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AHRQ Research Studies

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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.

Buys DR, Kennedy RE, Williams CP
Social and demographic predictors of nutritional risk: cross-sectional analyses from the UAB Study of Aging II.
Social factors may disparately affect access to food and nutritional risk among older adults by race and gender. This study assesses these associations using the Mini Nutritional Assessment among 414 community-dwelling persons 75+ years of age in Alabama. Multivariable analyses indicated that social factors affect nutritional risk differently by race and gender. Nutritional risk interventions are warranted for older adults.
Fam Community Health 2018 Apr/Jun;41 Suppl 2 Suppl, Food Insecurity and Obesity:S33-s45. doi: 10.1097/fch.0000000000000180.
AHRQ-funded; HS013852.
View abstract on the National Library of Medicine site.
Keywords: Elderly, Nutrition, Obesity, Risk Factors, Socioeconomic Factors
Wong A, Seger DL, Slight SP
Evaluation of 'definite' anaphylaxis drug allergy alert overrides in inpatient and outpatient settings.
The aim of this study was to determine the rate of anaphylaxis overrides, the reasons for these overrides, whether the overrides were appropriate, and if harm occurred from overrides. Overrides of 'definite' anaphylaxis drug-allergy interactions were common and often appropriate. Most overrides were due to desensitizations.
Drug Saf 2018 Mar;41(3):297-302. doi: 10.1007/s40264-017-0615-1.
AHRQ-funded; HS021094.
View abstract on the National Library of Medicine site.
Keywords: Adverse Drug Events, Clinical Decision Support (CDS), Electronic Health Records, Medication Safety, Medications
Thomas HN, Hamm M, Hess R
Changes in sexual function among midlife women: "I'm older... and I'm wiser".
Researchers conducted 20 individual interviews and three focus groups among sexually active women aged 45 to 60 years (total n = 39) to explore how sexual function changes during midlife. Women described experiencing both positive and negative changes in sexual function during midlife. When negative changes occurred, women often adapted behaviorally and psychologically.
Menopause 2018 Mar;25(3):286-92. doi: 10.1097/gme.0000000000000988.
AHRQ-funded; HS022989.
View abstract on the National Library of Medicine site.
Keywords: Aging, Sexual Health, Women's Health
Sorkin DH, Amin A, Weimer DL
Hospital discharge and selecting a skilled nursing facility: a comparison of experiences and perspectives of patients and their families.
This article seeks to examine and compare the experiences and perspectives of patients and others involved in the selection of the nursing home (predominately adult children and spouses). It found that patients were the primary decision makers about 23 percent of the time but were often involved in the decision even when family members/involved others were primarily making decisions in the discharge process.
Prof Case Manag 2018 Mar/Apr;23(2):50-59. doi: 10.1097/ncm.0000000000000252.
AHRQ-funded; HS021844.
View abstract on the National Library of Medicine site.
Keywords: Decisionmaking, Hospital Discharge, Long-Term Care, Nursing Homes, Patient Experience
Ng X, dosReis S, Beardsley R
Understanding systemic lupus erythematosus patients' desired outcomes and their perceptions of the risks and benefits of using corticosteroids.
This qualitative study examined systemic lupus erythematosus (SLE) patients' most desired outcomes and their concerns with corticosteroid use in SLE treatment. The SLE patients' most desired outcomes: reduction in flares, maintenance of normal activities, minimization of treatment side effects, prevention of future organ damage, and finding a cure. The patients’ primary concerns with the adverse effects of corticosteroids: weight gain, organ damage, mood swings/irritability, sleep disturbances, and dental issues.
Lupus 2018 Mar;27(3):475-83. doi: 10.1177/0961203317726375.
AHRQ-funded; HS022135.
View abstract on the National Library of Medicine site.
Keywords: Adverse Drug Events, Medications, Patient-Centered Outcomes Research
DuGoff EH, Walden E, Ronk K
Can claims data algorithms identify the physician of record?
This study sought to determine the agreement of the primary care physician (PCP) identified by claims algorithms with the PCP of record in electronic health record data. It concluded that researchers may be more likely to identify a patient's PCP when focusing on primary care visits only; however, these algorithms perform less well among vulnerable populations and those experiencing fragmented care.
Med Care 2018 Mar;56(3):e16-e20. doi: 10.1097/mlr.0000000000000709.
AHRQ-funded; HS021899.
View abstract on the National Library of Medicine site.
Keywords: Diabetes, Elderly, Electronic Health Records, Primary Care
Agimi Y, Albert SM, Youk AO
Dementia and motor vehicle crash hospitalizations: role of physician reporting laws.
This study sought to determine the effect of physician reporting laws and state licensing requirements on crash hospitalizations among drivers with dementia. It concluded that physician reporting laws, mandated or legally protected, were not associated with a lower likelihood of dementia among crash hospitalized drivers. Vision testing at in-person renewal and in-person renewal requirements were significantly related with a lower prevalence of dementia in hospitalized older drivers.
Neurology 2018 Feb 27;90(9):e808-e13. doi: 10.1212/wnl.0000000000005022.
AHRQ-authored.
View abstract on the National Library of Medicine site.
Keywords: Dementia, Elderly, Healthcare Cost and Utilization Project (HCUP), Hospitalization, Legislation/Regulations
AHRQ Author: Steiner CA
Baggett TP, Berkowitz SA, Fung V
Prevalence of housing problems among community health center patients.
This study used data from a national survey to assess the prevalence and health-related correlates of housing problems among community health center patients. It found that, compared with those without housing problems, participants with housing problems were more likely to report health problems, emergency department use, and delays in care.
JAMA 2018 Feb 20;319(7):717-19. doi: 10.1001/jama.2017.19869.
AHRQ-funded; HS025378.
View abstract on the National Library of Medicine site.
Keywords: Community-Based Medicine, Health Services Research (HSR), Vulnerable Populations
Shah MP, Lopman BA, Tate JE
Use of Internet search data to monitor rotavirus vaccine impact in the United States, United Kingdom, and Mexico.
In this study, researchers aimed to study the correlation between internet query searches (IQS) for "rotavirus" and rotavirus disease activity in the United States, United Kingdom, and Mexico before and after introduction of rotavirus vaccine. They found positive correlation between the rotavirus IQS and laboratory reports in the United States and United Kingdom and between the rotavirus IQS and acute gastroenteritis hospitalizations in the United States and Mexico for all correlations.
J Pediatric Infect Dis Soc 2018 Feb 19;7(1):56-63. doi: 10.1093/jpids/pix004.
AHRQ-authored.
View abstract on the National Library of Medicine site.
Keywords: Healthcare Cost and Utilization Project (HCUP), Vaccination, Web-Based
AHRQ Author: Steiner CA
Desai S, McWilliams JM
Consequences of the 340B drug pricing program.
Researchers used Medicare claims and a regression-discontinuity design, taking advantage of the threshold for program eligibility among general acute care hospitals to isolate the effects of the 340B Drug Pricing Program on hospital-physician consolidation and on the outpatient administration of parenteral drugs. They concluded that the Program has been associated with hospital-physician consolidation in hematology-oncology and with more hospital-based administration of parenteral drugs in hematology-oncology and ophthalmology.
N Engl J Med 2018 Feb 8;378(6):539-48. doi: 10.1056/NEJMsa1706475.
AHRQ-funded; HS024072.
View abstract on the National Library of Medicine site.
Keywords: Health Care Costs, Health Care Payment, Hospitals, Medicare, Medications
Khan S, Biju A, Wang S
Mobile critical care recovery program (m-CCRP) for acute respiratory failure survivors: study protocol for a randomized controlled trial.
The Mobile Critical Care Recovery Program (m-CCRP) study is a two arm, randomized clinical trial. The researchers will randomize 620 patients admitted to the ICU with acute respiratory failure requiring mechanical ventilation to one of two arms - m-CCRP intervention versus attention control. Their primary aim is to assess the efficacy of m-CCRP in improving the quality of life of acute respiratory failure survivors at 12 months
Trials 2018 Feb 7;19(1):94. doi: 10.1186/s13063-018-2449-2.
AHRQ-funded; HS024384.
View abstract on the National Library of Medicine site.
Keywords: Critical Care, Intensive Care Unit (ICU), Quality of Life, Respiratory Care, Respiratory Conditions
Maciejewski ML, Hammill BG, Voils CI
Prescriber continuity and medication availability in older adults with cardiometabolic conditions.
Researchers examined whether the number of prescribers of essential medications was associated with the availability of medications, a surrogate for adherence, to manage diabetes, hypertension or dyslipidemia. They found that the number of prescribers was not significantly associated with availability of oral diabetes agents but having more prescribers is associated with increased medication availability in older Medicare beneficiaries with dyslipidemia or hypertension.
SAGE Open Med 2018 Feb 6;6:2050312118757388. doi: 10.1177/2050312118757388.
AHRQ-funded; HS023085.
View abstract on the National Library of Medicine site.
Keywords: Chronic Conditions, Elderly, Medicare, Medications, Patient Adherence
Adam GP, Di M, Cu-Uvin S
Strategies for improving the lives of US women aged 40 and above living with HIV/AIDS: an evidence map.
This work aims to identify and characterize empirical studies of strategies for the comprehensive management of women over 40, including transgender women, who live with HIV/AIDS. Few of the 37 eligible studies focused on women facing obvious challenges, such as immigrants, transgender, physically abused, or those recently released from prison. No studies focused on women caring for dependents, including children and grandchildren, or those diagnosed after age 40.
Syst Rev 2018 Feb 2;7(1):25. doi: 10.1186/s13643-018-0684-y.
AHRQ-funded; 290201500002I.
View abstract on the National Library of Medicine site.
Keywords: Evidence-based Medicine, Human Immunodeficiency Virus (HIV), Vulnerable Populations, Women's Health
Brunwasser SM, Gillham JE
Identifying moderators of response to the Penn Resiliency Program: a synthesis study.
Researchers sought to identify moderators of a cognitive-behavioral depression prevention program's effect on depressive symptoms among youth in early adolescence. Data from three randomized controlled trials of the Penn Resiliency Program (PRP) were aggregated to maximize statistical power and sample diversity. The primary analyses suggested that PRP's effects are limited to youth whose parents are unmarried.
Prev Sci 2018 Feb;19(Suppl 1):38-48. doi: 10.1007/s11121-015-0627-y.
AHRQ-funded; HS022990.
View abstract on the National Library of Medicine site.
Keywords: Adolescents, Behavioral Health, Depression, Patient-Centered Outcomes Research, Prevention and Care Management
Wasfy JH, Yeh RW
Understanding how to improve quality and value for patients with acute myocardial infarction.
The authors discuss an article in this issue of JAMA Cardiology, in which Likosky et al have set out to disentangle the types of care that have reduced mortality after acute myocardial infarction (AMI). They conclude that both from the perspective of individual patients and the health care system, very little is known about the optimal way to care for patients with AMI, particularly after the index hospitalization.
JAMA Cardiol 2018 Feb;3(2):102-03. doi: 10.1001/jamacardio.2017.4779.
Editorial accompanying AHRQ-funded study.
View abstract on the National Library of Medicine site.
Keywords: Elderly, Myocardial Infarction, Mortality, Outcomes, Quality Improvement
Wang Z, Pianosi PT, Keogh KA
The diagnostic accuracy of fractional exhaled nitric oxide testing in asthma: a systematic review and meta-analyses.
This study evaluated the diagnostic accuracy of fractional exhaled nitric oxide (FeNO) measurement in individuals with suspected asthma. It concluded that fractional exhaled nitric oxide measurement has moderate accuracy to diagnose asthma in individuals aged 5 years and older. Test performance may be modestly better in corticosteroid-naive asthmatics, children, and nonsmokers than in the general population with suspected asthma.
Mayo Clin Proc 2018 Feb;93(2):191-98. doi: 10.1016/j.mayocp.2017.11.012.
AHRQ-funded; 290201500013I.
View abstract on the National Library of Medicine site.
Keywords: Asthma, Diagnosis, Diagnostics
Valero-Elizondo J, Hong JC, Spatz ES
Persistent socioeconomic disparities in cardiovascular risk factors and health in the United States: Medical Expenditure Panel Survey 2002-2013.
This study aimed to describe the trends in prevalence of cardiovascular risk factors (CRFs) among US adults by SES from 2002 to 2013. It found that the proportion of individuals with obesity, diabetes and hypertension increased overall, with low-income groups representing a higher prevalence for each CRF. Of note, physical inactivity had the highest prevalence increase, with the "lowest-income" group observing a relative percent increase of 71.1 percent.
Atherosclerosis 2018 Feb;269:301-05. doi: 10.1016/j.atherosclerosis.2017.12.014.
AHRQ-funded; HS023000.
View abstract on the National Library of Medicine site.
Keywords: Disparities, Cardiovascular Conditions, Medical Expenditure Panel Survey (MEPS), Risk Factors, Socioeconomic Factors
Ono SS, Crabtree BF, Hemler JR
Taking innovation to scale in primary care practices: the functions of health care extension.
Health care extension is an approach to providing external support to primary care practices with the aim of diffusing innovation. EvidenceNOW was launched to rapidly disseminate and implement evidence-based guidelines for cardiovascular preventive care in the primary care setting. This article describes how cooperatives varied in their approaches to extension and provides early empirical evidence that health care extension is a feasible and potentially useful approach for providing quality improvement.
Health Aff 2018 Feb;37(2):222-30. doi: 10.1377/hlthaff.2017.1100.
AHRQ-funded; HS023940.
View abstract on the National Library of Medicine site.
Keywords: Cardiovascular Conditions, Dissemination, Evidence-based Practice, health care delivery, Primary Care
Nix M, McNamara P, Genevro J
Learning collaboratives: Insights and a new taxonomy from AHRQ's two decades of experience.
The authors examined AHRQ's experience with learning collaboratives to characterize their attributes, identify factors that might contribute to their success or failure, and assess the challenges they encountered. Building on the literature and insights from AHRQ's experience, they propose a taxonomy that can offer guidance to decision makers and funders about the factors they should consider in developing collaboratives.
Health Aff 2018 Feb;37(2):205-12. doi: 10.1377/hlthaff.2017.1144.
AHRQ-authored.
View abstract on the National Library of Medicine site.
Keywords: Collaborative Care, health care delivery, Health Care Quality, Health Care Systems, Innovations and Emerging Issues
AHRQ Author: Nix M, McNamara P, Genevro J, Vargas N, Mistry K, Fournier A, Shofer M, Lomotan E, Miller T, Ricciardi R, Bierman AS
Michelson KA, Hudgins JD, Monuteaux MC
Cardiac arrest survival in pediatric and general emergency departments.
Understanding whether pediatric emergency departments (EDs) have higher survival than general EDs may help identify ways to improve care for all patients with out-of-hospital cardiac arrest (OHCA). Researchers sought to determine if OHCA survival differs between pediatric and general EDs. In their nationally representative sample, survival from nontraumatic OHCA was higher in pediatric EDs than general EDs. Survival did not differ in traumatic OHCA.
Pediatrics 2018 Feb;141(2). doi: 10.1542/peds.2017-2741.
AHRQ-funded; HS000063.
View abstract on the National Library of Medicine site.
Keywords: Cardiovascular Conditions, Emergency Department, Healthcare Cost and Utilization Project (HCUP), Patient-Centered Outcomes Research, Pediatrics

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