September 17, 2007, Issue No. 238
AHRQ News and Numbers
Americans spent nearly $5 billion in 2004 on Lipitor®, a cholesterol-reducing drug, which ranked first in terms of total spending on prescription medicines by adults ages 18 to 64. Another cholesterol-fighting drug, Zocor, ranked fourth at $2.3 billion. (Source: Agency for Healthcare Research and Quality [AHRQ], MEPS Statistical Brief #180: The Top Five Outpatient Prescription Drugs Ranked by Total Expense for Children, Adults, and the Elderly, 2004 [PDF Help].)
Today's Headlines
1. AHRQ and FDA to collaborate in largest study ever of possible heart risks with ADHD medications
2. Drug cuts NSAID users' risk of hospitalization for peptic ulcer by more than half
3. September is National Preparedness month
4. AHRQ's HCUP 2005 Nationwide Inpatient Sample is now available
5. New AHRQ evidence report on antiretroviral drug resistance in developing countries available
6. New mentoring program for emergency department pharmacists and research on peptic ulcers featured in AHRQ's Healthcare 411
7. HCUP data on potentially preventable hospitalizations goes to radio stations
8. AHRQ in the professional literature
1. AHRQ and FDA to Collaborate in Largest Study Ever of Possible Heart Risks with ADHD Medications
AHRQ and the Food and Drug Administration (FDA) are collaborating in the most comprehensive study to date of prescription medications used to treat attention deficit hyperactivity disorder (ADHD) and the potential for increased risk of heart attack, stroke or other cardiovascular problems. Researchers will examine the clinical data of about 500,000 children and adults who have taken medications used to treat ADHD, to determine whether those drugs increase cardiovascular risks. The study will be coordinated by Vanderbilt University researchers through AHRQ's Effective Health Care program. Data analysis will be performed by researchers at Vanderbilt, Kaiser Permanente of California, the HMO Research Network, and i3 Drug Safety, as well as from FDA and AHRQ. The analysis will include all drugs currently marketed for treating ADHD. The study will analyze the risks of all the drugs as a whole, and risks of the drugs grouped by class. The analysis will take about 2 years to complete. Results are expected to be important not only to patients, their families and health care providers, but also to government insurance programs. Medicaid, Medicare, and the State Children's Health Insurance Program provide reimbursement for drugs prescribed for ADHD. This information could also be used to inform product labeling, which is used by health care providers when making treatment decisions. Select to read our press release.
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2. Drug Cuts NSAID Users' Risk of Hospitalization for Peptic Ulcer by More than Half
People who take proton pump inhibitors to reduce stomach acid when regularly using aspirin, ibuprofen, or another non-steroidal anti-inflammatory drug (NSAID) for pain relief from arthritis or other conditions cut their odds of eventually being hospitalized for an ulcer by 54 percent, according to a new AHRQ study. Researchers with the AHRQ-supported Vanderbilt University Center for Education and Research on Therapeutics, led by Wayne A. Ray, Ph.D., analyzed the ulcer-related hospitalization rates of Medicaid patients who used either a traditional NSAID alone, or a coxib-2 drug with or without gastroprotective therapy—a strategy for preventing NSAID-induced ulcers in patients—between 1996 and 2004. The researchers found that proton pump inhibitors lowered ulcer hospitalization risks in users of traditional NSAIDs similarly to the 50 percent reduction achieved when the newer coxibs were prescribed with a proton pump inhibitor. When the researchers looked at all types of gastroprotective therapy, they found that patients who currently took a coxib drug without the therapy had a 40 percent reduction in their risk of peptic ulcer hospitalization. Patients who took a traditional NSAID in conjunction with any type of gastroprotective reduced their risk of ulcer hospitalization by 39 percent. "Risk of Peptic Ulcer Hospitalizations in Users of NSAIDs with Gastroprotective Cotherapy versus Coxibs," was published in the September 2007 issue of Gastroenterology. Select to read the abstract in PubMed®.
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3. September is National Preparedness Month
National Preparedness Month is a nationwide effort held each September to encourage Americans to take simple steps to prepare for emergencies in their homes, businesses and schools. Any mass casualty event such as a natural disaster or bioterrorist attack can quickly overwhelm hospitals and health care facilities, and communication between health care systems and emergency responders can easily break down. AHRQ has developed a variety of products to assist with preparing for public health emergencies. These tools range from evidence-based guides to questionnaires and resource atlases to help State and local areas meet Federal and local requirements for public health emergency preparedness. AHRQ also has many surge capacity tools that help people locate possible alternative sites, such as nursing homes or rehab facilities, that can be used for patient care if hospitals are overwhelmed during a health crisis. AHRQ has funded more than 60 emergency preparedness-related studies, workshops, and conferences to help hospitals and health care systems prepare for public health emergencies. Select for more information about these products. This week's Healthcare 411 audio newscast features AHRQ's Dr. Sally Phillips talking about AHRQ's Pubic Health Emergency Preparedness program. Select to listen to the 7-minute program.
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4. AHRQ's HCUP 2005 Nationwide Inpatient Sample Is Now Available
AHRQ's Healthcare Cost and Utilization Project (HCUP) Nationwide Inpatient Sample (NIS) featuring 2005 data was released in July. This inpatient care database includes all patients, regardless of payer—including people covered by Medicare, Medicaid, private insurance, and the uninsured. The data can be weighted to produce national estimates, allowing researchers and policymakers to use the NIS to identify, track, and analyze national trends in health care utilization, access, charges, quality, and outcomes. As part of the HCUP database family, the NIS is considered by health services researchers to be one of the most reliable and affordable databases for studying important health care topics. Visit HCUP NIS for additional information including how to purchase the data.
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5. New AHRQ Evidence Report on Antiretroviral Drug Resistance in Developing Countries Available
AHRQ released a new evidence report on the prevalence of antiretroviral drug resistance in the developing world that found the research to date too limited in quantity and quality to draw conclusions. Understanding the percentage of HIV-infected persons who have developed antiretroviral drug resistance and related causes and factors is important in determining how to improve the effectiveness of treatment guidelines and regimens. Due to the lack of research, the researchers recommend that future studies be conducted on the need for maternal single-dose neviripine—used in antiretroviral therapy—when an infant is given the drug at birth and the mother is given zidovudine, as well as on the optimum time to begin postpartum antiretroviral drug resistance. The authors also recommend that future studies oversample rare HIV clades—organisms believed to originate from a single, common ancestor—to provide meaningful data, and that India prioritize research on resistance patterns among HIV prevalence, given that the disease is widespread there. The report was requested by the National Institutes of Health's (NIH) Fogarty International Center and prepared by AHRQ's Southern California Evidence-based Practice Center. Select to access the report. A print copy is available by sending an E-mail to ahrqpubs@ahrq.hhs.gov.
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6. New Mentoring Program for Emergency Department Pharmacists and Research on Peptic Ulcers Featured in AHRQ's Healthcare 411
A recent AHRQ Healthcare 411 audio newscast features an interview with AHRQ researcher Rollin J. (Terry) Fairbanks, M.D., of the University of Rochester, New York, as he discusses his new mentoring program for emergency department pharmacists that is based on AHRQ research. The program is designed to connect teams of ED pharmacists with pharmacists who wish to develop these practices in their own hospitals. Select to listen to the 12-minute program.
Another recent Healthcare 411 newscast features stories on AHRQ's Healthcare Cost and Utilization Project statistics about adverse drug events in hospitals. Select to listen to the 10-minute program.
Another Healthcare 411 program provides information about Dr. Wayne Ray's Centers for Education and Research on Therapeutics (CERTs) research on peptic ulcers. Select to listen to the 2-minute program.
To access any of AHRQ's podcasts, visit our Healthcare 411 series main page.
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7. HCUP Data on Potentially Preventable Hospitalizations Goes to Radio Stations
A separate podcast just for radio stations discusses the HCUP statistical brief that says Americans may avoid nearly 4.5 million hospitalizations per year if they get better primary care, better access to treatment, and adopt healthier lifestyles. Select to listen to the 90-second program. Select to access the transcript.
Visit the Healthcare 411 series main page to hear all of AHRQ's full-length podcasts.
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8. 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.
Carter SK, Rizzo JA. Use of outpatient physical therapy services by people with musculoskeletal conditions. Phys Ther 2007 May; 87(5):497-512. Epub 2007 Mar 20. Select to read the abstract in PubMed®.
Shah SS, Hall M, Goodman DM, et al. Off-label drug use in hospitalized children. Arch Pediatr Adolesc Med 2007 Mar; 161:282-90. Select to read the abstract in PubMed®.
Rogowski J, Jain AK, Escarce JJ. Hospital competition, managed care, and mortality after hospitalization for medical conditions in California. Health Serv Res 2007 Apr; 42(2):682-705. Select to read the abstract in PubMed®.
Xiao Y, Seagull J, Bochicchio GV, et al. Video-based training increases sterile-technique compliance during central venous catheter insertion. Crit Care Med 2007 Apr 5; 35(5). Select to read the abstract in PubMed®.
Grant RW, Meigs JB Prevalence and treatment of low HDL cholesterol among primary care patients with type 2 diabetes. Diabetes Care 2007 Mar; 30(3):479-84. Select to read the abstract in PubMed®.
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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/enewsix.htm.
Contact Information
Please address comments and questions to Nancy Comfort at Nancy.Comfort@ahrq.hhs.gov or (301) 427-1866.
Current as of September 2007
Internet Citation:
AHRQ Electronic Newsletter. September 17, 2007, Issue No. 238. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/enews/enews238.htm
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