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Research Studies is a monthly compilation of research articles funded by AHRQ or authored by AHRQ researchers and recently published in journals or newsletters.
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1 to 25 of 10751 Research Studies Displayed
Yakovchenko V, Morgan TR, Chinman MJ
Mapping the road to elimination: a 5-year evaluation of implementation strategies associated with hepatitis C treatment in the Veterans Health Administration.
While few countries and healthcare systems are on track to meet the World Health Organization's hepatitis C virus (HCV) elimination goals, the US Veterans Health Administration (VHA) has been a leader in these efforts. In this study the investigators aimed to determine which implementation strategies were associated with successful national viral elimination implementation within the VHA. They conducted a five-year, longitudinal cohort study of the VHA Hepatic Innovation Team (HIT) Collaborative between October 2015 and September 2019.
AHRQ-funded; HS019461.
Citation:
Yakovchenko V, Morgan TR, Chinman MJ .
Mapping the road to elimination: a 5-year evaluation of implementation strategies associated with hepatitis C treatment in the Veterans Health Administration.
BMC Health Serv Res 2021 Dec 18;21(1):1348. doi: 10.1186/s12913-021-07312-4..
Keywords:
Hepatitis, Chronic Conditions, Veterans
Wurcel AG, Essien UR, Ortiz C
Variation by race in antibiotics prescribed for hospitalized patients with skin and soft tissue infections.
This cohort study examined antibiotics prescribed and variations by race among hospitalized patients with skin and soft tissue infections (SSTIs). A subanalysis of multisite, cross-sectional data collected through a national survey of acute care hospital groups within Vizient, Inc. considering adult inpatients treated for SSTIs was used. Of the 1242 adult inpatients included from 91 US hospitals, 45% were female, 18% were Black, and 69% were White with a mean age of 58 years. Penicillin allergy with hives was found in 23%, 19% with rash, and 18% with unknown effects, with allergy found more frequent in Black patients (23%) versus White (18%). Adjusting for multiple factors, White inpatients were at an increased risk of cefazolin use and decreased risk of clindamycin use compared with Black inpatients. Cefazolin use with less likely to be prescribed to Black inpatients than White inpatients and they were likely to be prescribed clindamycin. Cefazolin is considered a first-line SSTI treatment with clindamycin not recommended given frequent dosing and high potential for adverse effects including Clostridioides difficile infection (CDI). Although penicillin allergy is described as more prevalent among White patients, the authors observed an increased prevalence among Black inpatients compared with White inpatients treated for SSTI.
Citation:
Wurcel AG, Essien UR, Ortiz C .
Variation by race in antibiotics prescribed for hospitalized patients with skin and soft tissue infections.
JAMA Netw Open 2021 Dec;4(12):e2140798. doi: 10.1001/jamanetworkopen.2021.40798..
Keywords:
Antibiotics, Skin Conditions, Racial / Ethnic Minorities, Practice Patterns, Medication
Chui MA, Berbakov ME, Gilson AM
Effectiveness and sustainment of a tailored over-the-counter medication safety intervention in community pharmacies: a randomized controlled trial.
This paper is a protocol of a pilot study to address a gap in medication safety and decrease misuse of over-the-counter (OTC) medications by older adults aged 65 years or older by creating a pharmacy “Senior Section”. The study will occur in three phases: adaptation, effectiveness using a randomized controlled trial, and sustainment. The study will take place within a regional Midwest integrated health system in conjunction with administration leadership and pharmacy sites. The authors hope this project will provide a road map for pharmacy organizations to tailor and adopt the Senior Section.
AHRQ-funded; HS027737.
Citation:
Chui MA, Berbakov ME, Gilson AM .
Effectiveness and sustainment of a tailored over-the-counter medication safety intervention in community pharmacies: a randomized controlled trial.
Res Social Adm Pharm 2022 Nov;18(11):3953-63. doi: 10.1016/j.sapharm.2022.06.008..
Keywords:
Medication, Medication: Safety, Patient Safety, Provider: Pharmacist
Fraze TK, Beidler LB, Savitz LA
"It's not just the right thing . . . It's a survival tactic": disentangling leaders' motivations and worries on social care.
The purpose of this study was to understand the motivations and concerns of health care organizations when implementing activities targeted at improving patients’ social conditions, such as housing, food, and economic insecurity. The researchers conducted semi-structured interviews with the administrators of 29 health care organizations to explore their issues around their agency’s provision of social care. Participants described an interconnected set of motivations for delivering social care: 1) doing the right thing for their patients, 2) improving health outcomes, and 3) business/ financial aspects. Administrators voiced uncertainty around a) responsible for social care, b) whether health care has the capacity and abilities to provide social care, and c) whether social care activities can be sustained. The researchers concluded that administrators of health care agencies and organizations could benefit from policy-maker guidance and support on how to effectively prioritize social care activities, partner with other sectors to provide social care, and develop the workforce that would be required to do so.
AHRQ-funded; HS024075.
Citation:
Fraze TK, Beidler LB, Savitz LA .
"It's not just the right thing . . . It's a survival tactic": disentangling leaders' motivations and worries on social care.
Med Care Res Rev 2022 Oct;79(5):701-16. doi: 10.1177/10775587211057673..
Keywords:
Social Determinants of Health, Workforce
Hoonakker PLT, Carayon P, Brown RL
A systematic review of the Consumer Emergency Care Satisfaction Scale (CECSS).
In this study, researchers systematically reviewed the literature on the Consumer Emergency Care Satisfaction Scale (CECSS) and examined its psychometric properties. Their systematic literature search resulted in 28 articles in which the CECSS was used, demonstrating that, from a psychometric perspective, the CECSS is a valid and reliable instrument. However, their study also showed that the CECSS has several weaknesses, and they made recommendations for its improvement.
AHRQ-funded; HS026624.
Citation:
Hoonakker PLT, Carayon P, Brown RL .
A systematic review of the Consumer Emergency Care Satisfaction Scale (CECSS).
J Nurs Care Qual 2022 Oct-Dec;37(4):349-55. doi: 10.1097/ncq.0000000000000636..
Keywords:
Emergency Department, Patient Experience
Chen Z, Gleason LJ, Sanghavi P
Accuracy of pressure ulcer events in US nursing home ratings.
This study investigated the accuracy of the government website Nursing Home Compare (NHC) pressure ulcer measures, which are chief indicators of nursing home patient safety. The authors identified hospital admissions for pressure ulcers and linked them to the nursing home-reported data at the patient level using Medicare fee-for-service beneficiaries who were nursing home residents between 2011 and 2017. Percentages of pressure ulcers that were appropriately reported by stage, long-stay versus short-stay status, and race was calculated. Reporting rates were low for both short-stay (70.2%) and long-stay (59.7%) for stage 2-4 pressure ulcer hospitalizations. Black residents experienced more severe pressure ulcers than White residents. Correlations between claims-based measures and NHC ratings were found to be poor.
AHRQ-funded; HS026957.
Citation:
Chen Z, Gleason LJ, Sanghavi P .
Accuracy of pressure ulcer events in US nursing home ratings.
Med Care 2022 Oct;60(10):775-83. doi: 10.1097/mlr.0000000000001763.
AHRQ-funded; HS026957..
AHRQ-funded; HS026957..
Keywords:
Elderly, Nursing Homes, Long-Term Care, Pressure Ulcers, Quality Measures, Quality of Care, Patient Safety
Severance TS, Njuguna F, Olbara G
An evaluation of the disparities affecting the underdiagnosis of pediatric cancer in Western Kenya.
This study described the international collaboration to investigate disparities affecting the underdiagnosis of pediatric cancer in Western Kenya. Estimates of cancer incidence in similar populations around the world would indicate approximately 1500 patients should be diagnosed each year. However, internal review at a large tertiary hospital noted 200-250 patients were diagnosed annually, suggesting the remaining 75-80% of patients go undiagnosed and do not receive treatment. The authors reviewed 41 malaria slides at a local referring hospital that demonstrated both morphologic and genetic evidence of leukemia. This disparity suggested a lack of education and training that were the lead factors contributing to lower rates of diagnosis.
AHRQ-funded; HS026390.
Citation:
Severance TS, Njuguna F, Olbara G .
An evaluation of the disparities affecting the underdiagnosis of pediatric cancer in Western Kenya.
Pediatr Blood Cancer 2022 Oct;69(10):e29768. doi: 10.1002/pbc.29768..
Keywords:
Children/Adolescents, Cancer, Disparities, Diagnostic Safety and Quality
Khullar D, Prasad K, Neprash H
Factors associated with patient trust in their clinicians: results from the healthy work place study.
The goal of this study was to determine workplace, clinician, and patient correlates of patient trust in their clinician. The sample used baseline data from the Healthy Work Place trial, a randomized trial of Midwest and East Coast primary care practices. Trust was found to relate mainly to several aspects of care variables (including satisfaction with explanations, overall satisfaction with provider, learning about medical conditions, and the clinician's personal manner), with lesser association with patient characteristics and clinician work conditions. Findings showed that trust was primarily related to what happens between clinicians and patients in the examination room.
AHRQ-funded; HS018160.
Citation:
Khullar D, Prasad K, Neprash H .
Factors associated with patient trust in their clinicians: results from the healthy work place study.
Health Care Manage Rev 2022 Oct-Dec;47(4):289-96. doi: 10.1097/hmr.0000000000000336..
Keywords:
Patient-Centered Healthcare, Patient Experience, Clinician-Patient Communication
Chovatiya R, Begolka WS, Thibau IJ
Financial burden and impact of atopic dermatitis out-of-pocket healthcare expenses among Black individuals in the United States.
The purpose of this study was to explain the categories and impact of out-of-pocket (OOP) healthcare expenses associated with atopic dermatitis (AD) management among black individuals. The researchers administered a voluntary online survey to 113, 502 members of the National Eczema Association. 77.3% of respondents met the participation criteria of being U.S. residents, 18 years of age and older, and self-reporting that they had AD or were the primary caregivers of individuals with AD. The study found that Blacks (74.2%) vs. non-Blacks (63.3%) reported more OOP costs for prescription medications covered (65.1%) and not covered (46.5%), by insurance, emergency room visits (22.1% vs. 11.8%), and outpatient laboratory testing (33.3% vs. 21.8%,). There was a relationship between Black race and increased household financial impact from OOP expenses, and predictors of financial impact included minimally controlled AD, systemic therapy, greater than $200 monthly OOP expenses, and Medicaid. Blacks with Medicaid had greater odds of harmful financial impact than those of black race or with Medicaid alone. The researchers concluded that there is a relationship between Black race increased OOP costs for AD, with significant financial impact to the household.
AHRQ-funded; HS026385.
Citation:
Chovatiya R, Begolka WS, Thibau IJ .
Financial burden and impact of atopic dermatitis out-of-pocket healthcare expenses among Black individuals in the United States.
Arch Dermatol Res 2022 Oct;314(8):739-47. doi: 10.1007/s00403-021-02282-3..
Keywords:
Skin Conditions, Healthcare Costs, Racial / Ethnic Minorities
Bucher BT, Yang M, Richards Steed R, BT, Yang M, Richards Steed R
Geographic proximity of family members and healthcare utilization after complex surgical procedures.
This retrospective cohort study sought to determine the relationship between a patient's proximal familial social support, defined as the geographic proximity of family members, and healthcare utilization after complex cardiovascular and oncologic procedures. The authors defined healthcare utilization outcomes as 30-day all-cause readmission unplanned readmission, nonindex hospital readmission, index hospital length of stay, and home discharge disposition. The number of first-degree relatives (FDRs) living within 30 miles of the patient was measured using 60,895 patients undergoing complex cardiovascular procedures or oncologic procedures. Compared with patients with 0 to 1 FDRs, patients with 6+ FDRs living in close proximity had significantly lower rates of all-cause readmission (12.1% vs 13.5%), unplanned readmission, nonindex readmission; higher rates of home discharge. A larger number of FDRs living within 30 miles of the patient was significantly associated with a lower likelihood of all-cause readmission, 30-day unplanned readmission, nonindex readmission; higher likelihood of home discharge; and shorter index length of stay.
AHRQ-funded; HS025776.
Citation:
Bucher BT, Yang M, Richards Steed R, BT, Yang M, Richards Steed R .
Geographic proximity of family members and healthcare utilization after complex surgical procedures.
Ann Surg 2022 Oct 1;276(4):720-31. doi: 10.1097/sla.0000000000005584..
Keywords:
Surgery, Hospital Discharge, Hospital Readmissions, Healthcare Utilization
Adhia AH, Feinglass JM, Schlick CJR
Hospital volume predicts guideline-concordant care in stage III esophageal cancer.
This study developed quality measures for management of stage III esophageal cancer including: utilization of neoadjuvant therapy, surgical sampling of at least 15 lymph nodes, resection within 60 days of chemotherapy or radiation, and completeness of resection to determine whether hospital volume varies measure adherence of published guidelines. A total of 1345 hospitals participating in the National Cancer Database from 2004 to 2016 were included. The authors examined association of volume, program accreditation, safety net status, geographic region, and patient travel distance on adequate adherence (≥85% of patients are adherent) using logistic regression modeling. The rate of adequate adherence was worst in nodal staging at 12.6% and highest for utilization of neoadjuvant therapy at 84.8%. Academic programs had the highest rate of adequate adherence for induction therapy (77.2%), timing of surgery (56.6%), and completeness of resection (78.5%) but lowest for nodal staging at only 4.4%. Every additional esophagectomy performed per year increased the odds of adequate adherence for induction therapy and completeness of resection but decreased for nodal staging.
AHRQ-funded; HS026385.
Citation:
Adhia AH, Feinglass JM, Schlick CJR .
Hospital volume predicts guideline-concordant care in stage III esophageal cancer.
Ann Thorac Surg 2022 Oct;114(4):1176-82. doi: 10.1016/j.athoracsur.2021.07.092..
Keywords:
Hospitals, Cancer, Guidelines, Evidence-Based Practice
Bourgoin A, Balaban R, Hochman M
Improving quality and safety for patients after hospital discharge: primary care as the lead integrator in postdischarge care transitions.
The purpose of this study was to explain primary care-based transition workflow processes for hospitalized patients. The researchers conducted interviews with primary care thought leaders, staff at 9 primary care sites, community agency staff, and recently discharged patients. The researchers found that primary care postdischarge workflows vary across the different settings, rarely include communications with the patient or the inpatient team during the hospitalization and vary widely across settings. The researchers recommended the use of principles for primary care practices to encourage active participation in the full spectrum of postdischarge care, from admission through the first postdischarge visit to primary care.
AHRQ-authored; AHRQ-funded; 233201500019I/HHSP23337002T.
Citation:
Bourgoin A, Balaban R, Hochman M .
Improving quality and safety for patients after hospital discharge: primary care as the lead integrator in postdischarge care transitions.
J Ambul Care Manage 2022 Oct-Dec;45(4):310-20. doi: 10.1097/jac.0000000000000433..
Keywords:
Quality of Care, Patient Safety, Hospital Discharge, Transitions of Care, Hospitals, Workflow
De Guzman KR, Pratt M, Hwang A
Patient feedback and evaluation measures of a physical activity initiative: Exercise is Medicine program.
This paper discusses patient feedback and physician documentation practices for the Exercise is Medicine (EIM) initiative to increase physical activity (PA) with the objective of preventing chronic diseases. The initiative is currently being implemented in UC San Diego Health Systems’ primary care clinics. The research included collecting and summarizing patient perceptions of EIM and its components and to identify discrepancies between patient-reported feedback and primary care provider (PCP) documentation in corresponding visit notes in the electronic medical record (EMR). A 10-item survey was distributed via MyChart to 316 patients who provided patient recall of EIM components. Patient feedback was positive with approximately 70% of patients reporting having a PA discussion with their PCP at their most recent visit. However, only 21% of these discussions were documented by PCPs using the preprogrammed smartphrase in the EMR.
AHRQ-funded; HS026517.
Citation:
De Guzman KR, Pratt M, Hwang A .
Patient feedback and evaluation measures of a physical activity initiative: Exercise is Medicine program.
Fam Pract 2022 Sep 24;39(5):813-18. doi: 10.1093/fampra/cmab178..
Keywords:
Lifestyle Changes
Corby S, Ash JS, Whittaker K
Translating ethnographic data into knowledge, skills, and attitude statements for medical scribes: a modified Delphi approach.
This paper describes the curricular framework that was developed for standardized scribe training including desired core knowledge, skills, and attitudes (KSAs). First an ethnographic study was performed at 5 varied health care organizations in the US to gather qualitative data about knowledge, skills, and attitudes. Preliminary KSA related themes were generated from the team’s analysis, followed by a modified Delphi study to finalize the KSA lists. The team identified 90 descriptions of scribe-related KSAs with three lists ultimately defined as: (1) Hands-On Learning KSA list with 47 items amenable to simulation training, (2) Didactic KSA list consisting of 32 items appropriate for didactic lecture teaching, and (3) Prerequisite KSA list consisting of 11 items centered around items scribes should learn prior to being hired or soon after being hired.
AHRQ-funded; 290200810010.
Citation:
Corby S, Ash JS, Whittaker K .
Translating ethnographic data into knowledge, skills, and attitude statements for medical scribes: a modified Delphi approach.
J Am Med Inform Assoc 2022 Sep 12;29(10):1679-87. doi: 10.1093/jamia/ocac091..
Keywords:
Electronic Health Records (EHRs), Health Information Technology (HIT)
Bradford A, Shofer M, Singh H
Measure Dx: implementing pathways to discover and learn from diagnostic errors.
This paper discusses Measure Dx, a new AHRQ resource that translates knowledge from diagnostic measurement research into actionable recommendations. This resource guides healthcare organizations to detect, analyze, and learn from diagnostic safety events as part of a continuous learning and feedback cycle. The goal of Measure Dx is to advance new frontiers in reducing preventable diagnostic harm to patients.
AHRQ-authored; AHRQ-funded; 233201500022I; HS027363.
Citation:
Bradford A, Shofer M, Singh H .
Measure Dx: implementing pathways to discover and learn from diagnostic errors.
Int J Qual Health Care 2022 Sep 10;34(3). doi: 10.1093/intqhc/mzac068..
Keywords:
Diagnostic Safety and Quality, Patient Safety, Quality Improvement, Quality of Care, Electronic Health Records (EHRs), Health Information Technology (HIT), Health Systems, Learning Health Systems
Dixit RA, Ratwani RM, Bishop JA
The impact of expanded telehealth availability on primary care utilization.
This study examined the impact of telehealth availability due to the COVID-19 pandemic and whether it may result in an unnecessary increase in utilization. The authors analyzed 4,114,651 primary care encounters from three healthcare systems between 2019 and 2021 and found little change in telehealth utilization as it became widely available.
AHRQ-funded; HS028255.
Citation:
Dixit RA, Ratwani RM, Bishop JA .
The impact of expanded telehealth availability on primary care utilization.
NPJ Digit Med 2022 Sep 9;5(1):141. doi: 10.1038/s41746-022-00685-8..
Keywords:
Telehealth, Health Information Technology (HIT), Primary Care, Healthcare Utilization
Storck KE, Gawron LM, Sanders JN
"I just had to pay the money and be supportive": a qualitative exploration of the male-partner role in contraceptive decision-making in Salt Lake City, Utah family planning clinics.
This study explored in contraceptive decision-making using interviews with 30 male-female cis-hetero couples in Salt Lake City. The participants were stratified by sex assigned at birth and current contraceptive method and either long-acting reversible contraception (LARC) vs non-LARC users. Men and women both indicated a strong desire to prevent pregnancy, and felt that men’s actual contributions to decision-making were limited. To many couples, ideal partner support centered around emotional, financial, and logistical support options and placed high importance on interpersonal communication. The decision to use a LARC method did not influence sentiments around male-partner involvement or stated desire for partner involvement.
AHRQ-funded; HS027220.
Citation:
Storck KE, Gawron LM, Sanders JN .
"I just had to pay the money and be supportive": a qualitative exploration of the male-partner role in contraceptive decision-making in Salt Lake City, Utah family planning clinics.
Contraception 2022 Sep;113:78-83. doi: 10.1016/j.contraception.2022.04.005..
Keywords:
Sexual Health, Decision Making
Cohen TN, Anger JT, Kanji FF
A novel approach for engagement in team training in high-technology surgery: the Robotic-Assisted Surgery Olympics.
The purpose of this study was to develop the “Robotic-Assisted Surgery (RAS) Olympics,” a “serious game”-based educational competition to improve the skills required to successfully perform RAS. The pilot study was conducted at an academic medical center in Southern California. Sixteen operating room members participated in the event, reporting that they preferred the RAS Olympics to traditional training, enjoyed the activity, would recommend all staff participate, felt that it was relevant to their work, and believed that they practiced and learned new techniques that would improve their practice. The participants’ confidence in their skills did not change. The researchers concluded that new information was gained about new possibilities for simultaneously engaging and training surgical staff while emphasizing RAS safety and efficiency.
AHRQ-funded; HS026491.
Citation:
Cohen TN, Anger JT, Kanji FF .
A novel approach for engagement in team training in high-technology surgery: the Robotic-Assisted Surgery Olympics.
J Patient Saf 2022 Sep 1;18(6):570-77. doi: 10.1097/pts.0000000000001056..
Keywords:
Surgery, Training, Education: Continuing Medical Education, Simulation, Teams
Laverriere EK, Fiadjoe JE, McGowan N
A prospective observational study of video laryngoscopy-guided coaching in the pediatric intensive care unit.
The primary goal of this study was to evaluate whether implementation of video laryngoscopy-guided coaching for tracheal intubation in pediatric patients is feasible with a high level of compliance and associated with a reduction in adverse tracheal intubation-associated events. Findings showed that implementation of video laryngoscopy as a supervising device with standardized coaching language was feasible with a high level of adherence, yet was not associated with an increased occurrence of any adverse tracheal intubation-associated events and oxygen desaturation.
AHRQ-funded; HS024511; HS021583; HS022464.
Citation:
Laverriere EK, Fiadjoe JE, McGowan N .
A prospective observational study of video laryngoscopy-guided coaching in the pediatric intensive care unit.
Paediatr Anaesth 2022 Sep;32(9):1015-23. doi: 10.1111/pan.14505..
Keywords:
Children/Adolescents, Intensive Care Unit (ICU), Critical Care, Education: Continuing Medical Education
Oke I, Hall N, Elze T
Adjustable suture technique is associated with fewer strabismus reoperations in the Intelligent Research in Sight Registry.
This study compared the reoperation rates of patients who underwent strabismus surgery during the first year with or without the adjustable suture technique. This retrospective cohort study looked at a total of 34,872 patients who underwent strabismus surgery with 72% undergoing horizontal muscle surgery, 17% vertical muscle surgery, and 11% combined horizonal and vertical muscle surgery. Adjustable suture surgery rates were 18% of surgeries. The overall 1-year reoperation rate was 7.7%, with 6.0% for patients treated with adjustable sutures and 8.1% for patients treated without adjustable sutures. There was a statistically significant 30% decrease in the odds of 1-year reoperation when adjustable sutures were used, a 40% increase in those with a history of prior strabismus surgery, and a 9% increase per decade of age at surgery.
AHRQ-funded; HS000063.
Citation:
Oke I, Hall N, Elze T .
Adjustable suture technique is associated with fewer strabismus reoperations in the Intelligent Research in Sight Registry.
Ophthalmology 2022 Sep;129(9):1028-33. doi: 10.1016/j.ophtha.2022.04.021..
Keywords:
Surgery, Registries
Miller-Rosales C, Lewis VA, Shortell SM
Adoption of patient engagement strategies by physician practices in the United States.
Researchers analyzed data collected from the National Survey of Healthcare Organizations and Systems (NSHOS) on physician practice adoption of patient engagement strategies. They found modest adoption of shared decision-making and motivational interviewing, and low adoption of shared medical appointments. They noted that risk-based payment reform has the potential to motivate greater practice-level patient engagement, but the extent to which it occurs may depend on internal practice capabilities.
AHRQ-funded; HS024075.
Citation:
Miller-Rosales C, Lewis VA, Shortell SM .
Adoption of patient engagement strategies by physician practices in the United States.
Med Care 2022 Sep;60(9):691-99. doi: 10.1097/mlr.0000000000001748..
Keywords:
Patient and Family Engagement, Provider: Physician, Decision Making
Hicklin K, O'Leary MC, Nambiar S
Assessing the impact of multicomponent interventions on colorectal cancer screening through simulation: what would it take to reach national screening targets in North Carolina?
The authors simulated the impact of multicomponent interventions in North Carolina over 5 years to assess the potential for meeting national screening targets for colorectal cancer (CRC). They reported that each multicomponent intervention was associated with increased CRC screening and averted both CRC cases and deaths, while three had the potential to reach screening targets.
AHRQ-funded; HS022981.
Citation:
Hicklin K, O'Leary MC, Nambiar S .
Assessing the impact of multicomponent interventions on colorectal cancer screening through simulation: what would it take to reach national screening targets in North Carolina?
Prev Med 2022 Sep;162:107126. doi: 10.1016/j.ypmed.2022.107126..
Keywords:
Cancer: Colorectal Cancer, Cancer, Screening, Colonoscopy, Prevention
Grauer A, Duran AT, Liyanage-Don NA
Association between telemedicine use and diabetes risk factor assessment and control in a primary care network.
The purpose of this retrospective cohort study was to explore whether there is a relationship between telemedicine use in primary care and risk factor assessment and control for patients with diabetes mellitus. The study included patients with diabetes mellitus ages 18-75 with a telemedicine visit in a primary care network between February 2020 and December 2020. Researchers evaluated whether low-density lipoprotein cholesterol (LDL-C), blood pressure (BP), and hemoglobin A1c (HbA1c) and were assessed for each patient. The study identified 1,824 patients with diabetes during the study period and found that telemedicine use was associated with a lower proportion of patients with all three risk factors assessed. The researchers concluded that telemedicine use was related with gaps in risk factor assessment for patients with diabetes during the COVID-19 pandemic.
AHRQ-funded; HS026121; HS024262.
Citation:
Grauer A, Duran AT, Liyanage-Don NA .
Association between telemedicine use and diabetes risk factor assessment and control in a primary care network.
J Endocrinol Invest 2022 Sep;45(9):1749-56. doi: 10.1007/s40618-022-01814-6..
Keywords:
Diabetes, Chronic Conditions, Telehealth, Health Information Technology (HIT), Primary Care, Risk
Eliason EL, A Spishak-Thomas, Steenland MW
Association of the Affordable Care Act Medicaid expansions with postpartum contraceptive use and early postpartum pregnancy.
The purpose of this study was to assess the relationship of the Affordable Care Act (ACA) Medicaid expansion with postpartum contraception use and pregnancy. The researchers found that Medicaid expansion was associated with a 7.0 percentage point increase in postpartum use of the contraceptive implant and intrauterine device LARC, a 3.1 percentage point decrease in short-acting contraception, and a 3.9 percentage point decrease in non-prescription contraceptive use overall. Increases in LARC use were concentrated among non-Hispanic, White, and Black respondents. Medicaid expansion was associated with a decrease in early postpartum pregnancy only among non-Hispanic Black respondents. The researchers concluded that the ACA Medicaid expansion improved postpartum contraceptive access and led to shifts from methods with a lower upfront out-of-pocket cost for people without insurance towards methods with the higher upfront out-of-pocket cost for people without insurance. These changes suggest that Medicaid expansions increased access to the full range of contraceptive methods.
AHRQ-funded; HS027464; HS000011
Citation:
Eliason EL, A Spishak-Thomas, Steenland MW .
Association of the Affordable Care Act Medicaid expansions with postpartum contraceptive use and early postpartum pregnancy.
Contraception 2022 Sep;113:42-48. doi: 10.1016/j.contraception.2022.02.012..
Keywords:
Sexual Health, Pregnancy, Maternal Care, Women, Medicaid, Access to Care, Policy
Thompson I, Bryant AG, Stuebe AM
Centering the patient in postpartum contraceptive counseling.
This article discusses the timing of postpartum contraceptive counseling and the fact that many health care providers believe prevention of future pregnancies is a priority in the postpartum period and that the inpatient postpartum stay is an ideal time to discuss contraception. However, this belief is not necessarily shared by the birthing parent, and they might be unready to discuss contraceptives, especially for people whose reproduction has been marginalized. The authors state that health care providers must acknowledge this harmful and racist history to change counseling practices actively and thoughtfully to best meet patient needs while simultaneously respecting patient autonomy.
AHRQ-funded; HS027260.
Citation:
Thompson I, Bryant AG, Stuebe AM .
Centering the patient in postpartum contraceptive counseling.
Clin Obstet Gynecol 2022 Sep 1;65(3):588-93. doi: 10.1097/grf.0000000000000725..
Keywords:
Maternal Care, Pregnancy, Women, Sexual Health
