Research Findings

AHRQ newsletter articles about primary care

Research Activities, February 2013

Prescription of antidepressants for children and adolescents by office-based physicians is typically done off-label
Medical home for children and youth improves delivery of preventive services without raising expenditures
Patients who find it easy to access primary care are more likely to receive selected preventive services
Higher scores as a patient-centered medical home linked to higher operating costs
Researchers develop a task list to evaluate primary care workflow
Process improvements in family practice lead to some improvements in intermediate outcomes

Research Activities, January 2013

Planting seeds for change in primary care practice
High rates of paper-based prescribing errors found among community-based primary care providers
Electronic health record-based medication monitoring improves patient compliance in primary care clinics
Careful design of personal health records can improve the delivery of preventive care
Provision of personal digital assistants alone does not help providers avoid drug-drug interactions

Research Activities, December 2012

Delaying the control of blood pressure among middle-aged adults with diabetes lowers quality of life
Homeless and underserved women may not be receiving empiric treatment for Chlamydia
Primary care practices incur considerable costs for collecting data on diabetes quality improvement programs
Human-computer interaction evaluation can inform the redesign of computerized clinical reminders

Research Activities, November 2012

Improving care for patients with disabilities
Gaps in insurance coverage linked to less receipt of preventive services by patients with diabetes
Breathing retraining techniques may help adult asthma
Mother-infant interactions associated with use of health services
Electronic standing orders increase delivery of preventive services
Study finds personal health records do not impact hypertension care
Health information technology-supported quality improvement initiative reduces some ambulatory care disparities
Medicaid providers face common barriers to meaningful use

Research Activities, October 2012

Electronic health records improve diabetes care and outcomes
Electronic medical records reduce negative outcomes and related costs after patient safety events occur
Sending health maintenance reminders to personal health records helps patients adhere to some screenings
Effectiveness of active surveillance for men with localized prostate cancer is unclear
Black patients are negatively affected by clinicians' attitudes about race

Research Activities, September 2012

Distance-based training in spirometry use increases the quality of asthma diagnosis
Radionovela promotes awareness and knowledge of cervical cancer vaccine among Hispanic parents

Research Activities, August 2012

State Medicaid policy changes increasingly driven by evidence
Insulin pump and glucose monitoring improve blood-sugar control for diabetes patients
Provider-patient dialogue could be improved to foster medication adherence in HIV care
Patients often say good things about their physicians on rate-your-doc Web sites, but are less positive about system issues

Research Activities, July 2012

Having a usual source of care promotes preventive health counseling for children
Electronic health records can help detect diagnostic errors in primary care
Primary care practices can boost clinical preventive services with electronic health records and quality improvement support
Although the patient-centered medical home is a promising model of care, more studies are needed to assess its effectiveness
AHRQ report finds teamwork and followup as strengths of medical offices but work pressure and pace are problematic

Research Activities, June 2012

Dual Veterans Administration/Medicare users are not hospitalized more for ambulatory care sensitive conditions
1 in 10 computer-generated prescriptions include at least one error
Paper previsit reminders for doctors do not add value to electronic reminders from an electronic health record system

Research Activities, May 2012

Muscle training effective in treating urinary incontinence for women
Older, busier clinicians who see complex patients are more likely to use novel electronic health record (EHR) functions
Rural health care providers in California look to telehealth to supply the training needed to manage childhood obesity
Clinical inertia may represent good clinical judgment in hypertension telemanagement

Research Activities, April 2012

Majority of conditions treated in emergency departments are treatable in primary care clinics
Primary care providers who provide contraceptive counseling increase patients' contraceptive use
Primary care visits every 2 weeks linked to better treatment outcomes for patients with diabetes
A "diabetes dashboard" screen helps clinicians quickly and accurately access patient data needed for quality diabetes care
Blood pressure control persists after physician-pharmacist intervention ends
Physician personality factors do not seem to influence whether patients with symptoms undergo extended diagnostic evaluations
C-reactive protein testing is not more effective than an educational intervention to decrease antibiotic prescriptions for patients seen for acute cough
Self-measured blood pressure monitoring to manage hypertension may offer a small benefit

Research Activities, March 2012

Electronic health records in community health centers provide a better picture of care than insurance claims data
Growth in the physician assistant workforce will be insufficient to meet future needs of primary care

Research Activities, February 2012

E-prescribing systems within electronic health records reduce ambulatory prescribing errors in community-based practices
Physicians need better understanding of factors that patients use to decide about colorectal cancer screening
Children's unmet health needs similar for low- and middle-income families with either public or private insurance

Research Activities, January 2012

Experts call for integrating mental health into primary care
Primary care coordination is more difficult for patients who see many specialists
Accessible services in primary care practices promote preventive health screenings and care
Residents should document sexual history during health care maintenance visits for older, asymptomatic adults
Medical residents can use quality improvement methods to promote obesity screening
Measuring quality of care for middle ear infection has many pitfalls

Research Activities, December 2011:
Transitioning to new electronic health records can result in potential safety problems
Pediatric care providers identify desired characteristics for computerized flu vaccination alerts
Volume of paid outpatient malpractice claims underscores need for greater patient safety efforts in this area
Enrollment in Medicare Advantage managed care plans reduces racial/ethnic disparities in primary care quality in some States
Deaf patients who use American Sign Language receive more preventive care if their clinician also uses sign language

Research Activities, November 2011:
Among patients with diabetes, racial/ethnic discrimination by health care providers is uncommon
Primary care model helps treat underserved patients with hepatitis C virus infection
Physicians who use electronic health records more intensively are more likely to use patient registries to improve care
Parents are satisfied with telemedicine care for their child’s obesity

Research Activities, October 2011:
Patients with type 2 diabetes express mixed reactions to a mobile phone and Web-based disease management program
Study identifies costs of implementing electronic health records in network of physician practices
Medicare Part D reduces out-of-pocket costs and modestly boosts prescription volume

Research Activities, September 2011:
The challenge of prioritizing care for complex patients
Uninsured patients respond well to paying a monthly retainer for primary care services
Children's underenrollment in State health insurance programs may be due in part to parents' confusion about coverage
Low- and middle-income children with public and private insurance have similar rates of unmet health care needs
Computer system compares well with clinicians in assessing, but not treating children with asthma
Providers perceive e-prescribing as being very efficient

Research Activities, August 2011:
AHRQ's clinical care tools help clinicians ensure better and safer care
Having a usual source of care as well as insurance reduces unmet health needs
Parents and primary care physicians are satisfied with children's use of nonurgent emergency department services
A usual source of care may be more important than insurance on children's receipt of preventive health counseling
When primary care providers apply fluoride varnish, young Medicaid-insured children have fewer cavities

Research Activities, July 2011:
Health care quality gaps and disparities persist in every State
Studies examine safety of pain killers among older adults
Communication problems between hospitalists and primary care providers lead to postdischarge problems for seniors
Many primary care patients are at risk for obstructive sleep apnea, but few are sent for testing
Guideline familiarity does not equal guideline adherence
Chronic Care Model linked to exercise discussions during primary care office visits for diabetes
Over 3 million look to hospitals for headache relief
Report shows physicians view e-prescribing features as cumbersome
Connecting local providers to academic medical centers using video improved hepatitis C outcomes

Research Activities, June 2011:
Community hubs ensure better care for the most vulnerable
Treatment by physicians with same race and language as the patient may improve medication adherence
Hispanics with HIV have different communication styles with their health care providers than whites
An automated phone response system can help track adverse drug events in primary care patients
Doctor's comments during a child's physical exam can affect whether parents push for antibiotics

Research Activities, May 2011:
Practice setting, ownership, and specialty all affect volume of charity care provided by physicians
Specific primary care strategies may improve medication safety
Primary care physicians spend a fifth of their time in patient care activities outside of office visits

Research Activities, April 2011:
Medication safety indicators can guide improvement in primary care drug selection, dosing, and monitoring
Parents find telemedicine care of children in school and childcare to be helpful and convenient

Research Activities, March 2011:
Children with a medical home more likely to receive health screenings and advice
Innovations show the benefits of using phone-based care management

Research Activities, February 2011:
Primary care physicians' performance ratings depend on the makeup of their patient population
Primary care practices that take part in research networks report benefits beyond the study itself
Clinicians' adoption and use of electronic prescribing is likely linked to their views on technology

Research Activities, January 2011:
Health information technology improves care and saves lives
Most patients with type 2 diabetes suffer an adverse event between office visits