PBRN Grant Summaries (R03) PAR-03-006, 2003 Small Research Grants

Program Summary

The Agency for Healthcare Research and Quality (AHRQ) solicited proposals in early 2003 for the fourth round in a series of grant awards targeted to Primary Care Practice-Based Research Networks (PBRNs). The program called for exploratory/pilot projects or feasibility studies intended to facilitate future, large-scale research. AHRQ was interested specifically in projects focused on:

• Methods of translating research into practice.
• Innovative uses of information technology in primary care practices.
• Feasibility of implementing electronic health records and assessing their impact on safety, quality, and effectiveness of care.
• Optimal methods for delivering preventive services.
• Methods for improving detection and response to emerging public health threats.
• Strategies for reducing health care disparities in priority populations.

Award Recipients

Project Title: Trial To Reduce Antibiotic Use in Primary Care PBRN
Principal Investigator: Jeffrey Linder, M.D., M.Sc.
Organization: Brigham and Women's Primary Care PBRN
Grant Number: R03 HS014420
Project Period: 9/30/03-9/29/05
AHRQ Funding Amount: $100,000
Status: Complete

In this prototype and usability study, Linder and colleagues found that an electronic health record application, the Acute Respiratory Infection (ARI) Smart Form, had the potential to decrease inappropriate antibiotic prescribing.

• Linder JA, Chan JC, Bates DW. Evaluation and treatment of pharyngitis in primary care practice: the difference between guidelines is largely academic. Arch Intern Med 2006 Jul 10;166(13):1374-9. PubMed PMID: 16832002
• Linder JA, Chan JC, Bates DW. Appropriateness of antiviral prescribing for influenza in primary care: a retrospective analysis. J Clin Pharm Ther 2006 Jun;31(3):245-52. PubMed PMID: 16789990
• Linder JA, Rose AF, Palchuk MB, et al. Decision support for acute problems: the role of the standardized patient in usability testing. J Biomed Inform 2006 Dec;39(6):648-55. Epub 2006 Jan 6. PubMed PMID: 16442853
• Linder JA, Bates DW, Williams DH, et al. Acute infections in primary care: accuracy of electronic diagnoses and electronic antibiotic prescribing. J Am Med Inform Assoc 2006 Jan-Feb;13(1):61-66. Epub 2005 Oct 12. PubMed PMID: 16221947

Project Title: Infrastructure for Translational Research in a PBRN
Principal Investigator: Donald E. Nease, Jr., M.D.
Organization: Great Lakes Research Into Practice Network
Grant Number: R03 HS014413
Project Period: 9/1/03-9/29/06
AHRQ Funding Amount: $99,998
Status: Complete

Nease, et al., found that ClinfoTracker, a computerized reminder system, could be beneficial to a practice in conducting translational research.

No peer-reviewed publication from this grant.

Project Title: Computerized Interviews To Assist Secondary Prevention
Principal Investigator: Arthur J. Hartz, M.D., Ph.D.
Organization: Iowa Research Network
Grant Number: R03 HS014410
Project Period: 9/30/04-6/30/07
AHRQ Funding Amount: $86,314
Status: Complete

Hartz and colleagues developed a computerized tool that can be used by heath care providers without specialized training in diabetes to help patients better manage their diabetes self-care.

• Daly JM, Hartz AJ, Xu Y, et al. An assessment of attitudes, behaviors, and outcomes of patients with type 2 diabetes. J Am Board Fam Med 2009 May-Jun;22(3):280-90. PubMed PMID: 19429734
• Hartz A, Kent S, James P, et al. Factors that influence improvement for patients with poorly controlled type 2 diabetes. Diabetes Res Clin Pract 2006 Dec;74(3):227-32. Epub 2006 May 24. PubMed PMID: 16723163

Project Title: Developing and Testing the Feasibility of an “Asthma APGAR”
Principal Investigator: Barbara P. Yawn, M.D., M.Sc.
Organization: Olmsted Medical Center/Minnesota Academy of Family Physicians Research Network
Grant Number: R03 HS014476
Project Period: 9/30/03-1/24/05
AHRQ Funding Amount: $100,000
Status: Complete

Yawn, et al., found that use of asthma APGAR, a model for gathering basic asthma clinical information, resulted in statistically significant improvement in documentation of all APGAR elements, except asthma medication.

• Yawn B, Bertram S, Wollan P. Introduction of asthma APGAR tools improve asthma management in primary care practices. J Asthma Allergy 2008;1:1-10. No PubMed PMID

Project Title: Piloting Tools To Increase Nutritional Health in Primary Care
Principal Investigator: Adolfo J. Ariza, M.D.
Organization: Pediatric Practice Research Group/Children's Memorial Hospital
Grant Number: R03 HS014431
Project Period: 9/30/03-12/31/05
AHRQ Funding Amount: $100,000
Status: Complete

Ariza and colleagues had mixed results when they implemented a computerized system, Health Indicators Analyzer (HIA), to aid growth interpretation and nutritional counseling in pediatric practices. They found that physicians perceived that HIA use improved care; however, the number of parents who were very satisfied with growth information decreased.

• Ariza AJ, Greenberg RS, LeBailly SA, et al.; Pediatric Practice Research Group. Parent perspectives on messages to be delivered after nutritional assessment in pediatric primary care practice. Ann Fam Med 2005 Jul-Aug;3 Suppl 2:S37-39. PubMed PMID: 16049081

Project Title: Smoking Cessation in Pediatric Practice: Phase I
Principal Investigator: Johnathan Klein, M.D., M.P.H.
Organization: Pediatric Research in Office Settings
Grant Number: R03 HS014418
Project Period: 9/30/03-9/29/05
AHRQ Funding Amount: $99,999
Status: Complete

Klein, et al., found that paper training materials for an adolescent smoking cessation pilot study were preferred to Web-based training materials.

• Camenga DR, Klein JD, Roy J. The changing risk profile of the American adolescent smoker: implications for prevention programs and tobacco interventions. J Adolesc Health 2006 Jul;39(1):120.e1-10. PubMed PMID: 16781972
• Tanski SE, Prokhorov AV, Klein JD. Youth and tobacco. Minerva Pediatr 2004 Dec;56(6):553-65. Review. PubMed PMID: 15765019

Project Title: The Effect of EMR on Medication Safety: A SPUR-Net Study
Principal Investigator: Grace M. Kuo, Pharm.D., M.P.H.
Organization: Baylor College of Medicine (SPUR-Net)
Grant Number: R03 HS014406
Project Period: 9/30/03-9/25/05
AHRQ Funding Amount: $99,848
Status: Complete

In their study of medication counseling in paper-based medical record (PMR) or electronic medical record (EMR) practices, Kuo, et al., found the overall results inconclusive. The two significant differences found were that PMR practices reported more oral counseling for medication indications than EMR practices and multimode counseling was offered less in PMR practices than in EMR practices. In EMR practices, EMR printouts were underused by physicians.

• Kuo GM, Mullen PD, McQueen A, et al. Cross-sectional comparison of electronic and paper medical records on medication counseling in primary care clinics: a Southern Primary-Care Urban Research Network (SPUR-Net) study. J Am Board Fam Med 2007 Mar-Apr;20(2):164-73. PubMed PMID: 17341753

Project Title: The Wisconsin Bioterrorism and Influenza Sentinel Surveillance and Education Network
Principal Investigator: Johnathan L. Temte, M.D., Ph.D.
Organization: Wisconsin Research and Education Network
Grant Number: R03 HS014417
Project Period: 9/30/03-9/25/05
AHRQ Funding Amount: $99,630
Status: Complete

Temte, et al., found that clinicians affiliated with a PBRN had higher recruiting success rates for drop-in surveillance than those not affiliated with a PBRN.

• Temte JL, Grasmick ME. Recruiting primary care clinicians for public health and bioterrorism surveillance. WMJ 2009 Apr;108(2):104-8. PMID: 19437937