upper respiratory tract infections
Both aspirin and extended release dipyridamole/aspirin are cost-effective anticoagulant agents to prevent second strokes
Variants in certain receptor genes affect the survival of patients with acute coronary syndrome who are prescribed beta-blocker therapy
Concern about bleeding problems should not delay giving clot-busting drugs to heart attack patients with kidney disease
People with diabetes take less diabetes medication when costs increase

Research Activities, January 2006:
Computerized drug-laboratory interaction alerts change doctors' prescriptions
Broad-spectrum antibiotics given during labor are linked to late-onset serious bacterial infections in infants
Cognitive behavioral therapy offers adolescents with depression some benefit over treatment with antidepressants alone
Prohibiting physicians from dispensing drugs reduces overall drug use and inappropriate prescribing

Research Activities, December 2005:
AHRQ releases the first Comparative Effectiveness Review: Certain drugs are as effective as surgery for management of GERD
Preprinted prescription forms can improve compliance with prescription guidelines in neonatal intensive care units
Donepezil has a small effect in the treatment of dementia from Parkinson's disease

Research Activities, November 2005:
Low-dose insulin does not affect weight or physical development of children at risk for developing type 1 diabetes
Studies detail the impact of costs on drug and health care use

Research Activities, October 2005:
Keeping more medical appointments and taking medication as directed helps patients with diabetes control blood sugar levels
Screening and treatment for osteoporosis remains low among patients taking glucocorticoids
Knowledge and beliefs about lifestyle changes may contribute to ethnic differences in blood pressure control
One percent of Americans visit doctors each year to manage health problems caused by medication

Research Activities, September 2005:
Studies investigate watchful waiting over immediate antibiotics for young children with nonsevere ear infections
Improving physician knowledge of psychiatric problems and relevant medications could improve quality of care
Patients in intensive care units are at significant risk for adverse events and serious errors
Elderly people commonly use herbs or vitamin-mineral supplements, but use varies by ethnicity
Increased use of ACE inhibitors for elderly people with diabetes could improve outcomes and save money
Computerized guidelines for psychotropic drug use can improve prescribing and reduce falls among hospitalized elderly patients
Collaboration between gastroenterologists and pharmacists improves the management of patients with chronic acid-related symptoms
Study reveals a lower prevalence of a rare vasculitis syndrome among asthma drug users than previously reported

Research Activities, August 2005:
Estrogen therapy with progestin has higher discontinuation rates in women with diabetes and cardiovascular disease
Routine pertussis vaccination of adolescents would be beneficial and reasonably cost effective
It will be difficult to achieve strict cholesterol goals in many patients with diabetes and cardiovascular disease
Laboratory drug monitoring of outpatients taking long-term medications could be improved
Hydroxychloroquine can reduce risk of organ damage in patients with lupus

Research Activities, July 2005:
Adverse drug events occur frequently in long-term care facilities, and nearly half of them are preventable
Use of atypical antipsychotic drugs to treat children continues despite questions about their safety and efficacy in the young
Despite recent downward trends in antibiotic use among children, use of some broad-spectrum antibiotics has increased
Limited use of cephalosporins may reduce E. coli and Klebsiella bloodstream infections in hospitalized children
Fluoroquinolones were the most commonly prescribed class of antibiotics for adults in 2002
Patient education may reduce unnecessary use of antibiotics by adults
Both group and individual academic detailing can improve prescribing of antihypertensive medications
Higher copayments of 3-tier drug formularies reduce the likelihood that individuals will use certain medications

Research Activities, June 2005:
More than 13 percent of primary care patients do not know why they are taking at least one of their prescription medications
Herbal use is common among urban primary care patients and often is not disclosed to doctors
Women respond differently to medications than men and should be proactive about their medication use
Hospitals with internal support for quality improvement are most likely to prescribe beta-blockers for heart attack patients
Better monitoring of outpatients taking thyroid replacement therapy may reduce drug-related problems
One-third of a national sample of hospital staff nurses made an error or near error over a 1-month period
Partnering with hospitalized patients to monitor medication use is a feasible strategy for reducing drug errors

Research Activities, May 2005:
Latest data show that use of antibiotics to treat ear infections is declining
Prolonging clopidogrel therapy from 1 month to 1 year after coronary angioplasty with stent placement is cost effective
Researchers assess breast cancer risk and the effects of tamoxifen prophylaxis among women in primary care practices
Use of hormone replacement therapy plummeted after publication of findings from the Women's Health Initiative trial
Use of potentially inappropriate medications in patients aged 65 and older continues to be widespread

Research Activities, April 2005:
Study documents the prescribing of potentially harmful drugs to elderly outpatients prescribed multiple drugs
Recent market withdrawal of Vioxx underscores the need to limit new drugs to those who will most benefit from them
Researchers compare medications for stroke prevention in patients with atrial fibrillation
Study fails to establish cost-effectiveness of using palivizumab to prevent RSV infection in preterm infants
Medication use boosted treatment rates for mental health and substance abuse disorders in 2001 compared with 1996
Many Medicaid-insured schizophrenia patients are prescribed multiple long-term antipsychotics
Messages about appropriate antibiotic use must be responsive to ethnic differences and literacy issues
Pulmonary arterial hypertension markedly worsens a person's quality of life, but medication may help
Pain management is often inadequate for elderly patients hospitalized for surgery
Algorithms can enhance communication between pharmacists and physicians about medications prescribed for elderly patients
Study finds no evidence that antiretroviral therapy causes serious liver disease in HIV patients coinfected with hepatitis C
HIV-infected patients with severe depression or bipolar disorder often do not adhere to their medication regimens

Research Activities, March 2005:
Androgen-deprivation therapy for prostate cancer increases the risk of fracture among elderly men
Use of certain antidepressants may increase risk of hip fractures among older patients
Pharmacy data can help public health officials identify TB cases and assess their management by private-sector physicians
Pharmacogenomic drug development raises new challenges for drug regulatory agencies
Studies of COX-2 inhibitors have ramifications for other drugs and pharmaceutical policies
Significant exposure to tobacco smoke and underuse of controller medications exacerbate asthma symptoms among Head Start children
Women 65 and older used more medications and spent more for them than same-age men during the period 1999 to 2001

Research Activities, February 2005:
Drug regimens for treating pelvic inflammatory disease should include metronidazole
Study finds racial disparities in receipt of state-of-the-art care for HIV disease

Research Activities, January 2005:
Researchers find potentially inappropriate drug use in nursing homes associated with deaths of elderly residents
Voluntary primary care safety reporting system includes errors due to communication, diagnostic tests, and medication
Clinicians value medication safety alerts and welcome small-group training to make better use of them
Community pharmacists receive many computer-generated alerts about drug-drug interactions, most of which they override
Marketing and prescribing of hormone replacement therapy declined substantially following reports of harm
Study suggests that use of lifesaving beta-blockers for heart attack patients is increasing at community hospitals
Primary care doctors demonstrated restraint in prescribing antibiotics following the 2001 anthrax attacks
Elderly people who lack prescription drug coverage may not get needed medications for chronic conditions

Research Activities, December 2004:
Misconceptions are common among child care center staff about the need for antibiotics for upper respiratory infections
Use of antipsychotic medications nearly doubled among low-income children in Tennessee in the late 1990s

Research Activities, November 2004:
Researchers examine factors that affect voluntary reporting of medication errors
Better consumer education and marketing surveillance are needed for one over-the-counter drug used for urinary tract pain
Knowledge of pain medication and its management could be improved among nursing home staff

Research Activities, October 2004:
Quality-of-life benefits of short-term hormone therapy may outweigh the risks for some menopausal women
After more than 20 years, quality of life is similar for women who had a hysterectomy or went through natural menopause
Potentially inappropriate drugs are commonly prescribed for elderly outpatients
More effective and convenient medications for osteoporosis have increased recognition and treatment of the disease
Testing for hypercoagulable disorders in patients with deep vein thrombosis followed by 2 years of anticoagulation is cost effective
Medicare drug benefits with high out-of-pocket costs might not be effective for low-income beneficiaries with chronic diseases

Research Activities, September 2004:
Many chronically ill patients don't tell their doctors that they limit use of prescription drugs because of cost
Study finds that some pregnant women are prescribed drugs that may be considered unsafe during pregnancy
Oral erythromycin combined with a number of commonly used drugs may increase the risk of sudden cardiac death
Clopidogrel is a cost-effective medication for patients with a recent stroke or peripheral arterial disease
Use of rofecoxib at 50 mg for more than 5 days for osteoarthritis should be discouraged due to dose-related problems
Although muscle relaxants are often prescribed for acute low back pain, they do not appear to speed recovery of function
Decision model can help doctors identify which patients will develop a cough from taking an ACE inhibitor
Many diabetes patients at high risk for kidney failure are not receiving medication to slow its development
Lack of insurance coverage is not the only barrier to medication access among older Americans with chronic conditions
Despite their high risk for cardiovascular disease, two-thirds of kidney dialysis patients are not treated for hyperlipidemia
Despite overall national improvement in beta-blocker use after heart attack, the rate of improvement varies across hospitals
Researchers examine trends in spending on drugs for Medicare beneficiaries and insurance coverage for children

Research Activities, August 2004:
Study uncovers major differences in the use and cost of health care for privately insured men and women with HIV
Hospital costs and length of stay for HIV patients depend in part on geographic area
Initial surfactant treatment to prevent respiratory distress in very premature infants is often delayed in routine practice
One-third of heart failure patients stop taking their prescribed medication within a year of hospital discharge
Out-of-pocket costs and inconvenient monthly pharmacy visits may be barriers to women's consistent use of oral contraceptives
Postmarketing drug surveillance could be improved
Medication errors are frequent in the emergency department and often arise from the fast pace and heavy patient load
Teaching anesthesia during surgery may be a distraction that reduces the vigilance of anesthesia care
Hypertension control is greater in U.S. primary care practices than usually reported
Immunization rates in New Mexico have fallen significantly since the introduction of Medicaid managed care

Research Activities, July 2004:
Treatment of high cholesterol in women should be based on all risk factors of heart disease, not just lipid levels
Sibutramine can help manage obesity, but it may not be appropriate for patients with significant cardiovascular disease
Careful use of chloramphenicol and quinolone antibiotics may help preserve the use of chloramphenicol to treat vancomycin-resistant infections
Researchers find no evidence that vitamin E supplements have any benefit in preventing or treating cardiovascular disease
Patients may overstate their use of antihypertensive medication
Most pediatric ER workers say they are willing to receive the smallpox vaccine, but few have done so
Improved access to medication and therapy for depressed primary care patients improves 5-year outcomes
Study finds delays in prescribing protease inhibitors for some HIV-infected individuals

Research Activities, June 2004:
Regular use of inhaled antiinflammatory medication improves outcomes for children with persistent asthma
Researchers examine the impact of medication costs and mental health care for patients with diabetes
Physician prescribing preference plays a greater role than patient risk factors in prescribing COX-2 inhibitors
Emergency physicians vary widely in the prescribing of opioid analgesics for common, painful conditions
Doctors can use proactive office systems and patient education to persuade more elderly patients to get flu shots
Enhancing Hispanics' access to medications through increased Medicaid eligibility may improve their use of antihypertensives
Primary care of adults with chronic acid-related disorders could be improved if more doctors followed treatment guidelines
Researchers identify five information technologies that have great potential to improve patient safety for children
People with diabetes do a better job of managing their disease when HMOs cover diabetes self-monitoring devices
Despite some slowing, the growth in drug expenditures continues to outpace growth in overall health care expenditures

Research Activities, May 2004:
Significant increases in drug copayments may reduce patients' use of needed medications
Better monitoring of the cardiac drug amiodarone among outpatients could improve its safety
Researchers examine the diagnosis, testing, and treatment of bronchiolitis in infants
Conference participants outline research agenda for pediatric outpatient safety
Practices that allot more time for acute care visits and promote immunization have higher adult vaccination rates

Research Activities, April 2004:
Many medications are effective in managing atrial fibrillation
Clinicians and patients responded quickly to recent evidence of harms associated with hormone therapy
Doctors substantially reduced their prescribing of alpha-blockers for hypertension after published trial results showed problems
Studies focus on care for respiratory tract infections in the elderly
Medicare drug benefit bill will increase physicians' exposure to drug formularies
Medicare enrollees in for-profit plans are no less likely to receive high-cost procedures than those in non-profit plans

Research Activities, March 2004:
Patients who undergo surgery for gastroesophageal reflux disease use less care later than those who receive only medications
Researchers examine physician prescribing of closely controlled antiarrhythmic drugs dofetilide and Betapace AF
Certain oral blood-sugar-lowering drugs may increase the risk of heart failure in patients with type 2 diabetes
Inconsistent use of medications by elderly Mexican Americans with diabetes may explain their greater risk of some complications
Only about half of stroke survivors living in nursing homes receive medicine to prevent another stroke

Research Activities, February 2004:
New study estimates potential savings gained by expanding use of beta-blockers in heart failure patients
Study documents racial variations in the prescribing of opiods by ER doctors
Use of tamoxifen to prevent breast cancer should be weighed against an individual woman's potential to benefits and risks
Different changes in drug formulary administration and copayments can have very different effects on drug use and spending
Some managed care strategies to improve drug use appear to be effective, but little is known about long term clinical outcomes

Research Activities, January 2004:
Acid suppressant therapy is effective for short-term relief of heartburn for patients with persistent symptoms
Few postmenopausal women who have suffered a fracture receive drug treatment to prevent further fractures
Confounding factors may be the reason that randomized controlled trials of HRT conflict with observational studies
British Columbia's reference pricing for a calcium channel blocker may be a model for pharmaceutical cost-containment
Children are at risk for certain drug-resistant strains of Streptococcus pneumoniae
Assay for HIV protease inhibitors in patient blood developed to improve patient care