National Healthcare Quality and Disparities Report
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Topics
- Adverse Drug Events (ADE) (2)
- Adverse Events (1)
- Ambulatory Care and Surgery (1)
- Antibiotics (1)
- Back Health and Pain (3)
- Behavioral Health (1)
- Blood Pressure (2)
- Blood Thinners (1)
- Cardiovascular Conditions (7)
- Care Management (4)
- Case Study (1)
- Children/Adolescents (5)
- (-) Chronic Conditions (41)
- Community-Based Practice (1)
- Comparative Effectiveness (8)
- Complementary and Alternative Medicine (1)
- COVID-19 (1)
- Depression (1)
- Diabetes (6)
- Education: Patient and Caregiver (1)
- Elderly (2)
- (-) Evidence-Based Practice (41)
- Guidelines (12)
- Healthcare Delivery (2)
- Health Information Technology (HIT) (3)
- Health Services Research (HSR) (2)
- Heart Disease and Health (2)
- Hepatitis (2)
- Home Healthcare (1)
- Kidney Disease and Health (2)
- Medication (8)
- Medication: Safety (1)
- Newborns/Infants (1)
- Nutrition (1)
- Opioids (2)
- Outcomes (9)
- Pain (6)
- Patient-Centered Healthcare (5)
- Patient-Centered Outcomes Research (12)
- Patient and Family Engagement (2)
- Patient Experience (1)
- Patient Safety (1)
- Patient Self-Management (2)
- Practice Patterns (1)
- Prevention (8)
- Primary Care (5)
- Provider (1)
- Provider: Pharmacist (1)
- Provider Performance (1)
- Public Health (1)
- Quality Improvement (1)
- Quality Measures (1)
- Quality of Care (3)
- Racial and Ethnic Minorities (1)
- Registries (1)
- Research Methodologies (1)
- Respiratory Conditions (4)
- Risk (2)
- Screening (4)
- Shared Decision Making (2)
- Sickle Cell Disease (2)
- Skin Conditions (1)
- Sleep Problems (1)
- Surgery (3)
- Telehealth (1)
- Transitions of Care (1)
- Treatments (2)
- U.S. Preventive Services Task Force (USPSTF) (8)
- Women (3)
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 25 of 41 Research Studies DisplayedChu CD, Xia F, Du Y
Estimated prevalence and testing for albuminuria in US adults at risk for chronic kidney disease.
The purpose of this cohort study was to assess the extent of albuminuria underdetection from lack of testing and examine its association with CKD treatment. Researchers examined records of adults with hypertension or diabetes, utilizing data from the 2007 to 2018 National Health and Nutrition Examination Surveys (NHANES) and the Optum deidentified electronic health record (EHR) data set of US health care organizations. The total EHR study population included 192,108 patients; 96.6% with hypertension, and 26.2% with diabetes. The study found that 17.5% of patients had albuminuria testing; of whom 34.3% had albuminuria. Among 158,479 patients who were untested, the estimated albuminuria prevalence rate was 13.4%. Thus, only 35.2% of the projected population with albuminuria had been tested. Albuminuria testing was associated with higher adjusted odds of receiving ACEi or ARB treatment, SGLT2i treatment, and having blood pressure controlled to less than 140/90 mm Hg. The researchers concluded that approximately two-thirds of patients with albuminuria were undetected due to lack of testing.
AHRQ-funded; HS026383.
Citation: Chu CD, Xia F, Du Y .
Estimated prevalence and testing for albuminuria in US adults at risk for chronic kidney disease.
JAMA Netw Open 2023 Jul; 6(7):e2326230. doi: 10.1001/jamanetworkopen.2023.26230..
Keywords: Kidney Disease and Health, Chronic Conditions, Diabetes, Blood Pressure, Evidence-Based Practice
Tracer H, Haselby C
AHRQ Author: Tracer H
Hormone therapy for the primary prevention of chronic conditions in postmenopausal people.
This case study described a 50-year-old woman whose last menstrual cycle was more than a year previous. Case study questions related to the USPSTF recommendation on hormone therapy addressed whether this patient would benefit from hormone therapy to prevent the onset of chronic conditions that become more common after menopause.
AHRQ-authored.
Citation: Tracer H, Haselby C .
Hormone therapy for the primary prevention of chronic conditions in postmenopausal people.
Am Fam Physician 2023 Jun; 107(6):645-46..
Keywords: U.S. Preventive Services Task Force (USPSTF), Guidelines, Evidence-Based Practice, Prevention, Chronic Conditions, Women
Reeves SL, Peng HK, Wing JJJ
Changes in hydroxyurea use among youths enrolled in Medicaid with sickle cell anemia after 2014 revision of clinical guidelines.
The objective of this cross-sectional study was to describe changes in hydroxyurea use among youths with sickle cell anemia (SCA) before and after the release of the 2014 National Heart, Lung, and Blood Institute guidelines. Data was taken from Michigan and New York State Medicaid programs, 2010-18, and the study population included youths aged 1 to 17 with SCA. The findings suggest that hydroxyurea was substantially underused in spite of its establishment as the primary disease-modifying therapy for SCA, and that there was incomplete clinician or patient uptake of the new guidelines. The authors conclude that increased use of hydroxyurea may require a multifaceted approach that includes addressing multiple system- and patient-level barriers.
AHRQ-funded; HS027785.
Citation: Reeves SL, Peng HK, Wing JJJ .
Changes in hydroxyurea use among youths enrolled in Medicaid with sickle cell anemia after 2014 revision of clinical guidelines.
JAMA Netw Open 2023 Mar;6(3):e234584. doi: 10.1001/jamanetworkopen.2023.4584.
Keywords: Children/Adolescents, Sickle Cell Disease, Chronic Conditions, Evidence-Based Practice
Mills J, Barnhart H
AHRQ Author: Mills J
Screening for prediabetes and type 2 diabetes in children and adolescents.
This Putting Prevention into Practice case study is used to increase understanding of the USPSTF final recommendation on screening for prediabetes and type 2 diabetes in children and adolescents. A case study was presented using a 12-year-old-patient with no specific concerns but had gained 18 pounds since their last wellness visit and lives a sedentary lifestyle. The patient’s family history of type 2 diabetes mellitus in maternal and paternal grandparents is described. Three multiple-choice questions are presented regarding harms and benefits of screening for prediabetes and type 2 diabetes for that patient.
AHRQ-authored.
Citation: Mills J, Barnhart H .
Screening for prediabetes and type 2 diabetes in children and adolescents.
Am Fam Physician 2023 Jan; 107(1):79-80..
Keywords: U.S. Preventive Services Task Force (USPSTF), Children/Adolescents, Diabetes, Screening, Evidence-Based Practice, Guidelines, Prevention, Chronic Conditions, Case Study
Gartlehner G, Patel SV, Reddy S
Hormone therapy for the primary prevention of chronic conditions in postmenopausal persons: updated evidence report and systematic review for the US Preventive Services Task Force.
This US Preventive Services Task Force (USPSTF) recommendation is an updated evidence report and systematic review on the use of hormone therapy in postmenopausal persons for the primary prevention of chronic conditions. The reviewers included 20 trials (N = 39,145) and 3 cohort studies (N = 1,155,410) from a dual review of abstracts, full-text articles, and study quality. Harms and benefits were compared for participants using estrogen only compared with estrogen plus progestin. Participants using estrogen only compared with placebo had significantly lower risks for diabetes and fractures, but increased for gallbladder disease over 7.1 years, stroke over 7.2 years, venous thromboembolism over 7.2 years and urinary incontinence over 1 year. For participants using estrogen plus progestin some benefits were found, but there was also an increased risk of harms significantly for invasive breast cancer, gallbladder disease, venous thromboembolism, probable dementia, and urinary incontinence.
AHRQ-funded; 75Q80120D00007.
Citation: Gartlehner G, Patel SV, Reddy S .
Hormone therapy for the primary prevention of chronic conditions in postmenopausal persons: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2022 Nov 1;328(17):1747-65. doi: 10.1001/jama.2022.18324..
Keywords: U.S. Preventive Services Task Force (USPSTF), Prevention, Evidence-Based Practice, Guidelines, Chronic Conditions, Women
McDonagh MS, Morasco BJ, Wagner J
Cannabis-based products for chronic pain : a systematic review.
Researchers sought to evaluate the benefits and harms of cannabinoids for chronic pain. They found that oral, synthetic cannabis products with high THC-to-CBD ratios and sublingual, extracted cannabis products with comparable THC-to-CBD ratios may be associated with short-term improvements in chronic pain and increased risk for dizziness and sedation.
AHRQ-funded; 75Q80120D00006.
Citation: McDonagh MS, Morasco BJ, Wagner J .
Cannabis-based products for chronic pain : a systematic review.
Ann Intern Med 2022 Aug;175(8):1143-53. doi: 10.7326/m21-4520.
AHRQ-funded; 75Q80120D00006..
AHRQ-funded; 75Q80120D00006..
Keywords: Pain, Chronic Conditions, Complementary and Alternative Medicine, Treatments, Evidence-Based Practice
Aboumatar H, Pitts S, Sharma R
Patient engagement strategies for adults with chronic conditions: an evidence map.
Existing research indicates that patient and family engagement (PFE) in health care is necessary for improving outcomes. The purpose of this study was to explore the evidence on PFE strategies for adults with chronic conditions and identify the areas where additional research is needed. The authors searched existing databases, including CINAHL, Cochrane, EMBASE, and PubMed, for data between January 2015 and September 2021, to identify systematic reviews on strategies for engaging patients with chronic conditions. The study also included their caregivers. Strategies were categorized into the following levels: direct patient care, health system, and community-policy. The authors discovered 131 reviews of direct patient care strategies, 5 reviews of health system strategies, and no reviews of community-policy strategies. The study concluded that there is much more available evidence on the effects of direct patient care strategies on PFE than on the effects of the health system or community policy strategies. In addition, the evidence map created by the researchers focused on reviews which did not provide details of individual chronic disease interventions. The authors concluded that the evidence map created provides awareness of the research gaps related to efforts to improve patient and family engagement for patients with chronic conditions.
AHRQ-funded; 290201500006I.
Citation: Aboumatar H, Pitts S, Sharma R .
Patient engagement strategies for adults with chronic conditions: an evidence map.
Syst Rev 2022 Mar 5;11(1):39. doi: 10.1186/s13643-021-01873-5..
Keywords: Patient and Family Engagement, Chronic Conditions, Evidence-Based Practice
Ong T, Onchiri FM, Britto MT
Impact of guideline-recommended dietitian assessments on weight gain in infants with cystic fibrosis.
This study’s purpose was to characterize nutrition management for infants with cystic fibrosis (CF) with inadequate weight gain and to assess association of dietitian assessments and center-level weight-for-age Z-scores (WAZ). Encounter data from 226 infants was used from across 28 US CF Centers from the Baby Observational Nutritional study between January 2012 through December 2017. The authors identified dietitian assessments and consensus guideline-recommended responses to inadequate weight gain: calorie increases, pancreatic enzyme replacement therapy (PERT) increases, or shortened time to next visit. They compared center assessments by funnel plot and summarized median WAZ by center. Of 2,527 visits, 808 visits had identified inadequate weight gain, distributed in 216 infants. Assessments occurred in 77% of visits but varied widely between centers (range 17% - 98%). They used funnel plot analysis to identify high-performers for frequent dietitian assessments (range 92% - 98%) and 4 under-performers (range 17% - 56%). High-performers treated inadequate weight gain more often with adequate calories (80% vs 52%) and closer follow-up (63% vs 49%) compared to underperformers. Three of 4 high-performing sites met center nutrition goals for positive median WAZ at 2 years old unlike 3 under-performers, despite similar patient characteristics.
AHRQ-funded; HS026393.
Citation: Ong T, Onchiri FM, Britto MT .
Impact of guideline-recommended dietitian assessments on weight gain in infants with cystic fibrosis.
J Cyst Fibros 2022 Jan; 21(1):115-22. doi: 10.1016/j.jcf.2021.08.005..
Keywords: Newborns/Infants, Respiratory Conditions, Chronic Conditions, Nutrition, Evidence-Based Practice, Guidelines
Ibemere SO, Tanabe P, Bonnabeau E
Awareness and use of the sickle cell disease toolbox by primary care providers in North Carolina.
The authors developed a decision support tool for sickle cell disease (SCD) for SCD management (SCD Toolbox) based on the National Heart, Lung, and Blood Institute's SCD guidelines. Using data from primary care providers (PCPs) in North Carolina, they found that PCPs rarely co-managed with a specialist, had low awareness and use of the SCD Toolbox, and requested multiple formats for the toolbox.
AHRQ-funded; HS024501.
Citation: Ibemere SO, Tanabe P, Bonnabeau E .
Awareness and use of the sickle cell disease toolbox by primary care providers in North Carolina.
J Prim Care Community Health 2021 Jan-Dec;12:21501327211049050. doi: 10.1177/21501327211049050..
Keywords: Sickle Cell Disease, Primary Care, Chronic Conditions, Shared Decision Making, Evidence-Based Practice
Swietek KE, Domino ME, Grove LR
Duration of medical home participation and quality of care for patients with chronic conditions.
The objective of this study was to examine whether the length of participation in a patient-centered medical home (PCMH), an evidence-based practice, led to higher quality care for Medicaid enrollees with multiple co-morbid chronic conditions and major depressive disorder (MDD). The investigators concluded that the PCMH model was associated with higher quality of care for patients with multiple chronic conditions and MDD over time, and these benefits increased the longer a patient was enrolled.
AHRQ-funded; HS000032; HS019659.
Citation: Swietek KE, Domino ME, Grove LR .
Duration of medical home participation and quality of care for patients with chronic conditions.
Health Serv Res 2021 Oct;56(Suppl 1):1069-79. doi: 10.1111/1475-6773.13710..
Keywords: Chronic Conditions, Patient-Centered Healthcare, Quality of Care, Evidence-Based Practice, Depression, Behavioral Health
Samal L, Fu HN, Camara DS
AHRQ Author: Camara DS, Wang J, Bierman AS
Health information technology to improve care for people with multiple chronic conditions.
The objective of this study was to review evidence regarding the use of Health Information Technology (health IT) interventions aimed at improving care for people living with multiple chronic conditions (PLWMCC) in order to identify critical knowledge gaps. The investigators concluded that the body of literature included in this review provides critical information on the state of the science as well as the many gaps that need to be filled for digital health to fulfill its promise in supporting care delivery that meets the needs of PLWMCC.
AHRQ-authored; AHRQ-funded; HS026849; 290201600001B.
Citation: Samal L, Fu HN, Camara DS .
Health information technology to improve care for people with multiple chronic conditions.
Health Serv Res 2021 Oct;56(Suppl 1):1006-36. doi: 10.1111/1475-6773.13860..
Keywords: Chronic Conditions, Health Information Technology (HIT), Evidence-Based Practice, Shared Decision Making, Healthcare Delivery
Bierman AS, Wang J, O'Malley PG
AHRQ Author: Bierman AS, Wang J, O'Malley PG, Moss DK
Transforming care for people with multiple chronic conditions: Agency for Healthcare Research and Quality's research agenda.
This article describes issues addressing the needs of those with multiple chronic conditions and discusses the AHRQ research agenda.
AHRQ-authored.
Citation: Bierman AS, Wang J, O'Malley PG .
Transforming care for people with multiple chronic conditions: Agency for Healthcare Research and Quality's research agenda.
Health Serv Res 2021 Oct;56(Suppl 1):973-79. doi: 10.1111/1475-6773.13863..
Keywords: Chronic Conditions, Health Services Research (HSR), Healthcare Delivery, Quality of Care, Primary Care, Guidelines, Evidence-Based Practice
Smith BM, Sharma R, Das A
Patient and family engagement strategies for children and adolescents with chronic diseases: a review of systematic reviews.
Patient and family engagement is important for family-centered care, particularly for children and adolescents with chronic disease. In this study the investigators aimed to 1) identify available evidence from systematic reviews on engagement strategies used to help children, adolescents, and their caregivers manage chronic conditions, and 2) identify gaps in the literature. They searched PubMed and CINAHL from January 2015 to January 2020 for systematic reviews on patient and family engagement strategies in the pediatrics population (<18 years).
AHRQ-funded; 290201500006I.
Citation: Smith BM, Sharma R, Das A .
Patient and family engagement strategies for children and adolescents with chronic diseases: a review of systematic reviews.
Patient Educ Couns 2021 Sep;104(9):2213-23. doi: 10.1016/j.pec.2021.02.026..
Keywords: Children/Adolescents, Patient and Family Engagement, Chronic Conditions, Patient-Centered Healthcare, Evidence-Based Practice, Patient Self-Management
Aiyegbusi OL, Nair D, Peipert JD
A narrative review of current evidence supporting the implementation of electronic patient-reported outcome measures in the management of chronic diseases.
This review discusses and summarizes evidence of the impact of electronic patient-reported outcomes measures (ePROMs) on clinical parameters and outcomes relevant to chronic diseases. Various studies have demonstrated the feasibility of ePROMs in routine clinical practice with patients increasing expressing a preference for an electronic mode of administration. These ePROMs could have significant impacts on outcomes valued by patients, healthcare providers, and researchers. Recently published literature.
AHRQ-funded; HS026395.
Citation: Aiyegbusi OL, Nair D, Peipert JD .
A narrative review of current evidence supporting the implementation of electronic patient-reported outcome measures in the management of chronic diseases.
Ther Adv Chronic Dis 2021 May 24;12:20406223211015958. doi: 10.1177/20406223211015958..
Keywords: Chronic Conditions, Patient Experience, Health Information Technology (HIT), Outcomes, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Evidence-Based Practice
Carey RM, Wright JT, Taler SJ
Guideline-driven management of hypertension: an evidence-based update.
This paper is an evidence-based update to the 2017 American College of Cardiology/American Heart Association Blood Pressure Guideline. The authors conducted a literature review of relevant observational studies, randomized clinical trials, and meta-analyses published between January 2018 and March 2021. Topics included blood pressure (BP) measurement, patient evaluation, patient evaluation for secondary hypertension, cardiovascular disease risk assessment and BP threshold for drug therapy, lifestyle and pharmacological management, treatment target BP goal, management of hypertension in older adults, diabetes, chronic kidney disease, resistant hypertension, and optimization of care using patient, provider, and health system approaches.
AHRQ-funded; HS027944.
Citation: Carey RM, Wright JT, Taler SJ .
Guideline-driven management of hypertension: an evidence-based update.
Circ Res 2021 Apr 2;128(7):827-46. doi: 10.1161/circresaha.121.318083..
Keywords: Blood Pressure, Guidelines, Evidence-Based Practice, Cardiovascular Conditions, Chronic Conditions
Brown CS, Osborne NH, Kim GY
Effect of concomitant deep venous reflux on truncal endovenous ablation outcomes in the Vascular Quality Initiative.
This study looked at outcomes for patients with varicose veins (C2 disease) undergoing truncal endovenous ablation with and without deep venous reflux. Data from the Vascular Quality Initiative was analyzed from 2015 to 2019. A total of 4881 patients were included, with 46.2% having combined deep and superficial reflux. Follow-up around a year later (median 336.5 days) was conducted after. Patients with deep reflux were less likely to be female, more likely to be Caucasian, and had no difference in BMI. Additionally, there were no differences in rates of prior varicose vein treatments, number of pregnancies, or history of deep venous thrombosis. However, patients without deep reflux were more likely to use anticoagulants at the time of the procedure. Patients without deep reflux had slightly higher median preprocedural Venous Clinician Severity Score (VCSS) scores as well as postprocedural VCSS scores. Total symptom score was higher for patients without deep reflux before and after the procedure, but there was no change in symptom score after the procedure. Patients with deep reflux had substantially higher rates of complications with a particular increase in proximal thrombus extension.
AHRQ-funded; HS000053.
Citation: Brown CS, Osborne NH, Kim GY .
Effect of concomitant deep venous reflux on truncal endovenous ablation outcomes in the Vascular Quality Initiative.
J Vasc Surg Venous Lymphat Disord 2021 Mar;9(2):361-68.e3. doi: 10.1016/j.jvsv.2020.04.031..
Keywords: Cardiovascular Conditions, Chronic Conditions, Surgery, Outcomes, Patient-Centered Outcomes Research, Evidence-Based Practice
Brown CS, Obi AT, Cronenwett JL
Outcomes after truncal ablation with or without concomitant phlebectomy for isolated symptomatic varicose veins (C2 disease).
This study looked outcomes of patients with varicose veins (C2 disease) who were treated with venous ablation alone or ablation plus phlebectomy using the Vascular Quality Initiative Varicose Vein Registry. Data between January 2015 and March 2015 was used to investigate postoperative as well as long-term clinical and patient-reported outcomes among patients with documented symptomatic C2 disease undergoing truncal endovenous ablations alone and combined ablation and phlebectomy. Out of 3375 patients, 40.1% underwent isolated truncal ablation and the rest had the combined procedure of ablation and phlebectomy. Complications were low for both procedures (8.4% and 8.7%). Overall, improvement in symptoms was experienced by 94.4% of patients with more increases in patients undergoing ablation and phlebectomy than ablation alone. Both procedures are recommended by the authors to be covered by insurance.
AHRQ-funded; HS000053.
Citation: Brown CS, Obi AT, Cronenwett JL .
Outcomes after truncal ablation with or without concomitant phlebectomy for isolated symptomatic varicose veins (C2 disease).
J Vasc Surg Venous Lymphat Disord 2021 Mar;9(2):369-76. doi: 10.1016/j.jvsv.2020.05.016..
Keywords: Cardiovascular Conditions, Chronic Conditions, Surgery, Outcomes, Patient-Centered Outcomes Research, Comparative Effectiveness, Evidence-Based Practice
Brown CS, Osborne NH, Kim GY
Comparison of unilateral vs bilateral and staged bilateral vs concurrent bilateral truncal endovenous ablation in the Vascular Quality Initiative.
This study compares outcomes in patients who have undergone unilateral vs bilateral venous ablation procedures or between staged and concurrent bilateral procedures. Data from the Vascular Quality Initiative from 2015 to 2019 was used to investigate immediate postoperative as well as long-term clinical and patient-reported outcomes. A total of 5029 patients were included, of whom 75.2% underwent unilateral procedures. Follow-up was conducted with a median of 227 days after. Unilateral patients were less likely to be female and white and had lower BMI compared with patients undergoing bilateral procedures. In addition, unilateral patients had fewer prior varicose vein treatments and had higher Venous Clinical Severity Scores (VCSS). There were no differences in complications in patients undergoing unilateral vs bilateral procedures. Systemic complications were rare in both groups.
AHRQ-funded; HS000053.
Citation: Brown CS, Osborne NH, Kim GY .
Comparison of unilateral vs bilateral and staged bilateral vs concurrent bilateral truncal endovenous ablation in the Vascular Quality Initiative.
J Vasc Surg Venous Lymphat Disord 2021 Jan;9(1):113-21.e3. doi: 10.1016/j.jvsv.2020.05.008..
Keywords: Cardiovascular Conditions, Chronic Conditions, Surgery, Outcomes, Patient-Centered Outcomes Research, Comparative Effectiveness, Evidence-Based Practice
Navis A, George MC, Nmashie A
Validation of the Safer Opioid Prescribing Evaluation Tool (SOPET) for assessing adherence to the Centers for Disease Control opioid prescribing guidelines.
This study assessed the use of the Safer Opioid Prescribing Evaluation Tool (SOPET) which was designed to improve the implementation of the 2016 Centers for Disease Control Guidelines on the prescription of opioids for chronic pain. Four raters with varying levels of clinical experience were trained to use the SOPET and then used it to evaluate 21 baseline patient scenarios. Inter-rater reliability was measured using intraclass correlation coefficient (ICC) estimates and their 95% confidence intervals for the total SOPET score based on a mean-rating absolute-agreement, two-way random-effects model. Inter-rater reliability was found to be good for the three physician raters (0.92, 0.97, and 0.99). However, inter-rater reliability for the non-physician rater was lower (0.67).
AHRQ-funded; HS025641.
Citation: Navis A, George MC, Nmashie A .
Validation of the Safer Opioid Prescribing Evaluation Tool (SOPET) for assessing adherence to the Centers for Disease Control opioid prescribing guidelines.
Pain Med 2020 Dec 25;21(12):3655-59. doi: 10.1093/pm/pnaa138..
Keywords: Opioids, Medication, Medication: Safety, Patient Safety, Guidelines, Practice Patterns, Pain, Chronic Conditions, Evidence-Based Practice
Chou R, Blazina I, Bougatsos C
Screening for hepatitis B virus infection in nonpregnant adolescents and adults: updated evidence report and systematic review for the US Preventive Services Task Force.
The authors updated the 2014 hepatitis B virus (HBV) screening review in nonpregnant adolescents and adults to inform the USPSTF. They found no direct evidence for the clinical benefits and harms of HBV screening vs no screening. Antiviral therapy for HBV infection was associated with improved intermediate outcomes and may improve clinical outcomes.
AHRQ-funded; 290201500009I.
Citation: Chou R, Blazina I, Bougatsos C .
Screening for hepatitis B virus infection in nonpregnant adolescents and adults: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2020 Dec 15;324(23):2423-36. doi: 10.1001/jama.2020.19750..
Keywords: U.S. Preventive Services Task Force (USPSTF), Children/Adolescents, Hepatitis, Chronic Conditions, Screening, Evidence-Based Practice, Prevention
Gelfand JM, Armstrong AW, Bell S
National Psoriasis Foundation COVID-19 Task Force guidance for management of psoriatic disease during the pandemic: Vversion 1.
This article describes the process that was used to create the first version of a guidance document for management of psoriatic disease during the COVID-19 pandemic developed by the National Psoriasis Foundation. A task force of 18 physician voting members with expertise in dermatology, rheumatology, epidemiology, infectious diseases, and critical care was created with supplementation by nonvoting members. A Delphi process was created, out of which 22 guidance statements were approved. All guidance statements were recommended, with 9 of them high consensus, and the remaining 13 were moderate consensus. Topics covered included how COVID-19 can impact patients, how medical care can be optimized during the pandemic, and what patients can do to lower their risk of getting infected with COVID-19. This guidance will be updated by the TF as new data emerges.
AHRQ-funded; HS026372.
Citation: Gelfand JM, Armstrong AW, Bell S .
National Psoriasis Foundation COVID-19 Task Force guidance for management of psoriatic disease during the pandemic: Vversion 1.
J Am Acad Dermatol 2020 Dec;83(6):1704-16. doi: 10.1016/j.jaad.2020.09.001..
Keywords: Skin Conditions, Chronic Conditions, Care Management, Evidence-Based Practice, Guidelines, COVID-19
Presley C, Agne A, Shelton T
Mobile-enhanced peer support for African Americans with Type 2 diabetes: a randomized controlled trial.
This study compared the effectiveness of a community-based diabetes self-management education (DSME) plus mobile health (mHealth)-enhanced peer support intervention to community-based DSME alone for African American adults with poorly controlled type 2 diabetes. This randomized controlled trial took place in Jefferson County, Alabama within a safety-net healthcare system with a group diagnosed with type 2 diabetes and hemoglobin A1C ≥ 7.5%. The intervention group reviewed community-based DSME plus 6 months of mHealth-enhanced peer support, including 12 weekly phone calls, then 3 monthly calls from community health workers. The control group received community based DSME only. Primary outcomes were lower A1C and secondary outcomes were lower diabetes distress, depressive symptoms, self-efficacy or confidence in their ability to manage diabetes, and social support. Of 120 participants selected, 97 completed the study. Both groups experienced clinical meaning reduction in A1C. Participants in the intervention group experienced a significantly larger reduction in diabetes distress compared to the control group.
AHRQ-funded; HS019465.
Citation: Presley C, Agne A, Shelton T .
Mobile-enhanced peer support for African Americans with Type 2 diabetes: a randomized controlled trial.
J Gen Intern Med 2020 Oct;35(10):2889-96. doi: 10.1007/s11606-020-06011-w..
Keywords: Telehealth, Health Information Technology (HIT), Patient Self-Management, Diabetes, Chronic Conditions, Racial and Ethnic Minorities, Community-Based Practice, Comparative Effectiveness, Patient-Centered Outcomes Research, Evidence-Based Practice, Outcomes, Education: Patient and Caregiver
Obinwa U, Pérez A, Lingvay I
Multilevel variation in diabetes screening within an integrated health system.
Variation in diabetes screening in clinical practice is poorly described. In this study, the investigators examined the interplay of patient, provider, and clinic factors explaining variation in diabetes screening within an integrated health care system in the U.S. They concluded that screening practices varied widely and were only partially explained by patient, provider, and clinic factors available in the EHR.
AHRQ-funded; HS022418.
Citation: Obinwa U, Pérez A, Lingvay I .
Multilevel variation in diabetes screening within an integrated health system.
Diabetes Care 2020 May;43(5):1016-24. doi: 10.2337/dc19-1622..
Keywords: U.S. Preventive Services Task Force (USPSTF), Diabetes, Screening, Primary Care, Prevention, Evidence-Based Practice, Chronic Conditions
Dobler CC, Morrow AS, Beuschel B
Pharmacologic therapies in patients with exacerbation of chronic obstructive pulmonary disease: a systematic review with meta-analysis.
The authors evaluated the comparative effectiveness and adverse events of pharmacologic interventions for adults with exacerbation of COPD. Sixty-eight randomized controlled trials were selected for evaluation and data extraction. They found that antibiotics and systemic corticosteroids reduced treatment failure in adults with mild to severe exacerbation of COPD.
AHRQ-funded.
Citation: Dobler CC, Morrow AS, Beuschel B .
Pharmacologic therapies in patients with exacerbation of chronic obstructive pulmonary disease: a systematic review with meta-analysis.
Ann Intern Med 2020 Mar 17;172(6):413-23. doi: 10.7326/m19-3007..
Keywords: Respiratory Conditions, Chronic Conditions, Evidence-Based Practice, Patient-Centered Outcomes Research, Comparative Effectiveness, Medication, Antibiotics, Treatments, Adverse Drug Events (ADE), Adverse Events
Wilson ME, Dobler CC, Morrow AS
Association of home noninvasive positive pressure ventilation with clinical outcomes in chronic obstructive pulmonary disease: a systematic review and meta-analysis.
The association of home noninvasive positive pressure ventilation (NIPPV) with outcomes in chronic obstructive pulmonary disease (COPD) and hypercapnia is uncertain. The purpose of this study was to evaluate the association of home NIPPV via bilevel positive airway pressure (BPAP) devices and noninvasive home mechanical ventilator (HMV) devices with clinical outcomes and adverse events in patients with COPD and hypercapnia.
AHRQ-funded; 290201500013I.
Citation: Wilson ME, Dobler CC, Morrow AS .
Association of home noninvasive positive pressure ventilation with clinical outcomes in chronic obstructive pulmonary disease: a systematic review and meta-analysis.
JAMA 2020 Feb 4;323(5):455-65. doi: 10.1001/jama.2019.22343..
Keywords: Respiratory Conditions, Chronic Conditions, Patient-Centered Outcomes Research, Outcomes, Evidence-Based Practice, Home Healthcare