AHRQ Views Blog Post: Implementing Screening and Treatment of Unhealthy Alcohol Use During COVID-19

AHRQ Stats: Emergency Care of Injuries in Children Following a Hurricane

Among people living in the direct path of a hurricane between 2005 and 2016, about one-quarter of children up to age 17 had injury-related emergency department visits that resulted in a hospital admission (23 percent) during the week of the hurricane. (Source: AHRQ, Healthcare Cost and Utilization Project Statistical Brief #267: Impact of Hurricanes on Injury-Related Emergency Department Visits, 2005-2016.)

Today's Headlines:

• AHRQ Views Blog Post: Implementing Screening and Treatment of Unhealthy Alcohol Use During COVID-19.
• Reform Programs Fail To Engage Primary Care Organizations, AHRQ Study Finds.
• Potentially Inappropriate Medication Prescriptions More Likely From Physicians.
• Analysis Identifies Possible Solutions to Electronic Health Record-Related Burnout.
• Highlights From AHRQ’s Patient Safety Network.
• New Research and Evidence From AHRQ.
• AHRQ in the Professional Literature. 

AHRQ Views Blog Post: Implementing Screening and Treatment of Unhealthy Alcohol Use During COVID-19

AHRQ’s support for the use of evidence-based strategies in primary care to curb unhealthy alcohol use is highlighted in a new AHRQ Views blog post. In noting that April is Alcohol Awareness Month, blog author Sebastian Tong, M.D., M.P.H., a senior staff fellow in AHRQ’s Center for Evidence and Practice Improvement, notes that alcohol sales and unhealthy alcohol use have risen dramatically during the COVID-19 pandemic. Despite recommendations to routinely screen and an AHRQ evidence review to treat alcohol use disorder with medications, rates of routine screening and treatment of patients remain low in primary care. The blog highlights AHRQ’s EvidenceNow: Managing Unhealthy Alcohol Use Initiative, which is aimed at implementing screening, brief behavioral counseling and medication for patients in approximately 600 practices across the nation. Access the blog post. To receive all blog posts, submit your email address and select “AHRQ Views Blog.”

Reform Programs Fail To Engage Primary Care Organizations, AHRQ Study Finds

Healthcare reform programs have not succeeded in broadly engaging primary care organizations despite years of effort, a new AHRQ-funded study has found. The study, published in Health Services Research, reviewed participation by the nation’s more than 56,000 organizations that deliver primary care services in three major reform programs: Medicare and Medicaid Promoting Interoperability Programs, commonly known as Meaningful Use; the Medicare Shared Savings Program; and the National Committee for Quality Assurance’s Patient-Centered Medical Home program. Researchers found that 50 percent of primary care organizations participated in at least one program but only 1 percent participated in all three. Just over 14 percent of organizations participated in five or more years of Meaningful Use, but less than 1 percent participated in five or more years of the Patient-Centered Medical Home program. Researchers concluded that organizations participating in multiple programs are likely those already providing high-quality care. Access the abstract.

Potentially Inappropriate Medication Prescriptions More Likely From Physicians

Physicians were more likely to prescribe potentially inappropriate medications than were nurse practitioners, an AHRQ-funded study has found. In their analysis of 2016 Texas Medicare data, researchers reviewed prescriptions for 76 high-risk medications that might not be considered appropriate. They found 24.1 potentially inappropriate medication prescriptions per 1,000 visits overall, with 9.0 prescriptions for initial visits and 15.1 for refills. A visit to a nurse practitioner was less likely to result in either an initial or refill potentially inappropriate prescription, the data showed. But because more than 93 percent of outpatient visits were to a physician, physicians had more opportunity for error. Access the abstract of the study, published in the Journal of the American Geriatrics Society.

Analysis Identifies Possible Solutions to Electronic Health Record-Related Burnout

Time spent filling out documentation, reviewing patient charts and managing inbox notifications are the three greatest sources of burden for clinicians who use electronic health records (EHRs), according to an AHRQ-supported analysis published in The Journal of the American Medical Informatics Association. The authors share evidence-based approaches for reducing burden by leveraging speech recognition technologies, natural language processing, artificial intelligence and redesign of EHR workflow and user interfaces. Access the abstract.

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:

• Improving peripherally inserted central catheter appropriateness and reducing device-related complications: a quasiexperimental study in 52 Michigan hospitals.
• A human factors intervention in a hospital--evaluating the outcome of a TeamSTEPPS program in a surgical ward.
• Association of clinician diagnostic performance with machine learning–based decision support systems: a systematic review.

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).

New Research and Evidence From AHRQ

• Maternal, Fetal, and Child Outcomes of Mental Health Treatments in Women: A Systematic Review of Perinatal Pharmacologic Interventions.

AHRQ in the Professional Literature

Rural hospital mergers increased between 2005 and 2016-what did those hospitals look like? Williams D, Jr., Reiter KL, Pink GH, et al. Inquiry 2020 Jan-Dec;57:46958020935666. Access the abstract on PubMed®.

A national survey of telemedicine use by US emergency departments. Zachrison KS, Boggs KM, Hayden EM, et al. J Telemed Telecare 2020 Jun;26(5):278-84. Epub 2018 Dec 17. Access the abstract on PubMed®.

Effect of retail clinic use on continuity of care among Medicare beneficiaries. Abara NO, Huang N, Raji MA, et al. J Am Board Fam Med 2019 Jul-Aug;32(4):531-8. Access the abstract on PubMed®.

Pros and cons of pre-emptive screening programmes before peanut introduction in infancy. Abrams EM, Brough HA, Keet C, et al. Lancet Child Adolesc Health 2020 Jul;4(7):526-35. Access the abstract on PubMed®.

Neighborhood disadvantage is associated with depressive symptoms but not depression diagnosis in older adults. Bolstad CJ, Moak R, Brown CJ, et al. Int J Environ Res Public Health 2020 Aug 8;17(16). Access the abstract on PubMed®.

Integrity of clinical information in radiology reports documenting pulmonary nodules. Lacson R, Cochon L, Ching PR, et al. J Am Med Inform Assoc 2021 Jan 15;28(1):80-5. Access the abstract on PubMed®.

Comparative access to and use of digital breast tomosynthesis screening by women's race/ethnicity and socioeconomic status. Lee CI, Zhu W, Onega T, et al. JAMA Netw Open 2021 Feb;4(2):e2037546. Access the abstract on PubMed®.

Nonpharmacological interventions for managing breathlessness in patients with advanced cancer: a systematic review. Gupta A, Sedhom R, Sharma R, et al. JAMA Oncol 2021 Feb;7(2):290-8. Access the abstract on PubMed®.