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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
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1 to 25 of 11623 Research Studies DisplayedSquires A, Gerchow L, Ma C
A multi-language qualitative study of limited English proficiency patient experiences in the United States.
The objective of this study was to understand the experience of limited English proficiency patients with health care services in an urban setting. Individuals who spoke either Spanish, Russian, Cantonese, Mandarin, or Korean shared their experiences through semi-structured interviews. A major theme that emerged throughout all interviews was a sense that the language barrier with clinicians posed a threat to safety when receiving healthcare. Participants also identified factors they felt would improve their sense of security specific to clinician interactions. The authors concluded that these findings highlight ongoing challenges that spoken language barriers pose at multiple points of care in the US health care system.
AHRQ-funded; HS023593.
Citation: Squires A, Gerchow L, Ma C .
A multi-language qualitative study of limited English proficiency patient experiences in the United States.
PEC Innov 2023 Dec; 2:100177. doi: 10.1016/j.pecinn.2023.100177..
Keywords: Patient Experience, Disparities, Vulnerable Populations
Huff NR, Liu G, Chimowitz H
COVID-19 related negative emotions and emotional suppression are associated with greater risk perceptions among emergency nurses: a cross-sectional study.
The objectives of this study were to investigate the relationship between emergency nurses' emotional experiences in response to the COVID-19 pandemic and their perceptions of risk to both patients and themselves, and also to investigate the extent to which the use of suppression and reappraisal processes for emotion management were associated with these perceptions. Nurses' negative emotions in response to the pandemic were associated with greater perceptions of both personal and patient safety risks. Chronic tendencies to suppress emotions uniquely predicted higher perceptions of risk. The authors concluded that understanding the factors that influence perceptions of risk are important, since these perceptions can motivate behaviors that may impact patient safety adversely.
AHRQ-funded; HS025752.
Citation: Huff NR, Liu G, Chimowitz H .
COVID-19 related negative emotions and emotional suppression are associated with greater risk perceptions among emergency nurses: a cross-sectional study.
Int J Nurs Stud Adv 2023 Dec; 5:100111. doi: 10.1016/j.ijnsa.2022.100111.
Keywords: COVID-19, Emergency Department, Provider: Nurse
Squires A, Engel P, Ma C
Continuity of care versus language concordance as an intervention to reduce hospital readmissions from home health care.
The purpose of this study was to examine the relative effectiveness of continuity of care and language concordance as alternative or complementary interventions to improve health outcomes of people with limited English proficiency. Participants included over 22,000 non-English-speaking patients from the New York City area who were admitted to their home health site following hospital discharge. Findings revealed that high continuity of care and high language concordance significantly decreased readmissions, along with high continuity of care and low language concordance; low continuity of care and high language concordance did not significantly impact readmissions. The authors concluded that enhancing continuity of care for those with language barriers the US home health system may help to address disparities and reduce hospital readmission rates.
AHRQ-funded; HS023593.
Citation: Squires A, Engel P, Ma C .
Continuity of care versus language concordance as an intervention to reduce hospital readmissions from home health care.
Med Care 2023 Sep; 61(9):605-10. doi: 10.1097/mlr.0000000000001884..
Keywords: Hospital Readmissions, Transitions of Care, Home Healthcare
Marcotte LM, Khor S, Flum DR
Factors associated with lung cancer risk factor documentation.
This cross-observational study’s objective was to identify factors associated with the minimum necessary information to determine an individual’s eligibility for lung cancer screening (ie, sufficient risk factor documentation) and to characterize clinic-level variability in documentation. The authors calculated the relative risk of sufficient lung cancer risk factor documentation by patient-, provider-, and system-level variables using Poisson regression models, clustering by clinic. They compared unadjusted, risk-adjusted, and reliability-adjusted proportions of patients with sufficient smoking documentation across 31 clinics using logistic regression models and 2-level hierarchical logit models to estimate reliability-adjusted proportions across clinics. A majority (60%) of 20,632 individuals were found to have sufficient risk factor documentation to determine screening eligibility. Patient-level factors were inversely associated with risk factor documentation including Black race, non-English preferred language, Medicaid insurance, and nonactivated patient portal, with documentation varying across clinics.
AHRQ-funded; HS026369.
Citation: Marcotte LM, Khor S, Flum DR .
Factors associated with lung cancer risk factor documentation.
Am J Manag Care 2023 Sep; 29(9):89354..
Keywords: Cancer: Lung Cancer, Cancer, Risk
Sprague BL, Ichikawa L, Eavey J
Breast cancer risk characteristics of women undergoing whole-breast ultrasound screening versus mammography alone.
This study evaluated mammography screening failure risk among women undergoing supplemental ultrasound screening in clinical practice in comparison with women undergoing mammography alone. Screening ultrasounds and screening mammograms without supplemental screening were identified within three Breast Cancer Surveillance Consortium registries. A clinically significant proportion of women who had undergone mammography screening alone were at high mammography screening failure risk. Ultrasound screening was highly targeted to women with dense breasts, but only a small proportion were high mammography screening failure risk.
AHRQ-funded; HS018366.
Citation: Sprague BL, Ichikawa L, Eavey J .
Breast cancer risk characteristics of women undergoing whole-breast ultrasound screening versus mammography alone.
Cancer 2023 Aug 15; 129(16):2456-68. doi: 10.1002/cncr.34768..
Keywords: Cancer: Breast Cancer, Cancer, Women, Imaging, Screening, Risk
Tugwell P, Welch V, Magwood O
Protocol for the development of guidance for collaborator and partner engagement in health care evidence syntheses.
The objectives of this protocol were to: Identify, map, and synthesize findings related to engagement in evidence syntheses; Explore how engagement in evidence synthesis promotes health equity; Develop equity-oriented guidance on methods for conducting, evaluating, and reporting engagement. The authors intended to use their findings to develop draft guidance checklists and assess agreement with each item through an international survey. The guidance checklists will be co-produced and after being finalized at a consensus meeting, an international team will develop guidance for collaborators and partner engagement. The authors concluded that incorporating partnership values and expectations may result in better uptake, potentially reducing health inequities.
AHRQ-authored.
Citation: Tugwell P, Welch V, Magwood O .
Protocol for the development of guidance for collaborator and partner engagement in health care evidence syntheses.
Syst Rev 2023 Aug 2; 12(1):134. doi: 10.1186/s13643-023-02279-1..
Keywords: Evidence-Based Practice, Health Services Research (HSR), Healthcare Delivery
Jones EK, Ninkovic I, Bahr M
A novel, evidence-based, comprehensive clinical decision support system improves outcomes for patients with traumatic rib fractures.
This study’s objective to investigate if a traumatic rib fracture clinical decision support system (CDSS) reduced hospital length of stay (LOS), 90-day and 1-year mortality, unplanned ICU transfer, and the need for mechanical ventilation. The CDSS included an admission evidence-based (EB) order set and a pain-inspiratory-cough (PIC) score early warning system (EWS). The CDSS was implemented at 9 US trauma centers, with 3,279 patients meeting inclusion criteria. Hospital LOS pre vs post-intervention was unchanged but unplanned transfer to the ICU was reduced, as was 1-year mortality. Provider utilization was associated with significantly reduced LOS. The EWS triggered on 34.4% of patients; however, it was not associated with a significant reduction in hospital LOS.
AHRQ-funded; HS026379.
Citation: Jones EK, Ninkovic I, Bahr M .
A novel, evidence-based, comprehensive clinical decision support system improves outcomes for patients with traumatic rib fractures.
J Trauma Acute Care Surg 2023 Aug 1; 95(2):161-71. doi: 10.1097/ta.0000000000003866..
Keywords: Clinical Decision Support (CDS), Health Information Technology (HIT), Evidence-Based Practice, Injuries and Wounds, Trauma
Russell A, Jenkins JL, Zhang A
A review of infectious disease epidemiology in emergency medical service clinicians.
This review synthesized existing literature on the prevalence, incidence, and severity of infections in emergency medical service (EMS) workforce personnel. The majority of studies that met the inclusion criteria were focused on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection; prevalence of methicillin-resistant Staphylococcus aureus (MRSA) and Hepatitis C also featured in a small number of studies. In the studies that compared infection rates between EMS clinicians and firefighters, EMS clinicians had a higher chance of hospitalization or death from SAR-CoV-2, a higher prevalence of Hepatitis C, and no significant differences in MRSA colonization. The authors concluded that more research was needed to characterize the incidence and severity of occupationally acquired infections in the EMS workforce.
AHRQ-funded; 75Q80120D00003.
Citation: Russell A, Jenkins JL, Zhang A .
A review of infectious disease epidemiology in emergency medical service clinicians.
Am J Infect Control 2023 Aug; 51(8):931-37. doi: 10.1016/j.ajic.2022.12.001..
Keywords: Infectious Diseases, Emergency Medical Services (EMS)
Rankine J, Kidd KM, Sequeira GM
Adolescent perspectives on the use of telemedicine for confidential health care: an exploratory mixed-methods study.
Gender-diverse youth (GDY) may benefit from telemedicine access but may have unique confidentiality issues; this article examined adolescents' perceived acceptability, preferences, and self-efficacy related to the use of telemedicine for confidential care. Participants included GDY and cisgender females aged 12 to 17 who were surveyed following a telemedicine visit with an adolescent medicine subspecialist. Results indicated that adolescents were interested in using telemedicine for confidential care but recognized threats to confidentiality. The authors concluded that clinicians and health systems should consider youth's preferences and unique confidentiality needs to ensure equitable access, uptake, and outcomes.
AHRQ-funded; HS026393.
Citation: Rankine J, Kidd KM, Sequeira GM .
Adolescent perspectives on the use of telemedicine for confidential health care: an exploratory mixed-methods study.
J Adolesc Health 2023 Aug; 73(2):360-66. doi: 10.1016/j.jadohealth.2023.04.005..
Keywords: Clinician-Patient Communication, Communication
Hamer 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
Sequeira GM, Kahn NF, Ricklefs C
Barriers pediatric PCP's identify to providing gender-affirming care for adolescents.
The purpose of this study was to explore pediatric primary care providers’ (PCPs) perspectives on barriers experienced in providing gender-affirming care to transgender and gender diverse (TGD) youth. Pediatric PCPs who had sought support from the Seattle Children's Gender Clinic were recruited to participate in semi-structured, one-hour interviews. They identified both health system and community-level barriers to providing gender-affirming care. The authors concluded that these barriers must be overcome in the pediatric primary care setting to ensure that TGD youth receive timely, effective, and more equitable gender-affirming care.
AHRQ-funded; HS026393.
Citation: Sequeira GM, Kahn NF, Ricklefs C .
Barriers pediatric PCP's identify to providing gender-affirming care for adolescents.
J Adolesc Health 2023 Aug; 73(2):367-74. doi: 10.1016/j.jadohealth.2023.04.007..
Keywords: Children/Adolescents, Primary Care, Access to Care
Rolfzen ML, Wick A, Mascha EJ
Best Practice Alerts Informed by Inpatient Opioid Intake to Reduce Opioid Prescribing after Surgery (PRIOR): a cluster randomized multiple crossover trial.
This study tested the hypothesis that a decision-support tool embedded in electronic health records (EHRs) leads clinicians to prescribe fewer opioids at discharge after inpatient surgery. Over 21,000 surgical inpatient discharges in a cluster randomized multiple crossover trial in four Colorado hospitals were included. The results indicated that within the context of vigorous opioid education and awareness efforts a decision-support tool incorporated into EHRs did not reduce discharge opioid prescribing for postoperative patients. The authors concluded that opioid prescribing alerts might be valuable in other contexts.
AHRQ-funded; HS027795.
Citation: Rolfzen ML, Wick A, Mascha EJ .
Best Practice Alerts Informed by Inpatient Opioid Intake to Reduce Opioid Prescribing after Surgery (PRIOR): a cluster randomized multiple crossover trial.
Anesthesiology 2023 Aug 1; 139(2):186-96. doi: 10.1097/aln.0000000000004607..
Keywords: Opioids, Medication, Surgery, Inpatient Care, Clinical Decision Support (CDS), Health Information Technology (HIT)
Nguyen JK, P P
Comparison of survival outcomes among older adults with major trauma after trauma center versus non-trauma center care in the United States.
This study’s objective was to compare level 1 and 2 trauma centers with similarly sized non-trauma centers on survival after major trauma among older adults. The authors used claims of 100% of 2012-2017 Medicare fee-for-service beneficiaries who received hospital care after major trauma. They assessed the roles of prehospital care, hospital quality, and volume. Thirty-day mortality was higher overall at level 1 versus non-trauma centers by 2.2 percentage points (pp). Thirty-day mortality was higher at level 1 versus non-trauma centers by 2.3 pp for falls and 2.3 pp for motor vehicle crashes. Outcomes were similar at level 1 and 2 trauma centers. The difference was not explained by hospital quality and volume. There were also no statistical differences in the ambulance-transported group, after adjusting for prehospital variables.
AHRQ-funded; HS025720.
Citation: Nguyen JK, P P .
Comparison of survival outcomes among older adults with major trauma after trauma center versus non-trauma center care in the United States.
Health Serv Res 2023 Aug; 58(4):817-27. doi: 10.1111/1475-6773.14148..
Keywords: Elderly, Trauma, Outcomes, Injuries and Wounds, Emergency Department, Hospitals
Roberts MM, Marino M, Wells R
Differences in use of clinical decision support tools and implementation of aspirin, blood pressure control, cholesterol management, and smoking cessation quality metrics in small practices by race and sex.
The objective of this cross-sectional study was to evaluate the association between population-based clinical decision support (CDS) tools and racial and sex disparities in the aspirin use, blood pressure control, cholesterol management, and smoking cessation (ABCS) care quality metrics among smaller primary care practices. Researchers used practice-level data from the EvidenceNOW initiative, from practices that submitted both survey data and electronic health record (EHR)-derived ABCS data stratified by race and sex. Their findings suggested that practices using CDS tools had small disparities but were not statistically significant; however, CDS tools were not associated with reductions in disparities. They concluded that more research was needed on effective practice-level interventions to mitigate disparities.
AHRQ-funded; HS023940.
Citation: Roberts MM, Marino M, Wells R .
Differences in use of clinical decision support tools and implementation of aspirin, blood pressure control, cholesterol management, and smoking cessation quality metrics in small practices by race and sex.
JAMA Netw Open 2023 Aug; 6(8):e2326905. doi: 10.1001/jamanetworkopen.2023.26905..
Keywords: Clinical Decision Support (CDS), Health Information Technology (HIT), Cardiovascular Conditions, Tobacco Use, Tobacco Use: Smoking Cessation, Primary Care, Evidence-Based Practice, Prevention
McGee-Avila JK, Richmond J, Henry KA
Disparities in geospatial patterns of cancer care within urban counties and structural inequities in access to oncology care.
This study examined geospatial patterns of cancer care utilization across diverse populations in New Jersey-a state where most residents live in urban areas. The authors used data from the New Jersey State Cancer Registry. They examined the location of cancer treatment among patients 20-65 years of age diagnosed with breast, colorectal, or invasive cervical cancer and investigated differences in geospatial patterns of care by individual and area-level (e.g., census tract-level) characteristics. They observed significant differences in geospatial patterns of cancer treatment by race/ethnicity, insurance type, and area-level factors. They found that Black patients had a 5.6% higher likelihood of receiving care within their own residential county compared to non-Hispanic White patients. Patients living in census tracts with the highest quintile of social vulnerability were 4.6% more likely to receive treatment within their residential county and were 2.7% less likely to seek out-of-state care.
AHRQ-funded; HS026122.
Citation: McGee-Avila JK, Richmond J, Henry KA .
Disparities in geospatial patterns of cancer care within urban counties and structural inequities in access to oncology care.
Health Serv Res 2023 Aug; 58(Suppl 2):152-64. doi: 10.1111/1475-6773.14182..
Keywords: Disparities, Urban Health, Rural/Inner-City Residents, Cancer, Cancer: Breast Cancer, Cancer: Colorectal Cancer, Cancer: Cervical Cancer
Markham JL, Richardson T, Stephens JR
Essential concepts for reducing bias in observational studies.
This study discussed ways to reduce bias in pediatric observational studies, which may be used instead of randomized controlled trials (RCTs) due to barriers within pediatric populations, including lower disease prevalence, high costs, inadequate funding, and additional regulatory requirements. Observational studies do not involve randomization and thus have more potential for bias when compared with RCTs because of imbalances that can exist between comparison groups. The authors describe techniques to minimize bias by controlling for important measurable covariates within observational studies and discuss the challenges and opportunities in addressing specific variables.
AHRQ-funded; HS028845.
Citation: Markham JL, Richardson T, Stephens JR .
Essential concepts for reducing bias in observational studies.
Hosp Pediatr 2023 Aug; 13(8):e234-e39. doi: 10.1542/hpeds.2023-007116..
Keywords: Research Methodologies, Health Services Research (HSR)
Brajcich BC, Johnson JK, Holl JL
Evaluation of emergency department treat-and-release encounters after major gastrointestinal surgery.
The purpose of this study was to assess the incidence of, reasons for, and predictors of emergency department treat-and-release encounters after gastrointestinal cancer operations. The researchers identified patients who underwent elective colorectal, esophageal, gastric, hepatobiliary, pancreatic, or small intestinal operations for cancer from the 2015-2017 Healthcare Cost and Utilization Project State Inpatient and State Emergency Department Databases for New York, Maryland, and Florida. The study found that among 51,527 patients at 406 hospitals, 7.9% had an ED treat-and-release encounter, and 10.8% had an ED encounter with readmission. In total, 40.7% of ED encounters were treat-and-release encounters. 12% of ED treat-and-release encounters were for pain, 11.7% for device/ostomy complaints, and 11.4% were for wound complaints (11.4%). ED treat-and-release encounters predictors included non-Hispanic Black race/ethnicity and Medicare or Medicaid coverage.
AHRQ-funded; HS026385.
Citation: Brajcich BC, Johnson JK, Holl JL .
Evaluation of emergency department treat-and-release encounters after major gastrointestinal surgery.
J Surg Oncol 2023 Aug; 128(2):402-08. doi: 10.1002/jso.27292..
Keywords: Emergency Department, Digestive Disease and Health, Surgery, Hospital Readmissions
Viswanathan M, Urrutia RP, Hudson KN
Folic acid supplementation to prevent neural tube defects: updated evidence report and systematic review for the US Preventive Services Task Force.
The objective of this evidence review was to evaluate new evidence on the benefits and harms of folic acid supplementation for the prevention of neural tube defects to inform the US Preventive Services Task Force. New evidence from observational studies provided evidence of the benefit of folic acid supplementation and no evidence of harms related to multiple gestation, autism, or maternal cancer. The new evidence was consistent with previously reviewed evidence on benefits and harms.
AHRQ-funded; 75Q80120D00007.
Citation: Viswanathan M, Urrutia RP, Hudson KN .
Folic acid supplementation to prevent neural tube defects: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2023 Aug 1; 330(5):460-66. doi: 10.1001/jama.2023.9864..
Keywords: U.S. Preventive Services Task Force (USPSTF), Evidence-Based Practice, Guidelines, Newborns/Infants, Maternal Care, Women
Sparling JL, France D, Abraham J
Handoff Effectiveness Research in periOperative environments (HERO) Design Studio: a conference report.
This conference report reviewed the historical background which led to the Handoff Effectiveness Research in periOperative environments (HERO) Design Studio. The objectives of the HERO Design Studio were to examine the existing literature base, create a national research agenda, and build the research infrastructure necessary to address critical evidence gaps in perioperative handoff quality and safety. The authors described how they prepared for the research conference and synthesized the conference’s results. They also recommended future directions regarding perioperative handoff improvement.
AHRQ-funded; HS027769.
Citation: Sparling JL, France D, Abraham J .
Handoff Effectiveness Research in periOperative environments (HERO) Design Studio: a conference report.
Jt Comm J Qual Patient Saf 2023 Aug; 49(8):422-30. doi: 10.1016/j.jcjq.2023.02.004..
Keywords: Health Information Technology (HIT), Workflow, Transitions of Care, Electronic Health Records (EHRs), Evidence-Based Practice
Ramirez M, De Anda S, Jin H
Health information-seeking behavior of Latino caregivers of people living with dementia: a mixed-methods study.
This study examined the health information-seeking behavior of Latino caregivers of people living with dementia. This mixed-methods study used a structured survey and semi-structured interviews with 21 Latino caregivers in Los Angeles, California. Semi-structured interviews were also conducted with six healthcare and social service providers. The results showed that caregivers sought information on what changes to expect as dementia progresses to be better prepared. The most common action they used was to search the Internet. However, those who did were concerned about the quality of information.
AHRQ-funded; HS00046,HS026369.
Citation: Ramirez M, De Anda S, Jin H .
Health information-seeking behavior of Latino caregivers of people living with dementia: a mixed-methods study.
J Appl Gerontol 2023 Aug; 42(8):1738-48. doi: 10.1177/07334648231163430..
Keywords: Caregiving, Dementia, Neurological Disorders, Racial and Ethnic Minorities
Kalenderian E, Bangar S, Yansane A
Identifying contributing factors associated with dental adverse events through a pragmatic electronic health record-based root cause analysis.
This study’s objective was to analyze harmful dental adverse events (AEs) to assess potential contributing factors. Harmful AEs were defined as those that resulted in temporary moderate to severe harm, required hospitalization, or resulted in permanent moderate to severe harm. The authors classified potential contributing factors according to (1) who was involved (person), (2) what were they doing (tasks), (3) what tools/technologies were they using (tools/technologies), (4) where did the event take place (environment), (5) what organizational conditions contributed to the event? (organization), (6) patient (including parents), and (7) professional-professional collaboration. A second review was conducted by a blinded panel of dental experts to confirm the presence of an AE. A total of 59 cases at 2 dental institutions had 1 or more harmful AEs. The most common harmful AE was pain (27.1%) followed by nerve injury (16.9%), hard tissue injury (15.2%), and soft tissue injury (15.2%). The most common contribution factor was the care provider (training, supervision, and fatigue at 31.5%) followed by patient ((noncompliance, unsafe practices at home, low health literacy, 17.1%), and professional-professional collaboration (15.3%).
AHRQ-funded; HS027268.
Citation: Kalenderian E, Bangar S, Yansane A .
Identifying contributing factors associated with dental adverse events through a pragmatic electronic health record-based root cause analysis.
J Patient Saf 2023 Aug 1; 19(5):305-12. doi: 10.1097/pts.0000000000001122..
Keywords: Dental and Oral Health, Adverse Events, Electronic Health Records (EHRs), Health Information Technology (HIT), Medical Errors, Patient Safety
Tarnutzer AA, Gold D, Wang Z
Impact of clinician training background and stroke location on bedside diagnostic test accuracy in the acute vestibular syndrome - a meta-analysis.
Researchers conducted a systematic review to assess the accuracy of bedside diagnosis of acute dizziness/vertigo to differentiate peripheral vestibular from central neurologic causes. Their review indicated that the Head Impulse, Nystagmus, Test of Skew (HINTS) examination by trained clinicians can differentiate peripheral from central causes and show higher diagnostic accuracy for stroke in the first 24-48 hours than MRI diffusion-weighted imaging. They concluded that these techniques should be disseminated to clinicians evaluating dizziness/vertigo.
AHRQ-funded; HS029350.
Citation: Tarnutzer AA, Gold D, Wang Z .
Impact of clinician training background and stroke location on bedside diagnostic test accuracy in the acute vestibular syndrome - a meta-analysis.
Ann Neurol 2023 Aug; 94(2):295-308. doi: 10.1002/ana.26661..
Keywords: Diagnostic Safety and Quality, Training, Education: Continuing Medical Education, Provider: Clinician, Stroke, Cardiovascular Conditions
Miller-Rosales C, Busch SH, Meara ER
Internal and environmental predictors of physician practice use of screening and medications for opioid use disorders.
This study examined the extent of screening for opioid use and availability of medications for opioid use disorder (MOUD) in a national cross-section of multi-physician primary care and multispecialty practices. The authors found that a total of 26.2% of practices offered MOUD, while 69.4% of practices screened for opioid use. Offering of MOUD in a practice was associated with having advanced HIT functionality, while access to on-site behavioral clinicians was positively associated with offering MOUD in adjusted models.
AHRQ-funded; HS024075.
Citation: Miller-Rosales C, Busch SH, Meara ER .
Internal and environmental predictors of physician practice use of screening and medications for opioid use disorders.
Med Care Res Rev 2023 Aug; 80(4):410-22. doi: 10.1177/10775587231162681..
Keywords: Opioids, Substance Abuse, Behavioral Health, Screening, Medication, Practice Patterns
Niederdeppe J, Avery RJ, Liu J
Is exposure to pharmaceutical direct-to-consumer advertising for heart disease and diabetes associated with physical activity and dietary behavior?
This study examined associations between estimated exposure to direct consumer-to-advertising (DTCA) for drugs focused on heart disease/cholesterol and diabetes and self-reported exercise and consumption of a variety of unhealthy foods (candy, sugary drinks, alcohol, and fast food). The authors estimated exposure to DTCA by combining data from Kantar Media Intelligence (Kantar) on televised pharmaceutical DTCA airings in the U.S. from January 2003 to August 2016 (n = 7,696,851 airings) with thirteen years of data from the Simmons National Consumer Survey (Simmons), a mailed survey on television viewing patterns. They estimated associations between exposure to advertising (both overall and for advertisements with specific content) and self-reported physical activity and dietary behavior using Simmons data from January 2004 to December 2016 (n = 288,483 respondents from n = 157,621 unique households in the U.S.). They found that higher estimated exposure to DTCA for heart disease and diabetes drugs were not consistently associated with meaningful differences in the frequency of engaging in regular physical activity. However, greater estimated exposure to DTCA for both diseases were linked to small but consistently higher volume of consumption of candy, sugar-sweetened beverages, alcohol, and fast food.
AHRQ-funded; HS025983.
Citation: Niederdeppe J, Avery RJ, Liu J .
Is exposure to pharmaceutical direct-to-consumer advertising for heart disease and diabetes associated with physical activity and dietary behavior?
Soc Sci Med 2023 Aug; 330:116062. doi: 10.1016/j.socscimed.2023.116062..
Keywords: Communication, Diabetes, Heart Disease and Health, Medication
Jackson-Cowan L, Silverberg JI
Longitudinal course of cognitive impairment in patients with atopic dermatitis.
This study’s objective was to investigate the longitudinal course predictors of cognitive impairment (CI) in atopic dermatitis (AD). A prospective dermatology practice-based study was performed using questionnaires and evaluation by a dermatologist (n = 210). Patients with 2 or more visits were included, and cognitive function was assessed using the Patient-Reported Outcomes Measurement Information System (PROMIS) Cognitive Function 8-item Short-Form. At baseline, 20.85% of patients had PROMIS T scores greater or equal to 45, indicating CI. Among patients with baseline CI, 34.09% had persistent CI, 47.72% had a fluctuating course, and 18.18% had sustained improvement of cognitive function. In repeated-measures regression models, cognitive function scores declined overtime in patients with worse AD severity [SCORing Atopic Dermatitis (SCORAD), Atopic Dermatitis Severity Index:, increased itch, skin pain, and sleep disturbance. Persistent CI was associated with female gender and depressive symptoms. Two classes of cognitive dysfunction were identified using latent class analysis: normal cognition (77.23%), moderate dysfunction (16.21%) and severe impairment (6.55%). Black/African-American race, moderate-to-severe SCORAD, dermatology life quality index, Patient Health Questionnaire-9 (PHQ9), itch and skin pain were more likely to experience moderate dysfunction or severe cognitive impairment.
AHRQ-funded; HS023011.
Citation: Jackson-Cowan L, Silverberg JI .
Longitudinal course of cognitive impairment in patients with atopic dermatitis.
Arch Dermatol Res 2023 Aug; 315(6):1553-60. doi: 10.1007/s00403-023-02536-2..
Keywords: Skin Conditions
