The AHRQ Multiple Chronic Conditions Research Network

Project Summary

More than a quarter of all Americans—and two out of three older Americans—are estimated to have at least two chronic physical or behavioral health problems. Treatment for people living with these multiple chronic conditions (MCC) currently accounts for an estimated 66% of the Nation's health care costs. As the U.S. population ages, the number of patients with MCC continues to grow. This mounting challenge has become a major public health issue that is linked to suboptimal health outcomes and rising health care costs. As part of its ongoing effort to improve care for patients with MCC through evidence-based research, the Agency for Healthcare Research and Quality (AHRQ) has funded the AHRQ MCC Research Network. The Network aligns with a Department of Health and Human Services (HHS) effort to address MCC issues; specifically, to increase clinical, community, and patient-centered health research on MCC.

AHRQ's MCC Research Network aims to improve understanding about which interventions provide the greatest benefit to patients with MCC, the safety and effectiveness of interventions that may be affected by MCC, and interventions that may need to be modified for specific patient populations. Over time, this foundational research can begin to help our country meet the needs of Americans living with MCC.

The MCC Research Network includes:

• Eighteen exploratory and developmental (R21) grants funded in 2008 to begin addressing the gap in knowledge about patients with MCC, with a focus on the use of preventive services. Additional funding in 2009 was awarded to two of the original 18 grantees to support collaborative activities.
• Thirteen infrastructure development (R24) grants funded in 2010 to create new datasets for improved examination of care for patients with MCC. Each project also includes a pilot study to demonstrate the use of its newly developed infrastructure. Datasets will be made available to interested researchers and other stakeholders when these grants are completed.
• Fourteen exploratory (R21) grants funded in 2010 to use existing data to conduct comparative effectiveness research for patients with MCC. This research will help prioritize testing and treatments for these patients and suggest adaptations to currently recommended preventive and care management guidelines.
• A Learning Network and Technical Assistance Center (the Center) to encourage collaboration among the MCC investigators and provide them with technical support. The Center is staffed by Abt Associates, the MacColl Center for Healthcare Innovation, and the Inter-University Consortium for Political and Social Research.

For more information about the AHRQ MCC Research Network, including profiles of the individual grants, please visit: http://www.ahrq.gov/professionals/prevention-chronic-care/decision/mcc/.

To find datasets and related materials developed as a part of this project, please visit: http://www.icpsr.umich.edu/icpsrweb/AHRQMCC/ .

Exploratory (R21) Grants

Determining Processes of Cardiovascular Care Relevant to Complex Patients
Elizabeth Bayliss, Kaiser Foundation Research Institute

Should High-Risk Statin Utilization Rates Be Increased for Complex AMI Patients?
John M. Brooks, University of Iowa

Individualized Treatment Strategies and Optimal Hematocrit Target for Complex Dialysis Patient Background
Dennis J. Cotter, Medical Technology & Practice Patterns Institute

Comparative Effectiveness of Lipid-Lowering and Antihypertensive Medications among HIV-Infected Individuals
Heidi M. Crane, University of Washington

Impact of Mental Illness and/or Substance Abuse on Diabetes Intervention and Outcomes
Elsie J. Freeman, Maine State Department of Health and Human Services

Multiple Chronic Conditions in Very Low Birth Weight Infants: Epidemiology, NICU Care, and Outcomes
William P. Gardner, Research Institute Nationwide Children's Hospital

Statins and ACE Inhibitors in Adults with Diabetes and Comorbid Conditions
David Grembowski, University of Washington

Fluoride Effectiveness in Prevention of Dental Caries in High Caries Risk Adults
Judith A. Jones, Boston University School of Dental Medicine

The Continuity of Medication Management (COMM) Study
Matthew L. Maciejewski, Duke University

Outpatient versus Residential Treatment Comparison for Pregnant Substance Abusers
Bentson H. McFarland, Oregon Health and Science University

Safety and Effectiveness Evaluations for Kidney Disease in Complex Patients
Donald R. Miller, Boston University Medical Campus

A Study of Trends in Obesity Progression among Complex Patients
Ming Tai-Seale, Palo Alto Medical Foundation Research Institute

B-Blocker Effect on a Range of Health Outcomes in Older Adults with CAD and COPD
Mary E. Tinetti, Yale University

Optimizing Chronic Disease Prevention and Management in Advanced Dementia
Jennifer Tjia, University of Massachusetts Medical School Worcester

Infrastructure Development (R24) Grants

Clinical Database to Support Comparative Effectiveness Studies of Complex Patient
Caroline S. Blaum, University of Michigan, Ann Arbor

Infrastructure for CER on Innovative Delivery Systems for Complex Patients
Joel C. Cantor, Rutgers University

Enhanced Data to Accelerate Complex Patient Comparative Effectiveness Research
Elizabeth A. Chrischilles, University of Iowa

Research Capability to Study Comparative Effectiveness in Complex Patients
Carol A. Dubard, North Carolina Community Care Networks

Expanding CER Capability through Complex Patient Relationship Management
Henry Fischer, Denver Health and Hospital Authority

Washington University Comparative Effectiveness Administrative Data Repository
Victoria J. Fraser, Washington University

Expansion Research Capability to Study Comparative Effectiveness in Complex Patients
Youjie Huang, Florida State Department of Health

Building Infrastruture for Comparative Effectiveness Protocols (BICEP)
John T. Lynch, Connecticut Center for Primary Care

Development of the Post-Acute Care Supplement (PACS) Research Files
Thomas E. Macurdy, Sphere Institute

Collaborative National Network Examining Comparative Effectiveness Trials
Benjamin Miller, University of Colorado Denver School of Medicine

Enhancing Comparative Effectiveness Research Capabilities in PPRNet
Steven M. Ornstein, Medical University of South Carolina

Optimal & Equitable Care: Medicaid Data Research Infrastructure
George S. Rust, Morehouse School of Medicine

Computer Assisted Quality of Life and Symptom Assessment
William E. Trick, Hektoen Institute for Medical Research