Rates of prescription opioid misuse and abuse led to recommendations for dose tapering for patients with chronic pain. However, concerns have been raised about the potential harms associated with rapidly decreasing doses or discontinuing opioids. Building on previous research, these researchers used a large claims database to explore the unintended negative consequences of tapering patients on stable, long-term opioid therapy. Findings indicate that opioid tapering was associated with fewer primary care visits, greater numbers of emergency department visits, and reduced adherence to antihypertensive and antidiabetic medications.

Adverse events associated with long-term opioid therapy have led to recommendations for dose tapering for patients with chronic pain. This study assessed the long-term risks of overdose and mental health crisis as a result of dose tapering. Consistent with earlier research on short-term risks, results indicate that opioid tapering is associated with increased risk of adverse events up to 24 months after initiation of tapering.

Sudden discontinuation of opioids has been linked to increased patient harm. This observational study evaluated the link between tapering and overdose, and mental health crisis among patients who were receiving long-term opioid therapy. Patients who underwent dose tapering had an increased risk of overdose and mental health crisis compared to those who did not undergo dose tapering. 

Suboptimal communication between patients and physicians can result in patients misunderstanding important aspects of their care. This study found that the majority of patients with cancer reported a more optimistic survival prognosis than their oncologists. These findings suggest the need to improve physician–patient communication about prognosis in order to ensure appropriate discussion of treatment decisions and goals.

The AHRQ Patient Safety Indicator accurately identified accidental injuries due to medical care, but many cases identified were clinically inconsequential.

Postoperative venous thromboembolism is one of several preventable conditions for which hospitals will not receive additional reimbursement from the Centers for Medicare and Medicaid Services. The AHRQ Patient Safety Indicators (PSIs) are intended for use in screening medical records to identify possible safety events. However, this study found that the PSI for postoperative venous thromboembolism lacks sufficient predictive ability to be used as the sole method for detecting cases.

… the International Society for Quality in Health Care … Int J Qual Health Care … This study applied the AHRQ patient …

This review examines the literature on coordination of care and its effectiveness to better understand how a generalist operates in an increasingly complex health care delivery system. The authors present six key recommendations. These include the need for greater evidence to substantiate the value of care coordination in improving health outcomes; a belief that a generalist’s practice represents an effective hub for coordinating care in most patients; and that improved communication and coordination among generalists, specialists, patients, and their family members must be fostered. The authors advocate for greater emphasis on teamwork, increased education about effective communication and collaboration skills, and wider adoption and application of medical informatics.

This study demonstrates that considerable adjustment is necessary in order to use the Patient Safety Indicators as a valid means of comparing patient safety across countries.