Chronic Care

Research Findings

Research Activities, February 2013:
Patients with coronary artery disease who get ongoing support from their community pharmacy may adhere better to medications
An empowerment-based educational approach improves understanding and knowledge for patients with diabetes
Abnormal electrocardiogram results nearly double the risk of cardiovascular-related death for patients without heart disease
Bevacizumab, when added to chemotherapy regimen for elderly patients with lung cancer, does not increase survival rates
Benefits of case management for chronic illness limited
Some assessment tools and medications are effective for chronic cough
Rural patients with a serious form of gallstone disease are less likely than urban patients to receive treatment

Research Activities, January 2013:
Four drugs to treat chronic heart failure found similarly effective
Dual therapy may be slightly less effective than triple therapy for chronic infection with hepatitis C virus
New review evaluates treatment options for plaque psoriasis
AHRQ Stats: Adult asthma rates nearly doubled in past decade

Top of Page

Research Activities, December 2012:
Automated quality measures can be used to improve asthma care
Delaying the control of blood pressure among middle-aged adults with diabetes lowers quality of life
Quality improvement collaborative improves outcomes in children with inflammatory bowel disease
Surgery for ureter congenital abnormality results in efficacy and long-term durability for children
Limited evidence of benefit of interventions during early stages of chronic kidney disease
Type of insurance affects use and intensity of postacute care for stroke survivors

Research Activities, November 2012:
Diabetes substantially affects school dropout rates and wages
Gaps in insurance coverage linked to less receipt of preventive services by patients with diabetes
Self-monitoring of blood pressure along with nurse counseling leads to greater blood pressure control
Breathing retraining techniques may help adult asthma
Patient decision aids can reduce uncertainty in decisions about whether to undergo total knee replacement
Radiation therapy linked to dry mouth in elderly patients with head and neck cancers
Study finds personal health records do not impact hypertension care
Health information technology-supported quality improvement initiative reduces some ambulatory care disparities

Research Activities, October 2012:
Diabetes treatment involves more multidrug regimens and high financial burden
Survival rates for colon cancer patients on chemotherapy improve with addition of oxaliplatin
Diagnostic coding formulas underestimate hospitalizations for acute exacerbations of COPD
About three fourths of patients in the United States estimated to remain in HIV care
Electronic health records improve diabetes care and outcomes
Children with juvenile idiopathic arthritis are at high risk of hospital stays that involve bacterial infections
Noninvasive positive pressure ventilation improves COPD patient outcomes

Research Activities, September 2012:
Distance-based training in spirometry use increases the quality of asthma diagnosis
Opioid prescriptions for treating chronic abdominal pain doubled between 1997 and 2008
Response to etanercept for rheumatoid arthritis can be predicted by 12 weeks
About three-fourths of patients in the United States estimated to remain in HIV care
No link found between stimulant treatment of youth with ADHD and cardiovascular problems
Pediatric visits for ADHD have risen and the condition is increasingly being managed by psychiatrists
Study fails to find link between guideline-based emergency treatment for pediatric asthma and patient outcomes
Despite more widespread prescribing of antiretroviral therapy for HIV infection, disparities remain
Clinician and patient resources now available on ADHD treatment options

Research Activities, August 2012:
Insulin pump and glucose monitoring improve blood-sugar control for diabetes patients
Screening based on risk factors and birth year boosts screening rates for hepatitis C
Provider-patient dialogue could be improved to foster medication adherence in HIV care
Single-lung transplantation for COPD improves access to transplantation without jeopardizing survival
Fewer patients with primary sclerosing cholangitis die while awaiting liver transplants than those with other liver diseases
No significant link found between treatments used for juvenile idiopathic arthritis and development of cancer

Research Activities, July 2012:
Experts seek better diagnosis and treatment for women's urinary incontinence and chronic pelvic pain
Urinary Incontinence—New Hope
Tumor necrosis factor-antagonists in patients with autoimmune diseases showed no overall increased risk of hospitalizations for serious infections than non-biologic drugs
Costly, ineffective tests used more often than more effective, but inexpensive tests to diagnose peripheral neuropathy
Depressed patients with anxiety who fail initial antidepressant therapy may benefit from adding a second drug
Key treatments for high blood pressure and high blood lipids do not reduce elderly patients' risk of limited mobility
Rise in prescription copays puts different patients at risk for nonadherence to medications
Primary care practices can boost clinical preventive services with electronic health records and quality improvement support
Web videonovela series helps Spanish-speaking patients compare treatments for diabetes
Limited evidence prevents firm conclusions on rheumatoid arthritis drug therapies
Consumer and clinician summaries now available on chronic pelvic pain treatment options

Research Activities, June 2012:
Dual Veterans Administration/Medicare users are not hospitalized more for ambulatory care sensitive conditions
Paper previsit reminders for doctors do not add value to electronic reminders from an electronic health record system
Limited evidence prevents firm conclusions on psoriatic arthritis drug therapies
Glaucoma treatments can lower eye pressure
Inmates remain at risk for HIV and HCV after release from prison

Research Activities, May 2012:
Clinical inertia may represent good clinical judgment in hypertension telemanagement
Study outlines factors associated with untreated diabetes
Teenage body size does not predict heart failure in older adults
Annual screening for malignancy among children with spina bifida with cystoplasty unlikely to be cost effective
Children with special health care needs with disabilities have greater unmet health care needs than those without disabilitiesOnly 75 percent of HIV patients stay in care

Research Activities, April 2012:
Injection of hyaluronic acid, a natural joint lubricant, appears effective in reducing pain from wear and tear on the knee
Heart failure hospitalization and mortality rates drop between 1998 and 2008
Drug-eluting stents appear safe for older patients with chronic kidney disease
Market forces underlie provision of peritoneal dialysis by dialysis facilities
Self-measured blood pressure monitoring to manage hypertension may offer a small benefit
Hospital readmissions higher for chronic conditions

Research Activities, March 2012:
Patients with hepatitis C virus infection who adhere to their drug regimen are more likely to show long-term benefit
Older patients with chronic conditions have greater risk of problems and death following bilateral knee replacement
Nine percent of adults with hypertension have resistant hypertension
Routinely collecting clinical data can improve pneumococcal vaccination of rheumatology patients on immunosuppressant drugs
Little evidence for benefit of interventions in the early stage of chronic kidney disease
Some diabetes practice guidelines do not reflect all available evidence

Research Activities, February 2012:
Tough questions get answers through health IT
Posttraumatic stress disorder (PTSD) associated with elevated hemoglobin A1c levels in low-income blacks with diabetes
Increasing body mass index lowers quality of life in obese individuals
HIV outcomes and medication use are similar between rural and urban HIV patients
Physicians need better understanding of factors that patients use to decide about colorectal cancer screening
Depending on a woman's age, hysterectomy may be the best option for resolving chronic pelvic pain and heavy bleeding
Depression, hearing impairment, and health literacy influence older adults' abilities to self-manage their care
Bronchitis and asthma most commonly treated conditions among children

Research Activities, January 2012:
Pediatric cardiology centers vary in treatment of infants with single ventricle congenital heart disease
Lower educational level increases the likelihood of preclinical changes in mobility in older women
Evidence lacking on optimal transition-of-care programs for heart attack and stroke patients following hospitalization

Top of Page

Research Activities, December 2011:
Many challenges remain in the design and use of consumer health informatics interventions
For-profit dialysis chains have higher mortality rates than non-profit dialysis chain
Overweight or obese patients have higher health care expenditures
Fewer than 1 in 5 emergency departments implement recommendations for HIV screening
Patients with myelodysplastic syndrome have shorter survival times if they have coexisting medical conditions
Moving adolescents with sickle cell disease from pediatric to adult care hampered by lack of knowledgeable adult hematologists
Children's use of asthma controller drugs doubles
Evidence lacking on transition-of-care programs for heart attack and stroke patients after hospital discharge

Research Activities, November 2011:
Primary care model helps treat underserved patients with hepatitis C virus infection
Brief psychotherapy helps multiple sclerosis patients with insomnia and depression -
Study finds regional differences in physicians’ recommendations of implantable cardioverter-defibrillators
Hospital readmissions for COPD highest among black patients

Research Activities, October 2011:
Minimally invasive heart treatments have reduced bypass surgeries and influenced valve repair and replacement
Full use of evidence-based therapies for heart failure could save nearly 70,000 lives each year
Cancer patients more likely to face higher cost burdens than those with other chronic conditions
Possible blood biomarkers for poorer asthma control identified
Study identifies fractures most and least likely to be caused by osteoporosis
A structured goal-setting approach can improve care outcomes for patients with type 2 diabetes

Research Activities, September 2011:
The challenge of prioritizing care for complex patients
Metformin just as effective as other medications for treating type 2 diabetes
Fewer heart bypass surgeries performed
Administrative data alone are insufficient to understand equivalence of two common blood pressure drugs
HIV/AIDS drugs have varied effects on lipid levels
Clinicians cautioned about use of antihypertensive in children receiving kidney transplants who take tacrolimus
The quality of children's asthma care is affected by emergency department crowding
Informal caregivers of older adults need more practical information to care for loved ones
Drug expenses for children with asthma more than doubled in 10 years

Research Activities, August 2011:
Patients with heart failure are older, have more illnesses, and take more medications than earlier
Drugs to treat hepatitis B may not prevent patients from liver disease later
The likelihood of bacterial blood infections among patients with HIV has risen slightly in recent years
Caregivers for advanced cystic fibrosis patients want to discuss intensive treatments and symptom relief
Studies examine possible disparities surrounding implantable cardioverter defibrillators

Research Activities, July 2011:
Studies examine safety of pain killers among older adults
A high percentage of patients with sickle cell disease self-discharge from hospital care
Chronic Care Model linked to exercise discussions during primary care office visits for diabetes
Metformin remains the medication of first choice in treating type 2 diabetes
Empowerment approach to diabetes education works better than the traditional didactic approach
Preventive care for patients with lupus could be improved
Trends in treating depression favor psychotropic medications over psychotherapy
Connecting local providers to academic medical centers using video improved hepatitis C outcomes

Research Activities, June 2011:
Patients with chronic diseases who pay coinsurance less likely to refill their medication than those with fixed copayments
Half of all annual medical expenditures are for chronic diseases
Patients with sickle cell disease employ various strategies to control their pain
Older persons with chronic kidney disease and lower systolic blood pressure have higher mortality rates

Research Activities, May 2011:
Inhaler costs contribute to medication nonadherence for Medicare patients with chronic pulmonary disease
Care for patients with HIV remains expensive
Diabetes testing plummets among poor, minority, and inner-city adults

Research Activities, April 2011:
Obese patients with hypertension and diabetes have a greater risk of dying after noncardiac surgery
Medications differ in their effect on risk of foot ulcers and limb amputations in patients with diabetes
Diet and medication adherence can reduce cardiovascular disease for patients with type 2 diabetes
Provider's communication style boosts results for acupuncture on arthritic knees
One in four U.S. adults reported having high blood pressure in 2008
Nearly 4 million adults reported being treated for kidney disease between 2003 and 2007
Spending for prescriptions to control diabetes, cholesterol, and other metabolic conditions exceeds $52 billion
Patients' income and where they live influence hospitalization for chronic lung disease

Research Activities, March 2011:
Asthma project helps resident physicians improve care for minority patients
AHRQ report finds unclear value of pretesting autoimmune disorder patients before prescribing thiopurine drugs

Research Activities, February 2011:
Telephone coaching improves quality of life for parents of children with asthma
Nurse-facilitated guided care for elders and their caregivers leads to improved perceptions of quality of care
The number of U.S. adults treated for diabetes more than doubled between 1996 and 2007

Research Activities, January 2011:
Patients taking only salmeterol seen in the emergency department for asthma more likely to be hospitalized
Most patients with type 2 diabetes suffer an adverse event between office visits
Some personality factors may affect success of chronic illness self-management programs
Medical complications add 30 percent to employers' chronic care costs

Top of Page

Research Activities, December 2010:
Access to care for patients with lupus affected by several local factors
Brand-name drugs not better than generics for controlling epilepsy
Fragmentation of care for complex diabetes patients may be associated with greater use of the emergency department
For hypertensive patients with diabetes, blood pressure drops quicker with more frequent interactions with clinicians
Despite their helpfulness to guiding care, home blood pressure readings are rarely documented in routine clinical care
Uncontrolled asthma events among Massachusetts patients declined between 2002 and 2007
Patients with inherited cancer syndrome need help with decisions and long-term support from their surgeons
Telephone counseling helps Korean Americans who speak little English improve hypertension management

Research Activities, November 2010:
Stroke recurrence rates vary by U.S. region
A simple test can help assess how accurately patients report colorectal cancer screening
Human growth hormone shows promise in treating cystic fibrosis symptoms
Potentially avoidable hospitalizations high among Medicare and Medicaid patients

Research Activities, October 2010:
Most spending on children's health care in Medicaid and CHIP goes for children with chronic health problems

Research Activities, September 2010:
Public insurance linked to longer perception of disease burden among children with asthma
Physicians report care barriers for young adults with childhood onset chronic diseases
Certain patients with lupus are more likely to end up in the emergency department three or more times a year
Impact of anti-arthritis drug on lipid levels in patients with rheumatoid arthritis remains unclear
Hydroxychloroquine still underused by patients with lupus, but use more likely if treated by rheumatologists
Being overweight does not have a negative impact on quality of life after a kidney transplant
Evidence-based care processes are associated with improved outcomes for heart failure
Predicting cardiovascular risk in patients with metabolic syndrome depends on definition used for the syndrome
Study shows Guided Care benefits family caregivers, chronically ill older adults, and physicians, and may reduce costs

Research Activities, August 2010:
Rate of extrapulmonary TB highest among blacks
More stress means worse asthma in inner-city adults
Care setting affects likelihood that children with persistent asthma will receive inhaled steroids
Health literacy level has no impact on frequency of blood-glucose monitoring for inner-city patients with diabetes

Research Activities, July 2010:
Community health center collaboratives improve care quality but have little impact on disparities
Disparities widen in the use of asthma medications

Research Activities, June 2010:
Physician-pharmacist teams can help lower blood pressure
Patient tool helps determine adherence to asthma medication
Personality factors play a role in responsiveness to disease self-management programs
Doctors underprescribe warfarin to prevent strokes in patients with atrial fibrillation and heart failure
Study reveals high rates of rehospitalizations and emergency pain treatment for sickle cell disease
More adults with diabetes are getting flu shots

Research Activities, May 2010:
Atypical antipsychotic medications increase fracture risk in patients with Parkinson's disease
Opioid-naïve nursing home residents are commonly prescribed long-acting opioids, a potentially dangerous practice
Team-based care of patients with hypertension improves control of blood pressure

Research Activities, April 2010:
Making nursing home quality reports public leads to improved posthospitalization care
Providing customized clinical information to patients and physicians does not improve diabetes care
Counseling education does not significantly boost residents' dietary counseling of patients with diabetes
A guided care approach helps curb health care costs of elderly patients with chronic conditions
Caregiver dissatisfaction affects outpatient care for the elderly with dementia

Research Activities, March 2010:
Wellness education and physical therapy improve health and functioning of persons with multiple sclerosis
Primary care organizational characteristics are linked to the self-management behaviors of patients with diabetes
Inner-city minority adults with chronic asthma are more likely to take inhaled medicine if they believe in its benefits

Research Activities, February 2010:
Health care costs of obesity are passed off to obese workers
Many patients with coronary artery disease who could benefit from cardiac rehabilitation are not referred for this treatment
Computerized tomography angiography may help determine appropriate treatment for stroke patients
Primary care doctors often don't know that a child sought care for asthma in the emergency department

Top of Page