| January 31, 2023, Issue #848  Access more information on this topic in the associated research review, plus additional AHRQ data infographics.  An AHRQ-supported study published in the journal Cancer found that 10 percent of children with leukemia or lymphoma experienced adverse drug events due to outpatient medication errors. In the study, conducted from 2016 to 2019, researchers monitored patients for six months using in-home observations and chart reviews. They found that failures in communication about changes in medication doses were common, and one in four caregivers reported administering double doses or missing doses due to miscommunication with another caregiver about whether the dose had already been given. In addition, 21 percent of caregivers handled chemotherapy with bare hands during in-home observation, risking harm to themselves. These findings underscored a critical need for interventions to support safe medication use at home. Researchers concluded that improvements addressing communication with and among caregivers should be co-developed with families and based on human-factors engineering. Access the abstract. | Registration is open for a two-day virtual event to explore healthcare algorithms' impacts on racial and ethnic bias. The webinars, sponsored by AHRQ and the National Institute on Minority Health and Health Disparities, are scheduled March 2 from 10:30 a.m. to 3:40 p.m. ET, and March 3 from 10 a.m. to 2 p.m. ET. Healthcare algorithms, often based on statistical or mathematical models including machine learning or other artificial intelligence approaches, can offer value in diagnostics and treatments. At the same time, algorithms can create and perpetuate inequities in healthcare. The online event will explore algorithms' impacts and approaches to identify and mitigate existing biases. It will include perspectives of patients, clinicians, payers, health systems, electronic health record vendors and federal agencies. A new AHRQ systematic review found no significant difference between partial breast irradiation (PBI) and whole breast irradiation (WBI) for early-stage breast cancer in same-side tumor recurrence, overall survival and cancer-free survival at five and 10 years. The systematic review, from AHRQ's Effective Health Care Program, also found PBI had significantly fewer acute adverse events than WBI, though there was no apparent difference in late adverse events. In addition, the study found that PBI's treatment regimen, which was shorter than the typical WBI regimen of 15–20 treatments over three to four weeks, was associated with lower transportation costs and fewer days away from work for patients. Radiotherapy is a widely used standard component of breast-conserving therapy for early-stage breast cancer. PBI was developed to provide a comparable treatment to the more traditional WBI but in a shorter time and with reduced radiation exposure to adjacent tissue.  The expansion of Medicaid under the Affordable Care Act (ACA) reduced disparities in preventable hospitalizations and emergency department (ED) visits by 10 percent or more between Black and White nonelderly adults, an AHRQ-study found. Researchers examined whether the increase in access to Medicaid-covered care under the ACA—from 55 million in 2013 to 87 million in 2022—mitigated racial and ethnic disparities in care. Using inpatient discharge data from 29 states and ED discharge data from 26 states from 2011 to 2018 in AHRQ's Healthcare Cost and Utilization Project, researchers examined the longer-term impact of the ACA's Medicaid expansion. While broader access to Medicaid coverage resulted in a 10 percent decrease in preventable hospitalization and a 13 percent decrease in preventable ED visits between Black and White adults, it did not significantly affect disparities between Hispanic and White adults. Access the abstract of the study published in Health Affairs. |  An AHRQ webinar on Feb. 28 from 2:30 to 4 p.m. ET will include presentations from experts who will share their research findings on reducing health disparities and improving the quality of care for diverse patients through innovative digital health interventions. Among topics to be discussed: the potential impact of telepsychiatry consultations with automated interpreting on mental health services for patients with limited English proficiency; how an innovative artificial intelligence communication system can identify and mitigate health risks for young African American women prior to pregnancy; and how using an electronic social needs screening tool in the emergency department can improve referrals for patients. Access more information, including how to register. | AHRQ's Patient Safety Network (PSNet) highlights journal articles, books and tools related to patient safety. Articles featured this week include: 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). Results from AHRQ's s Surveys on Patient Safety Culture™ (SOPS®) Nursing Home Survey: 2023 User Database Report are now available. The new report shows an average 54 percent of respondents gave their nursing home an overall rating of "excellent" or "very good" on resident safety. The database includes 62 participating nursing homes and more than 3,200 nursing home staff. For questions about the SOPS Databases, email DatabasesOnSafetyCulture@westat.com or call 1-(888) 324-9790. | AHRQ in the Professional Literature "Anything that benefits the workers should benefit the client": opportunities and constraints in self-directed care during the COVID-19 pandemic. Wendel CL, LaPierre TA, Sullivan DL, et al. J Appl Gerontol. 2022 Dec 5. [Epub ahead of print.] Access the abstract on PubMed®. Operating room design using agent-based simulation to reduce room obstructions. Taaffe K, Ferrand YB, Khoshkenar A, et al. Health Care Manag Sci. 2022 Dec 19. [Epub ahead of print.] Access the abstract on PubMed®. Past disruptions in health insurance coverage and access to care among insured adults. Kirby JB, Nogueira LM, Zhao J, et al. Am J Prev Med. 2022 Dec 24. [Epub ahead of print.] Access the abstract on PubMed®. QuickStroop, a shortened version of EncephalApp, detects covert hepatic encephalopathy with similar accuracy within one minute. Acharya C, Shaw J, Duong N, et al. Clin Gastroenterol Hepatol. 2023 Jan;21(1):136-42. Epub 2022 Jan 6. Access the abstract on PubMed®. Effect of health system on the association of rurality and level of disadvantage with receipt of diabetic eye screening. Lock LJ, Channa R, Brennan MB, et al. BMJ Open Diabetes Res Care. 2022 Dec;10(6):e003174. Access the abstract on PubMed®. A systematic review of the effectiveness and safety of droperidol for pediatric agitation in acute care settings. Ramsden SC, Pergjika A, Janssen AC, et al. Acad Emerg Med. 2022 Dec;29(12):1466-74. Epub 2022 May 22. Access the abstract on PubMed®. A standardized emergency department order set decreases admission rates and in-patient length of stay for adults patients with sickle cell disease. Wachnik AA, Welch-Coltrane JL, Adams MCB, et al. Pain Med. 2022 Dec;23(12):2050-60. Access the abstract on PubMed®. Time-limited trials in the ICU: a mixed-methods sequential explanatory study of intensivists at two academic centres. Viglianti EM, Ervin JN, Newton CA, et al. BMJ Open. 2022 Apr 4;12(4):e059325. Access the abstract on PubMed®. Contact Information For questions or comments about AHRQ News Now, contact Bruce Seeman, (301) 427-1998 or Bruce.Seeman@ahrq.hhs.gov. |
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