AHRQ News Now: heat impacts on kidney disease patients; new data on COVID-19 hospitalizations; reducing long-term opioid use

AHRQ News Now

November 9, 2021, Issue #788

AHRQ Stats


Access more data on this topic in the associated statistical brief, plus additional AHRQ data infographics.

Today's Headlines:

Extreme Heat From Climate Change Poses Threat to Patients With End-Stage Kidney Disease

Higher temperatures are associated with increased deaths and hospital admissions risks for patients with end-stage kidney disease (ESKD), according to an AHRQ-funded study published in Environmental Research. The authors analyzed data for 1,981 patients receiving hemodialysis treatments for ESKD from 2011 to 2019. They found that a one-degree centigrade increase in ambient temperature was associated with decreases in blood pressure and weight between dialysis sessions. However, their goal of explaining the relationship between temperature and deaths/hospital admissions for potential clinical interventions was not necessarily achieved as the authors found that changes in blood pressure and interdialytic weight gain may not fully explain the relationship between temperature and mortality/hospital admissions. Access the abstract.

AHRQ Systematic Review: Current Migraine Treatments Effective for Most Patients


Triptans and nonsteroidal anti-inflammatory drugs should remain the standard for episodic migraine, and two newer treatments (lasmiditan and calcitonin gene-related peptide receptor antagonists) are effective in patients who cannot tolerate the former, according to an AHRQ-funded systematic review in JAMA. The two newer treatments need to be evaluated further for potential side effects such as dizziness or sleepiness, researchers suggested. Acetaminophen and other pharmacologic treatments also showed evidence of pain reduction. Nonpharmacologic treatments involving noninvasive nerve stimulation devices showed improved pain and function, though only a few studies examined their effectiveness, according to researchers. While opioids are often prescribed for migraine, the study found insufficient evidence for pain reduction and a higher risk of adverse events than other treatments, and researchers said the evidence supported the recommendation of current guidelines against their use. Access the associated AHRQ evidence report.

AHRQ Webinar on Nov. 18 Will Explore Science of Care for People With Multiple Chronic Conditions

A webinar on Nov. 18 from 11 a.m. to noon ET will feature authors who contributed to a recent special issue of Health Services Research on "The Science of Care for People With Multiple Chronic Conditions." Among featured speakers will be Arlene S. Bierman, M.D., M.S., director of AHRQ’s Center for Evidence and Practice Improvement, who co-authored an article about AHRQ’s efforts to develop a research agenda to transform care for people with multiple chronic conditions. Access more information about the webinar, including how to join.

Interactive Tool Provides New Data on Hospital Trends for COVID-19 and Other Conditions

COVID-19 data

AHRQ has updated the HCUP Visualization of Inpatient Trends in COVID-19 and Other Conditions, an interactive visualization displaying state-specific monthly trends in inpatient stays related to COVID-19 and other conditions. This visualization now includes the first quarter of 2021 data for 11 states and full year 2020 data for 29 states. The underlying data tables and methods have also been updated and are available on the HCUP Summary Trend Tables page of HCUP-US. Access HCUP infographics for data findings on additional healthcare topics.

“Six Building Blocks” Toolkit Helps Clinics Improve Opioid Prescribing

Six Building Blocks

An AHRQ-funded resource–“Six Building Blocks: A Team-Based Approach to Improving Opioid Management in Primary Care How-To-Implement Toolkit”—is available to help primary care teams reduce the number of patients on long-term opioid therapy for chronic pain. The evidence-based toolkit offers a quality improvement roadmap for redesigning patient care without practice facilitators or other external support. It helps clinical staff develop standardized workflows, track key measures and use electronic health record tools and registries.

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:

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).

Now Available: AHRQ Surveys On Patient Safety Culture™ Workplace Safety Supplemental Items for Hospitals

The new AHRQ Surveys On Patient Safety Culture™ (SOPS)® Workplace Safety Supplemental Items for hospitals and pilot study results are now available. The supplemental items assess the extent to which a hospital’s organizational culture supports workplace safety for providers and staff. Hospitals can administer the items at the end of the SOPS Hospital Survey, just before the background questions, and submit data from the Workplace Safety Supplemental Items with their SOPS Hospital Survey data during Hospital Database submission June 1–20, 2022. Register for a webcast on Dec. 16, at 1 p.m. ET, to learn more about the new Workplace Safety Supplemental Items.

Featured Impact Case Study: CommonSpirit Health Expands Use of AHRQ’s CANDOR Toolkit

AHRQ’s latest Impact Case Study describes how CommonSpirit Health, one of the nation's largest health systems, is expanding its use of AHRQ's Communication and Optimal Resolution (CANDOR) toolkit across its network of 140 hospitals and 1,000 ambulatory care centers. CANDOR helps hospitals, health system leaders and clinicians communicate accurately and openly with patients and their families when something goes wrong with their care. The health system hopes to build on its initial success implementing CANDOR training at 35 affiliated hospitals, where officials estimate 85 patients were spared the additional harm of not knowing what happened or why. Access the Impact Case Study.

New Research and Evidence From AHRQ

AHRQ in the Professional Literature

Alignment between objective and subjective assessments of health system performance: findings from a mixed-methods study. Khodyakov D, Buttorff C, Xenakis L, et al. J Healthc Manag. 2021 Sep-Oct;66(5):380-94. Access the abstract on PubMed®.

Assess, prevent, and manage pain; both spontaneous awakening and breathing trials; choice of analgesia/sedation; delirium: assess, prevent, and manage; early mobility; family engagement and empowerment bundle implementation: quantifying the association of access to bundle-enhancing supplies and equipment. Jeffery AD, Werthman JA, Danesh V, et al. Crit Care Explor. 2021 Sep 14;3(9):e0525. Access the abstract on PubMed®.

Rapid diagnostic tests for meningitis and encephalitis-BioFire. Fleischer E, Aronson PL. Pediatr Emerg Care. 2020 Aug;36(8):397-401. Access the abstract on PubMed®.

Consolidation of providers into health systems increased substantially, 2016-18. Furukawa MF, Kimmey L, Jones DJ, et al. Health Aff. 2020 Aug;39(8):1321-5. Access the abstract on PubMed®.

Association of primary and behavioral health integrated care upon pediatric mental disorder treatment. Chen H, Upadhyay N, Lyu N, et al. Acad Pediatr. 2021 Sep-Oct;21(7):1187-94. Epub 2021 Jun 1. Access the abstract on PubMed®.

Health information technology to improve care for people with multiple chronic conditions. Samal L, Fu HN, Djibril SC, et al. Health Serv Res. 2021 Oct;56(Suppl 1):1006-36. Epub 2021 Oct 5. Access the abstract on PubMed®.

Geographic variation of statin use among US nursing home residents with life-limiting illness. Mack DS, Baek J, Tjia J, et al. Med Care. 2021 May;59(5):425-36. Access the abstract on PubMed®.

A study protocol to evaluate the implementation and effectiveness of the Clinical Nurse Leader care model in improving quality and safety outcomes. Bender M, Williams M, Cruz MF, et al. Nurs Open. 2021 Nov;8(6):3688-96. Epub 2021 May 3. Access the abstract on PubMed®.

Contact Information

For comments or questions about AHRQ News Now, contact Bruce Seeman, (301) 427-1998 or Bruce.Seeman@ahrq.hhs.gov.