Analysis Concludes Medicare Drug Plans Should Eliminate Barriers to Opioid Use Disorder Treatment

AHRQ Stats: Hospital Readmission Rates by Payer

From 2010 to 2016, the overall hospital readmission rate decreased 7 percent for Medicare patients and 14 percent for uninsured patients, while remaining stable for patients with Medicaid or private insurance. (Source: AHRQ, Healthcare Cost and Utilization Project Statistical Brief #248: Characteristics of 30-Day All-Cause Hospital Readmissions, 2010-2016.)

Today's Headlines:

• Analysis Concludes Medicare Drug Plans Should Eliminate Barriers to Opioid Use Disorder Treatment.
• New AHRQ Views Blog Post: Step by Step, Improving Heart Health in America.
• Significant Decline in Antibiotic Prescribing in Dental Care Seen After Education Program .
• Featured Studies on the Nation's Health Systems.
• Highlights From AHRQ’s Patient Safety Network.
• AHRQ in the Professional Literature. 

Analysis Concludes Medicare Drug Plans Should Eliminate Barriers to Opioid Use Disorder Treatment

Eliminating Medicare Part D coverage restrictions on the medication buprenorphine would immediately improve patients’ access to opioid use disorder treatment, according to a research letter in JAMA. About 300,000, or 12 percent, of Americans diagnosed with opioid use disorder in 2013 were Medicare beneficiaries. Buprenorphine, which may cause less dependence and fewer withdrawal symptoms than other opioids, is often used to treat the disorder. AHRQ-funded researchers who analyzed drug formularies found that Part D coverage for buprenorphine was relatively high. In 2018,generic buprenorphine tablets were covered by all plans. And about three-fourths of plans covered brand-name and generic versions of buprenorphine-naloxone, which is another opioid medication. Access to both brand-name and generic formulations was often delayed, however, by prior authorization requirements. For example, prescriptions for generic buprenorphine tablets, despite having the lowest cost (about $80), required prior authorization by 66 percent of Part D plans. Access the abstract. 

New AHRQ Views Blog Post: Step by Step, Improving Heart Health in America

David Meyers, M.D., AHRQ’s chief physician, commemorates Heart Health Month by highlighting agency support of evidence-based care in primary care practices as well as an upcoming initiative designed to increase cardiac rehabilitation. Cardiac rehabilitation is a medically supervised program that involves education, exercise training and psychological support. An estimated 965,000 Americans experience a coronary event each year, but only about 20 percent of eligible patients participate in cardiac rehab. Estimates suggest that increasing participation to 70 percent would save nearly 25,000 lives a year. AHRQ’s project will engage hospital and health systems to increase rehabilitation referrals, enrollment and retention. It will also develop an online platform to raise awareness about the benefits of cardiac rehab and provide resources that promote its use. Access the blog post.

To receive all blog posts, submit your email address and select “AHRQ Views Blog.” 

Significant Decline in Antibiotic Prescribing in Dental Care Seen After Education Program

Antibiotic prescribing for acute oral infections fell by 73 percent between 2016 and 2018 at Illinois’ largest dental provider for Medicaid recipients following a program to standardize prescribing practices, according to an AHRQ-funded study. Beginning in 2016, University of Illinois at Chicago College of Dentistry initiated an antibiotic stewardship program that consisted of patient and provider education, clinical guideline updates and safety reminders sent to providers. With the reduction shown by 2018, researchers said that simple educational interventions may decrease antibiotic prescribing in the outpatient setting. They also said this approach could be adapted to other dental practices in the United States to improve antibiotic prescribing. Access an abstract of the study, which appeared in Open Forum Infectious Diseases. 

Featured Studies on the Nation's Health Systems

AHRQ's Comparative Health System Performance Initiative funds studies about how health care delivery systems promote evidence-based practices and patient-centered outcomes research in delivering care. Publications include:

• Patient engagement in ACO practices and patient-reported outcomes among adults with co-occurring chronic disease and mental health conditions.
• Using health IT to coordinate care and improve quality in safety-net clinics.
• Are value-based incentives driving behavior change to improve value?

Access the initiative's Compendium of U.S. Health Systems, 2016, the first publicly available database that gives researchers, policymakers and health care administrators a snapshot of the nation's health systems. 

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:

• The path to diagnostic excellence includes feedback to calibrate how clinicians think.
• How to be a very safe maternity unit: an ethnographic study.
• AHRQ Nursing Home Survey on Patient Safety Culture: 2019 User Comparative Database Report.

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

A double-blind placebo randomized controlled trial of minocycline to reduce pain after carpal tunnel and trigger finger release. Curtin CM, Kenney D, Suarez P, et al. J Hand Surg Am 2017 Mar;42(3):166-74. Access the abstract on PubMed®.

Primary cesarean delivery patterns among women with physical, sensory, or intellectual disabilities. Darney BG, Biel FM, Quigley BP, et al. Womens Health Issues 2017 May-Jun;27(3):336-44. Epub 2017 Jan 18. Access the abstract on PubMed®.

A systematic review of clinic and community intervention to increase fecal testing for colorectal cancer in rural and low-income populations in the United States—how, what and when? Davis MM, Freeman M, Shannon J, et al. BMC Cancer 2018 Jan 6;18(1):40. Access the abstract on PubMed®.  

The association between major depressive disorder and outcomes in older veterans hospitalized with pneumonia. DeWaters AL, Chansard M, Anzueto A, et al. Am J Med Sci 2018 Jan;355(1):21-6. Epub 2017 Nov 20. Access the abstract on PubMed®.

An examination of the food allergy quality of life questionnaire performance in a countrywide American sample of children: cross-cultural differences in age and impact in the United States and Europe. DunnGalvin A, Koman E, Raver E, et al. J Allergy Clin Immunol Pract 2017 Mar-Apr;5(2):363-8.e2. Epub 2016 Dec 22. Access the abstract on PubMed®.

Effects of a DXA result letter on satisfaction, quality of life, and osteoporosis knowledge: a randomized controlled trial. Edmonds SW, Cram P, Lou Y, et al. BMC Musculoskelet Disord 2016 Aug 26;17(1):369. Access the abstract on PubMed®.

Detecting signals of interactions between warfarin and dietary supplements in electronic health records. Fan Y, Adam TJ, McEwan R, et al. Stud Health Technol Inform 2017;245:370-4. Access the abstract on PubMed®.

Chronic airway inflammation provides a unique environment for B cell activation and antibody production. Feldman S, Kasjanski R, Poposki J, et al. Clin Exp Allergy 2017 Apr;47(4):457-66. Epub 2017 Jan 26. Access the abstract on PubMed®.