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Search All Research Studies
Topics
- Adverse Events (1)
- Cardiovascular Conditions (3)
- Chronic Conditions (1)
- Comparative Effectiveness (3)
- Dementia (1)
- Diabetes (1)
- Elderly (2)
- Healthcare-Associated Infections (HAIs) (1)
- Heart Disease and Health (4)
- (-) Medical Devices (7)
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 7 of 7 Research Studies DisplayedHamer MK, DeCamp M, Bradley CJ
Adoption and value of the Medicare annual wellness visit: a mixed-methods study.
Medicare's Annual Wellness Visit (AWV) was introduced in 2011 to encourage the utilization of preventive services, but many clinicians and patients still do not participate in the visit. We qualitatively and quantitatively assessed motivations and clinical and financial value of AWVs from a primary care perspective using interviews and Medicare claims from 2012 to 2019. Primary care providers with the highest acuity patients had AWV utilization rates 11.2 percentage points lower than providers with the lowest acuity patients; utilization rates were 3.8 percentage points lower in rural counties. Adoption was motivated by patient needs and financial incentives. AWVs closed gaps in preventive care, strengthened patient-provider relationships, facilitated advance care planning, and provided an opportunity to improve quality metrics. Overall, the AWV has the potential to increase the use of high-value preventive services although not all clinics have an economic incentive to adopt the visit, which may explain some of the variability in utilization rates.
AHRQ-funded; HS026613.
Citation: Hamer MK, DeCamp M, Bradley CJ .
Adoption and value of the Medicare annual wellness visit: a mixed-methods study.
Med Care Res Rev 2023 Aug; 80(4):433-43. doi: 10.1177/10775587231166037..
Keywords: Medical Devices, Prevention
Chandanabhumma PP, Fetters MD, Pagani FD
Understanding and addressing variation in health care-associated infections after durable ventricular assist device therapy: protocol for a mixed methods study.
This paper discusses an ongoing AHRQ-funded study to understand and address variation in health care-associated infections (HAIs) after durable ventricular assist device (VAD) implantation surgery. This procedure is used only on patients with advanced heart failure who have a poor 1-year estimated survival rate. This is a sequential mixed methods study which is conducting a systematic review of HAI prevention studies, and an in-depth quantitative analyses using administration claims, in-depth clinical data, and organizational surveys of VAD centers. The last aim is to develop and disseminate a best practices toolkit for HAI prevention. Data analysis is currently underway.
AHRQ-funded; HS026003.
Citation: Chandanabhumma PP, Fetters MD, Pagani FD .
Understanding and addressing variation in health care-associated infections after durable ventricular assist device therapy: protocol for a mixed methods study.
JMIR Res Protoc 2020 Jan 7;9(1):e14701. doi: 10.2196/14701..
Keywords: Healthcare-Associated Infections (HAIs), Surgery, Medical Devices, Prevention, Heart Disease and Health, Cardiovascular Conditions, Adverse Events
Hajduk AM, Gurwitz JH, Tabada G
Influence of multimorbidity on burden and appropriateness of implantable cardioverter-defibrillator therapies.
Researchers sought to determine whether burden of multiple chronic conditions (MCCs) influences the risk of receiving inappropriate vs appropriate device therapies. They studied adults with left ventricular systolic dysfunction receiving an implantable cardioverter-defibrillator (ICD) for primary prevention. In these patients, they found that MCC burden was independently associated with an increased risk of inappropriate but not appropriate device therapies. They recommended considering comorbidity burden when engaging patients in shared decision making about ICD implantation.
AHRQ-funded; 290050033.
Citation: Hajduk AM, Gurwitz JH, Tabada G .
Influence of multimorbidity on burden and appropriateness of implantable cardioverter-defibrillator therapies.
J Am Geriatr Soc 2019 Jul;67(7):1370-78. doi: 10.1111/jgs.15839..
Keywords: Cardiovascular Conditions, Heart Disease and Health, Chronic Conditions, Medical Devices, Prevention, Elderly, Risk, Patient-Centered Outcomes Research
Sharma A, Al-Khatib SM, Ezekowitz JA
Implantable cardioverter-defibrillators in heart failure patients with reduced ejection fraction and diabetes.
This study evaluates the effectiveness of a strategy that uses an implantable cardioverter-defibrillator (ICD) plus medical therapy versus medical therapy alone among patients with heart failure (HF) and diabetes. Researchers conducted a patient-level combined-analysis using a combined dataset that included four primary prevention ICD trials of patients with HF or severely reduced ejection fractions. The results indicate that primary prevention ICD in combination with medical therapy versus medical therapy alone was not significantly associated with a reduced risk of all-cause death. The authors conclude that further studies are needed to evaluate the effectiveness of ICDs among patients with diabetes.
AHRQ-funded; HS018505.
Citation: Sharma A, Al-Khatib SM, Ezekowitz JA .
Implantable cardioverter-defibrillators in heart failure patients with reduced ejection fraction and diabetes.
Eur J Heart Fail 2018 Jun;20(6):1031-38. doi: 10.1002/ejhf.1192..
Keywords: Cardiovascular Conditions, Comparative Effectiveness, Diabetes, Heart Disease and Health, Medical Devices, Prevention
Zeitler EP, Hellkamp AS, Schulte PJ
Comparative effectiveness of implantable cardioverter defibrillators for primary prevention in women.
The researchers examined clinical practice data to compare survival rates among women with heart failure with or without a primary prevention implantable cardioverter defibrillator (ICD). Theyn found that among patients with heart failure with reduced left ventricular ejection fraction, a primary prevention ICD was associated with a significant survival advantage among women and among men.
AHRQ-funded; HS021092.
Citation: Zeitler EP, Hellkamp AS, Schulte PJ .
Comparative effectiveness of implantable cardioverter defibrillators for primary prevention in women.
Circ Heart Fail 2016 Jan;9(1):e002630. doi: 10.1161/circheartfailure.115.002630.
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Keywords: Medical Devices, Comparative Effectiveness, Prevention, Heart Disease and Health, Mortality
Green AR, Leff B, Wang Y
Geriatric conditions in patients undergoing defibrillator implantation for prevention of sudden cardiac death: prevalence and impact on mortality.
The researchers sought to determine the prevalence of frailty and dementia among older adults receiving primary prevention implantable cardioverter-defibrillators (ICDs) and to determine the impact of multimorbidity on mortality within 1 year of ICD implantation. They concluded that more than 10 percent of Medicare beneficiaries with heart failure receiving primary prevention ICDs have frailty or dementia. These patients had significantly higher 1-year mortality than those with other common chronic conditions.
AHRQ-funded; HS019814; 290201200007I.
Citation: Green AR, Leff B, Wang Y .
Geriatric conditions in patients undergoing defibrillator implantation for prevention of sudden cardiac death: prevalence and impact on mortality.
Circ Cardiovasc Qual Outcomes 2016 Jan;9(1):23-30. doi: 10.1161/circoutcomes.115.002053.
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Keywords: Elderly, Medical Devices, Mortality, Prevention, Dementia
Earley A, Persson R, Garlitski AC
Effectiveness of implantable cardioverter defibrillators for primary prevention of sudden cardiac death in subgroups a systematic review.
The purpose of this review was to examine ICD effectiveness for primary prevention of SCD across subgroups by sex, age, QRS interval, time since myocardial infarction, blood urea nitrogen level, and diabetes. It concluded that there was weak evidence showing differences for all-cause mortality in subgroups of sex, age, and QRS interval. Also, evidence was indeterminate for all-cause mortality in the other subgroups and for SCD.
AHRQ-funded; 290200710055I.
Citation: Earley A, Persson R, Garlitski AC .
Effectiveness of implantable cardioverter defibrillators for primary prevention of sudden cardiac death in subgroups a systematic review.
Ann Intern Med 2014 Jan 21;160(2):111-21. doi: 10.7326/m13-1787..
Keywords: Medical Devices, Comparative Effectiveness, Prevention, Mortality