NCEPCR: What's New

AHRQ Announces Interest in Primary Care Research

March 2022

AHRQ has issued a Special Emphasis Notice (SEN) in support of Primary Care Research.

This SEN informs the research community that the Agency for Healthcare Research and Quality (AHRQ) is interested in receiving health services research grant applications to advance the science of primary care. We will use our standing R01, R18, and R03 mechanisms to fund primary care-focused health services research.

In this SEN, AHRQ is interested in applications that develop, implement, and evaluate interventions and models of care, including those targeting the specific needs and challenges of disadvantaged populations and people living with MCC, that improve access, quality, and outcomes of care. Proposed studies may focus on the patient, clinician, practice, or system-level interventions. Multilevel interventions are encouraged. Applicants are encouraged to partner with practices using innovative approaches to study design including co-production of the intervention design and evaluation, evidence generation from practice-based data, rapid-cycle evaluation, and adaptive designs. AHRQ also encourages projects that produce and disseminate timely insights that can be used to improve patient care and inform healthcare delivery.

We are particularly interested in application that leverage primary care practice-based research networks (PBRNs) infrastructure, expertise, and relationships.

Further Guidance

The Agency encourages research teams to submit applications in response to this emphasis using AHRQ's standing R18, R03, and R01 funding mechanisms (PA-18-793, PA-18-794, PA-18-795). AHRQ also is interested in supporting the career development of primary care researchers through our standing K-award grant mechanisms, which are found at http://www.ahrq.gov/funding/fund-opps/index.html.

Please direct all inquiries to: Patrick G. O'Malley, M.D., M.P.H. Patrick.O'Malley@ahrq.hhs.gov.

Research Gaps in Primary Care

March 2022

To identify primary care gaps, the Evidence-based Practice Center (EPC) Program examined all reviews conducted by an EPC in calendar years 2019-2021 that addressed a research topic in primary care. AHRQ defines primary care research as:

• Research conducted in a primary care setting.
• Research conducted by or about primary care cinicans.
• Research on a topic integral to the primary care setting.

Identified reports are presented in this report in descending order, by date. The purpose, key messages, and evidence gaps identified in each review are summarized. Evidence gaps are organized by population, intervention, study design, and outcomes to facilitate ease of use. Detailed descriptions of the gaps are also available in the original report as provided in the following links:

https://effectivehealthcare.ahrq.gov/products/research-gaps-primary-care

https://effectivehealthcare.ahrq.gov/products/search

AHRQ Announces Interest in Career Development for Primary Care Researchers

October 2021

AHRQ has issued a Special Emphasis Notice in support of career development of primary care researchers. 

AHRQ is interested in career development applications that will provide the opportunity for qualified promising primary care research scientists to develop into independent primary care researchers. Meritorious proposals will detail and describe:

• Plans for mentorship with an established primary care researcher.
• Sufficient infrastructure to support practice-based research.

Further Guidance

AHRQ sponsors several career development awards intended to foster the career development of promising new investigators. These programs provide salary and research support for a sustained period of time for early career clinicians and research scientists.

AHRQ will use standing program announcements for the K08 and K01 funding mechanisms to support this research.

Please direct all inquiries to: Tamara Willis, Ph.D., M.P.H. Tamara.Willis@ahrq.hhs.gov.

Incorporation of Social Risk in Primary Care

September 2021

The USPSTF published a manuscript in JAMA that assesses how social risks have been considered in USPSTF recommendation statements and identify current gaps in the evidence needed to expand the systematic inclusion of social risks in future recommendations. The findings and recommendations in this paper are informed by a USPSTF commissioned technical brief.

Investing in Primary Care to Ensure High-Quality Care for All Americans

July 2021

A new AHRQ Views blog by CEPI director Arlene Bierman and Bob McNellis, AHRQ's senior advisor for primary care, on Investing in Primary Care to Ensure High-Quality Care for All Americans discusses how the momentum for greater interest and investments in primary care and primary care research will allow AHRQ to achieve important impacts on everyday practice. AHRQ's efforts will be informed by two reports: one by the RAND Corporation and another by the National Academies of Sciences, Engineering, and Medicine. In addition, the President's FY22 budget proposal includes robust endorsements for this work for the first time in many years.

National Web Conference on Opportunities for Digital Healthcare: Lessons Learned From the COVID-19 Pandemic

July 2021

AHRQ hosted a free web conference on July 1, 2021, from 1:00 to 2:30 p.m. ET, to discuss how digital healthcare has been affected by the pandemic. The pressing need to put evidence into practice to optimize outcomes for all patients and improve experience and reduce burnout for all providers has been dramatically intensified by the COVID-19 pandemic. Participants described their research and efforts related to the use of digital healthcare strategies and tools to support information flow in caring for patients with COVID and other conditions, and implications of their results for leveraging digital healthcare going forward. Access the recording of the conference.

Recent AHRQ Publications on Primary Care

June 2021

AHRQ staff and grantees have had several recent publications on primary care:

• "Higher Medicare Spending on Imaging and Lab Services After Primary Care Physician Group Vertical Integration" by Chris Whaley and RAND Center of Excellence colleagues in Health Affairs. This study highlights how the growing trend of vertical integration, combined with differences in Medicare payment between hospitals and nonhospital providers, leads to higher Medicare spending.
• "Barriers to Using Clinical Decision Support in Ambulatory Care: Do Clinics in Health Systems Fare Better?" by Yunfeng Shi and RAND Center of Excellence colleagues in the Journal of the American Medical Informatics Association. This study found that CDS barriers related to resources and user acceptance remained substantial. Health systems, while being effective in promoting CDS tools, may need to provide further assistance to their affiliated ambulatory clinics to overcome barriers, especially the requirement to redesign workflow.
• "Cultural and Structural Features of Zero-Burnout Primary Care Practices" by Samuel Edwards and colleagues in Health Affairs. The study was based on a cross-sectional analysis of survey data from 715 small- to medium-sized primary care practices in the United States participating in the EvidenceNOW initiative and suggests that burnout prevention efforts in primary care may benefit from focusing on enhancing organization and practice culture, including promoting leadership development and fostering practice agency.

Improving Smoking and Blood Pressure Outcomes in Solo and Clinician-Owned Practices

May 2021

The EvidenceNOW Advancing Heart Health national evaluation team published "Improving Smoking and Blood Pressure Outcomes: The Interplay Between Operational and Local Context" in the current issue of The Annals of Family Medicine. The authors found that many solo and clinician-owned practices participating in the EvidenceNOW initiative implemented operational changes that improved outcomes for patients who smoked or had high blood pressure. Clinician-owned practices that implemented workflow changes increased the proportion of patients who were screened for and counseled against smoking by at least 10 percentage points. Practices that trained medical assistants to record blood pressure, as well as clinician-owned practices that recorded a second measurement after an elevated check, similarly increased the proportion of patients whose blood pressure was adequately controlled.

USPSTF Releases Final Recommendation Statements on Screening for Hypertension and Screening for Vitamin D Deficiency

April 2021

The U.S. Preventive Services Task Force (USPSTF) released final recommendation statements on Screening for Hypertension and Screening for Vitamin D Deficiency. The full statements are available on the USPSTF website.

USPSTF Releases Final Recommendation Statement on Screening for Lung Cancer

March 2021

The U.S. Preventive Services Task Force (USPSTF) released a final recommendation statement on screening for lung cancer. The full statement is available on the USPSTF website.

AHRQ Announces Interest in Health Services Research to Address Substance Use Disorder Epidemic

March 2021

AHRQ has issues a Special Emphasis Notice in health services research to prevent, identify, and treat substance use disorders with a high degree of interest in applications that respond to the following three specific areas of focus:

1. Dissemination and implementation of evidence-based, non-pharmacological and behavioral interventions that can treat multiple substances of polysubstance use in ambulatory care and primary care settings.
2. Development and testing of healthcare services interventions in primary care and ambulatory care settings to address substance use disorder that consider the social, environmental, economic, and psychological factors that contribute to substance use disorder.
3. Understanding and addressing the effect of substance use disorder on whole person health and the development and/or management of other chronic conditions.

AHRQ is especially interested in health services research applications that would reduce disparities and improve patient experience.

Please direct all inquiries to: Sebastian Tong, M.D., M.P.H. Sebastian.Tong@ahrq.hhs.gov

USPSTF Posts Draft Statements and Research Plans for Public Comment

March 2021

Draft Research Plans

• Menopausal Hormone Therapy for the Primary Prevention of Chronic Conditions in Postmenopausal Women is open for public comments through March 17.
• Screening for Autism Spectrum Disorder in Young Children is open for public comment until March 24.

Draft Recommendation Statements

• Aspirin Use to Prevent Preeclampsia and Related Morbidity and Mortality is open for public comments until March 22.
• Screening for Chlamydia and Gonorrhea is open for public comments until March 29.