Mixing Opioids and Psychotropic Drugs Increases Hospitalizations Among Older Dental Patients

AHRQ Stats: Hospitalizations in 2017

Nearly 36 million hospitalizations occurred in 2017, representing a total cost of $434 billion. (Source: AHRQ, Healthcare Cost and Utilization Project Statistical Brief #261, National Inpatient Hospital Costs: The Most Expensive Conditions by Payer, 2017.)

Note: Last week’s AHRQ Stats on emergency care and Medicaid incorrectly linked to a statistical brief that is being revised. An updated brief will be posted soon.

Today's Headlines:

• Mixing Opioids and Psychotropic Drugs Increases Hospitalizations Among Older Dental Patients.
• AHRQ Grantee Profile Highlights Bruce Lambert, Ph.D., and His Work To Reduce Drug Name Confusion.
• Highlights From AHRQ’s Patient Safety Network.
• AHRQ’s SHARE Approach Applies to Wider Range of Clinical Situations in Purposeful Shared Decision-Making.

Mixing Opioids and Psychotropic Drugs Increases Hospitalizations Among Older Dental Patients

One in 10 senior dental patients who were prescribed opioids for pain also were taking psychotropic medications such as antidepressants and antipsychotics, according to a new AHRQ study published in Pharmacotherapy. Researchers said those patients, age 65 or older, were associated with an increased risk of all-cause acute care hospitalization. The study was based on a review of nearly 41,000 senior dental visits from 2011 to 2015 in which opioids were prescribed. Researchers noted that dentists should be familiar with the American Geriatric Society Beers Criteria designed to limit inappropriate prescribing among older adults. When opioids are required, prescriptions should be short-term and at the lowest effective dose, they concluded. Access the study abstract. 

AHRQ Grantee Profile Highlights Bruce Lambert, Ph.D., and His Work To Reduce Drug Name Confusion

AHRQ’s most recent grantee profile features health communication innovator Bruce Lambert, Ph.D., director of the Center for Communication and Health at Northwestern University in Chicago and professor in the university’s communication department. Dr. Lambert is helping to improve patient safety with an algorithm that he and his research team developed to predict the likelihood of confusion between look-alike and sound-alike drugs. Find out more about  Dr. Lambert’s research and access additional AHRQ grantee profiles. 

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:

• Communication with patients and families regarding health care-associated exposure to coronavirus 2019: a checklist to facilitate disclosure.
• Adaptive design: adaptation and adoption of patient safety practices in daily routines, a multi-site study.
• Nurse workarounds in the electronic health record: an integrative review.

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

AHRQ’s SHARE Approach Applies to Wider Range of Clinical Situations in Purposeful Shared Decision-Making

Clinicians and patients can make shared decisions on a full range of care-related issues using AHRQ’s SHARE Approach. A new study published in Patient Education and Counseling described how the five-step SHARE model of generally accepted elements of shared decision-making was applied to and adapted for the Mayo Clinic’s recent “purposeful shared decision-making” model that describes different kinds of problems that appear in clinical practice, such as articulating priorities and setting goals, or discussing whether and when to withdraw from work with a serious illness. While many clinicians believe that shared decision-making can only be used for certain clinical decisions, the authors suggest a more individualized yet practical approach to patient problems may improve perception and adoption of shared decision-making. Access the abstract.

AHRQ in the Professional Literature

How the U.S. Agency for Healthcare Research and Quality promotes health literate health care. Brach C, Borsky A. Stud Health Technol Inform 2020 Jun 25;269:313-23. Access the abstract on PubMed®.

Treatment as prevention: concepts and challenges for reducing HIV incidence. Brault MA, Spiegelman D, Hargreaves J, et al. J Acquir Immune Defic Syndr 2019 Dec 1;82 Suppl 2(2):S104-12. Access the abstract on PubMed®.

Benzodiazepine treatment and fracture risk in young persons with anxiety disorders. Bushnell GA, Gerhard T, Crystal S, et al. Pediatrics 2020 Jul;146(1):e20193478. Epub 2020 Jun 4. Access the abstract on PubMed®.

Longer time before acute rehabilitation therapy worsens disability after intracerebral hemorrhage. Capo-Lugo CE, Askew RL, Muldoon K, et al. Arch Phys Med Rehabil 2020 May;101(5):870-6. Epub 2019 Dec 23. Access the abstract on PubMed®.

What outcomes matter to patients after joint or spine surgery? Whitebird RR, Solberg LI, Norton CK, et al. J Patient Cent Res Rev 2020 Apr 27;7(2):157-64. Access the abstract on PubMed®.

How introducing a registry with automated alerts for carbapenem-resistant Enterobacteriaceae (CRE) may help control CRE spread in a region. Lee BY, Bartsch SM, Hayden MK, et al. Clin Infect Dis 2020 Feb 14;70(5):843-9. Access the abstract on PubMed®.

Do residents participating in Minnesota's Return to Community Initiative experience similar postdischarge outcomes to their peers? Hass Z, Woodhouse M, Arling G. Med Care 2020 Apr;58(4):399-406. Access the abstract on PubMed®.

Use, perceived usability, and barriers to implementation of a patient safety dashboard integrated within a vendor EHR. Bersani K, Fuller TE, Garabedian P, et al. Appl Clin Inform 2020 Jan;11(1):34-45. Epub 2020 Jan 15. Access the abstract on PubMed®.