Research Activities

September 2004, No. 289

---

Contents

About Research Activities

Feature Story

Many chronically ill patients don't tell their doctors that they limit use of prescription drugs because of cost

Pharmaceutical Research

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

Chronic Illness

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
Interference of diabetes with social activities may be an early warning sign of subsequent disability
Certain biological factors that may represent insulin resistance are associated with a decline in physical functioning
Osteoarthritis patients have less pain and better functioning after joint replacement surgery, but they need support at 1 month
Problems with mobility make it hard for people with Parkinson's disease to express their personality

Elderly/Long-term Care

Communication problems often contribute to untimely care of acute infections in nursing homes
Researchers compare treatment of U.S. and Dutch nursing home residents with dementia who develop lower respiratory infections

Quality/Patient Safety

Despite overall national improvement in beta-blocker use after heart attack, the rate of improvement varies across hospitals
In-hospital mortality is similar for cardiac surgery patients treated at either medium- or high-volume hospitals
Based on postoperative complication rates, teaching and nonteaching hospitals may provide similar quality of care
Root cause analysis should be conducted after a wrong site surgery to reduce future errors
Potentially preventable hospital readmissions may be determined by the severity and complexity of underlying chronic problems
Hospital providers' understanding of patient safety is heavily influenced by their professional roles
In certain situations, nurses should raise a "red flag" to protect patient safety
Researchers examine the challenges of ensuring the safety of cardiovascular devices

Children's Health

Premature infants with bronchopulmonary dysplasia are rehospitalized at twice the rate of other premature infants
Only 9 percent of children with out-of-hospital cardiopulmonary arrest survive, despite prolonged CPR and epinephrine

Access to Care/Health Care Delivery

Racial/ethnic composition of a county can affect residents' access to care
Half of doctors in State-sponsored financial support-for-service programs stay in underserved areas over 8 years, most working happily
Collaborative care for acutely injured trauma survivors can reduce post-traumatic distress symptoms and alcohol abuse
Care is rarely coordinated for patients with mental disorders seeing both doctors and CAM providers

Primary Care Research

Diagnosis of pain by primary care doctors is influenced by pain severity, patient sex, and physician practice style
Even when primary care patients receive recommended treatment for their depression, nearly half remain depressed

Health Care Costs and Financing

Researchers examine trends in spending on drugs for Medicare beneficiaries and insurance coverage for children
Children with special health care needs in Medicaid managed care plans receive more needed care than those in Medicaid FFS plans
Expanded Medicaid eligibility reduced the risk of inadequate prenatal care in California during the 1990s
Researchers examine the effects of financial and nonfinancial incentives on health care use, costs, and quality
Individuals are unlikely to recommend an insurance plan if they do not like the provider choices or preventive services covered

Agency News and Notes

AHRQ reports review quality of U.S. health care services and differences in use of these services for at-risk groups

Announcements

New guide helps communities plan for vaccine and drug dispensing in response to bioterrorism or other public health emergencies
New tutorial for the National Guideline Clearinghouse™ now available from AHRQ

Research Briefs

Current as of September 2004
AHRQ Publication No. 04-0069

---

Internet Citation:

Research Activities Newsletter. September 2004, No. 289. AHRQ Publication No. 04-0069. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/research/sep04/

---