Study Finds Racial and Ethnic Inequities in End-of-Life Prescription Opioid Access
Issue Number
875
August 8, 2023
AHRQ Stats: Type of Medical Visits for COVID-19 by Income
In 2020, the proportion of COVID-19 patients who had an ambulatory visit ranged from 74.7 percent among poor or near-poor individuals to 90.6 percent among those with middle or high income. The proportion who visited an emergency room or had an inpatient stay was inversely related, ranging from 31.9 percent of poor or near-poor individuals to 16.4 percent of those with middle or high income. (Source: AHRQ Medical Expenditure Panel Survey Statistical Brief #549, Healthcare Use and Expenditures for COVID-19, U.S. Civilian Noninstitutionalized Population, 2020.)
Today's Headlines:
- Study Finds Racial and Ethnic Inequities in End-of-Life Prescription Opioid Access.
- Adoption Rates of New Cancer Therapies Vary Across Practices.
- Applications Due Sept. 25 and Oct. 5 for Research Projects on Healthcare-Associated Infections and Antibiotic Resistance.
- Highlights From AHRQ’s Patient Safety Network.
- Contribute to AHRQ’s Effective Health Care Program.
- Explore Careers at AHRQ.
- AHRQ in the Professional Literature.
Study Finds Racial and Ethnic Inequities in End-of-Life Prescription Opioid Access
An AHRQ-funded study of 318,549 White, Black, and Hispanic Medicare beneficiaries over age 65 who died of cancer found that they experienced steady declines in end-of-life opioid access. Disparities were also found in the frequency of drug screenings to gauge misuse of opioid medications. In the study, published in the Journal of Clinical Oncology, researchers found that compared with White patients, Black and Hispanic patients were less likely to receive any opioid and long-acting opioids. They also received lower daily doses and lower total doses. In addition, Black male patients were more likely be subject to urine drug screening, suggesting there are substantial and persistent racial and ethnic inequities in opioid access among older patients dying of cancer. Access the abstract.
Adoption Rates of New Cancer Therapies Vary Across Practices
AHRQ-funded research, recently published in JAMA Oncology, assessed evidence from 1,732 U.S. oncology practices on the adoption of immunotherapies—an alternative to chemotherapy that can improve patient outcomes—and examined associated practice characteristics with the variation in adoption by practice type. The study suggested geographic disparities in access to important innovations for treating patients with cancer. Between 2010 and 2021, the adoption rates surpassed 50 percent six months after Food and Drug Administration approval and grew to 75 percent within two years. Rural and smaller practices had lower adoption rates than urban and larger practices. In addition, independent and non-academic systems used immunotherapy less frequently than academic systems. Access the abstract.
Applications Due Sept. 25 and Oct. 5 for Research Projects on Healthcare-Associated Infections and Antibiotic Resistance
AHRQ is funding innovative research proposals to prevent healthcare-associated infections (HAIs) and to combat antibiotic-resistant bacteria (CARB). Applications are due Sept. 25 for demonstration and dissemination projects (R18) and on Oct. 5 for large research projects (R01). HAI projects in both grant categories should demonstrate new ways to detect, prevent and reduce HAIs. CARB projects should address ways to promote appropriate antibiotic use, reduce the transmission of resistant bacteria or prevent HAIs. Potential applicants are encouraged to carefully review these program announcements, which include several important policy updates. The funding is available to support research in all healthcare settings: long-term care, ambulatory care, acute care hospitals and transitions between care.
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:
- When to err is inhuman: an examination of the influence of artificial intelligence-driven nursing care on patient safety.
- Hospitalization due to adverse drug events in older adults with cancer: a retrospective analysis.
- Relationship between in-hospital adverse events and hospital performance on 30-day all-cause mortality and readmission for patients with heart failure.
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).
Contribute to AHRQ’s Effective Health Care Program
AHRQ encourages the public to participate in the agency’s Effective Health Care (EHC) Program, which conducts evidence reviews to inform healthcare decision-making on drugs, devices, surgeries and approaches to healthcare delivery. Since 2003, the EHC Program has published more than 300 systematic reviews and 200 research reports along with numerous research methods guides and white papers. These have been used by clinicians, policymakers and patients to inform clinical guidance, coverage decisions and future research. Suggest a research topic, comment on key research questions and draft reports or submit supplemental evidence and data.
Explore Careers at AHRQ
Join the team that strives to improve healthcare for all Americans by investing in health systems research, creating strategies to support practice improvement and providing data and analytics to identify opportunities for improvement. Current vacancies include:
- Health Scientist Administrator, Center for Evidence and Practice Improvement, Division of Digital Healthcare Research. Application deadline: Aug. 21.
AHRQ in the Professional Literature
Association of patient and primary care provider factors with outpatient COPD care quality. Keller TL, Wright J, Donovan LM, et al. Chronic Obstr Pulm Dis 2022 Jan 27;9(1):55-67. Access the abstract on PubMed®.
Using the Framework for Reporting Adaptations and Modifications-Expanded (FRAME) to study adaptations in lung cancer screening delivery in the Veterans Health Administration: a cohort study. Strayer TE, Spalluto LB, Burns A, et al. Implement Sci Commun 2023 Jan 12;4(1):5. Access the abstract on PubMed®.
Reliability and validity of assigning ultraprocessed food categories to 24-h dietary recall data. Sneed NM, Ukwuani S, Sommer EC, et al. Am J Clin Nutr 2023 Jan;117(1):182-90. Epub 2022 Dec 19. Access the abstract on PubMed®.
Antipsychotic medication use in Medicaid-insured children decreased substantially between 2008 and 2016. Bushnell G, Lloyd J, Olfson M, et al. Health Aff 2023 Jul;42(7):973-80. Access the abstract on PubMed®.
Prevalence of and spending on ear, nose, throat and respiratory infections among children with chronic complex conditions. Dunbar PJ, Sobotka SA, Rodean J, et al. Acad Pediatr 2023 Mar;23(2):434-40. Epub 2022 Sep 16. Access the abstract on PubMed®.
Psychiatrist networks In Medicare Advantage plans are substantially narrower than in Medicaid and ACA markets. Zhu JM, Meiselbach MK, Drake C, et al. Health Aff 2023 Jul;42(7):909-18. Access the abstract on PubMed®.
Adoption and value of the Medicare annual wellness visit: a mixed-methods study. Hamer MK, Decamp M, Bradley CJ, et al. Med Care Res Rev 2023 Aug;80(4):433-43. Epub 2023 Apr 26. Access the abstract on PubMed®.
Statewide perinatal quality improvement, teamwork and communication activities in Oklahoma and Texas. Stierman EK, O'Brien BT, Stagg J, et al. Qual Manag Health Care 2023 Jul-Sep;32(3):177-88. Epub 2023 Mar 7. Access the abstract on PubMed®.