Register Now: July 25 Webinar by National Action Alliance Will Address Involving Patients and Families in Safety

AHRQ Stats: Emergency Department Visits for Substance Use Disorders

Although estimates showed higher rates of substance use disorders (SUDs) among White individuals than Black and Hispanic individuals in 2019, emergency department visits for SUDs were more common among Black non-Hispanic individuals (48.3 percent per 1,000 population) than White non-Hispanic individuals (29.1 percent). Hispanic individuals had the lowest rate among any race/ethnicity group (17.6 percent). (Source: AHRQ Healthcare Cost and Utilization Project Statistical Brief #301, Racial and Ethnic Differences in Emergency Department Visits Related to Substance Use Disorders, 2019.) 

Today's Headlines:

• Register Now: July 25 Webinar by National Action Alliance Will Address Involving Patients and Families in Safety.
• Survey Finds That Many Patients Take Antibiotics Without a Prescription.
• Issue Briefs Highlight Patients’ Role in Remediation of Diagnostic Errors.
• Improved Use of Telehealth but Overuse of Emergency Departments Found Among Assisted Living Residents.
• Highlights From AHRQ’s Patient Safety Network.
• AHRQ in the Professional Literature.

Register Now: July 25 Webinar by National Action Alliance Will Address Involving Patients and Families in Safety

Registration is open for a webinar on July 25 from 2 to 3 p.m. ET on Involving Patients and Families in Safety. The webinar is part of an HHS series led by AHRQ and sponsored by the National Action Alliance To Advance Patient Safety, a public–private collaboration to support healthcare delivery systems’ move toward zero harm. Patient and family engagement is critical to creating a culture of safety. Practices to ensure meaningful inclusion of patients and families are evolving, and recent efforts have shown positive impacts on healthcare delivery. Expert presenters include Sue Sheridan, founding member, Patients for Patient Safety U.S.; Jennifer Lundblad, president and chief executive officer, Stratis Health; and Lisa Juliar, director of patient and family engagement, Minnesota Alliance for Patient Safety. Access more information about the Action Alliance, including information on past webinars.

Survey Finds That Many Patients Take Antibiotics Without a Prescription

More than two-fifths of 564 patients responding to a survey said they had taken antibiotics without a prescription, according to an AHRQ-funded study published in Clinical Infectious Diseases. The survey, conducted in 2020-21 at eight Texas healthcare facilities, found that 43.6 percent of respondents had taken an antibiotic without a prescription, and that 31.4 percent said they would do so if needed. Respondents reported obtaining antibiotics from friends or relatives (22.3 percent), purchasing them in the United States without a prescription (19.1 percent), or purchasing them abroad without a prescription (17.9 percent). Younger age, lack of health insurance and perceived high costs of doctor visits were predictors of nonprescription use. Researchers concluded that uninsured patients who report financial barriers to care are likely to acquire antibiotics without prescriptions. Access the abstract.

Issue Briefs Highlight Patients’ Role in Remediation of Diagnostic Errors

Two new AHRQ issue briefs describe the importance of patient engagement after a diagnostic error has occurred. Volume 1: Why Patient Narratives Matter highlights how patient perspectives offer unique information about the impacts of diagnosis-related events on patients’ trajectories through the healthcare system. It notes that patient feedback about the diagnostic process can enrich clinicians’ understanding of patient and family experience and reduce harms following adverse diagnostic events. Volume 2: Eliciting Patient Narratives emphasizes that rigorous methods are needed to elicit patient experiences. It describes the most effective ways of eliciting fulsome accounts about diagnosis-related events and how patient feedback about the diagnostic process can advance learning. Both briefs identify areas in which more research is needed about patients’ diagnostic experience.

Improved Use of Telehealth but Overuse of Emergency Departments Found Among Assisted Living Residents

Access to care among assisted-living facilities residents is the subject of two AHRQ-funded articles published in the Journal of the American Medical Directors Association. In one study, researchers found that the distance to the nearest hospital is a predictor of emergency department use rates among residents. The authors hypothesized that assisted-living facilities may rely on nearby emergency departments to provide nonemergency care to residents, potentially placing residents at risk of adverse events and generating wasteful Medicare spending. In the other article, researchers reported that as the COVID-19 pandemic progressed, Black and Hispanic residents and those living in a facility with a higher proportion of dual-eligible patients were increasingly more likely to access primary care via telemedicine. The authors said their findings support continuing pandemic-era telemedicine policies to improve access to primary care for minorities and individuals of lower socioeconomic status in assisted-living communities. 

Highlights From AHRQ’s Patient Safety Network

AHRQ’s Patient Safety Network (PSNet) highlights journal articles, books and tools related to patient safety. Articles featured this week include:

• Trends in maternal mortality and severe maternal morbidity during delivery-related hospitalizations in the United States, 2008 to 2021.
• Widespread misinterpretation of advance directives and Portable Orders for Life-Sustaining Treatments threatens patient safety and causes undertreatment and overtreatment.
• Contributory factors and patient harm including deaths associated direct acting oral anticoagulants (DOACs) medication incidents: evaluation of real world data reported to the national reporting and learning system.

Review additional new publications in PSNet’s current issue or access recent cases and commentaries in AHRQ’s WebM&M (Morbidity and Mortality Rounds on the Web).

AHRQ in the Professional Literature

Exploring mHealth potential to improve kidney function: secondary analysis of a randomized trial of diabetes self-care in diverse adults. Roddy MK, Mayberry LS, Nair D, et al. BMC Nephrol 2022 Aug 10;23(1):280. Access the abstract on PubMed®.

Identifying problematic opioid use in electronic health record data: are we looking in the right place? Schirle L, Kwun S, Suh A, et al. J Opioid Manag 2023 Jan-Feb;19(1):5-9. Access the abstract on PubMed®.

Pharmacist-provider collaborative visits after hospital discharge in a comprehensive acute kidney injury survivor model. Herges JR, May HP, Meade L, et al. J Am Pharm Assoc 2023 May-Jun;63(3):909-14. Epub 2022 Dec 31. Access the abstract on PubMed®.

Predictors of making a referral to child protective services prior to expert consultation. Zamalin D, Hamlin I, Shults J, et al. Acad Pediatr 2023 May 11. [Epub ahead of print.] Access the abstract on PubMed®.

Effects of a Medicaid dental coverage "cliff" on dental care access among low-income Medicare beneficiaries. Roberts ET, Mellor JM, McInerny MP, et al. Health Serv Res 2023 Jun;58(3):589-98. Epub 2022 Apr 9. Access the abstract on PubMed®.

Racial disparities in lung cancer stage of diagnosis among adults living in the southeastern United States. Richmond J, Murray MH, Milder CM, et al. Chest 2023 May;163(5):1314-27. Epub 2022 Nov 24. Access the abstract on PubMed®.

A coordinated approach for managing polypharmacy among children with medical complexity: rationale and design of the Pediatric Medication Therapy Management (pMTM) randomized controlled trial. Orth LE, Feudtner C, Kempe A, et al. BMC Health Serv Res 2023 Apr 29;23(1):414. Access the abstract on PubMed®.

A qualitative study of emergency physicians' and nurses' experiences caring for patients with psychiatric conditions and/or substance use disorders. Isbell LM, Chimowitz H, Huff NR, et al. Ann Emerg Med 2023 Jun;81(6):715-27. Epub 2023 Jan 18. Access the abstract on PubMed®.