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AHRQ Research Studies Date
Topics
- Access to Care (1)
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 16 of 16 Research Studies DisplayedBui LN, Knox M, Miller-Rosales C
Hospital capabilities associated with behavioral health integration within emergency departments.
The objective of this study was to identify hospital capabilities associated with behavioral health processes in emergency departments. Responses to the National Survey of Healthcare Organizations and Systems were linked American Hospital Association Annual Survey data. Most hospitals reported screening for behavioral health conditions and provided direct referrals to community-based clinicians. Approximately half the hospitals used team approaches to behavioral health. Hospitals that reported more barriers to care delivery innovations also reported less screening and usage of a team approach. The authors concluded that research and interventions which focus on removing barriers or adding processes to disseminate best practices offer a path to accelerate behavioral health integration in emergency departments.
AHRQ-funded; HS024075.
Citation: Bui LN, Knox M, Miller-Rosales C .
Hospital capabilities associated with behavioral health integration within emergency departments.
Med Care 2024 Mar; 62(3):170-74. doi: 10.1097/mlr.0000000000001973.
Keywords: Behavioral Health, Emergency Department, Hospitals, Substance Abuse, Teams, Telehealth, Health Information Technology (HIT)
Frimpong JA, Liu X, Liu L
AHRQ Author: Liu L
Adoption of electronic health record among substance use disorder treatment programs: nationwide cross-sectional survey study.
The purpose of this study was to explore the adoption of electronic health record (EHR) systems in substance use disorder (SUD) programs, with an emphasis on changes in adoption from 2014 to 2017, and identify organizational-level variables related with EHR adoption. The researchers utilized data from the 2014 and 2017 National Drug Abuse Treatment System Surveys, and analyzed 1,027 SUD programs. The study found the adoption of EHR increased significantly from 57.6% in 2014 to 69.2% in 2017. Nearly one-third of SUD programs had not yet adopted an EHR system by 2017. The researchers identified a significant increase in technology use and ownership by a parent company and a decrease in the percentage of uninsured patients in 2017 compared to 2014. Further analysis revealed significant differences by adoption status for three main barriers to adoption: 1. Costs of start-up, 2. Ongoing financial costs, and 3. Privacy or security concerns. Programs that used computerized scheduling and billing systems had a greater likelihood of adopting EHR. Ownership type, such as private nonprofit and public, or interest in taking part in a patient-centered medical home were related with a greater likelihood to adopt EHR. Overall, SUD programs were more likely to adopt an EHR system in 2017 compared to 2014.
AHRQ-authored.
Citation: Frimpong JA, Liu X, Liu L .
Adoption of electronic health record among substance use disorder treatment programs: nationwide cross-sectional survey study.
J Med Internet Res 2023 Dec 14; 25:e45238. doi: 10.2196/45238..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Substance Abuse, Behavioral Health
Button D, Levander XA, Cook RR
Substance use disorder treatment and technology access among people who use drugs in rural areas of the United States: a cross-sectional survey.
This study evaluated how technology access (cell phone use and access to the Internet) affected substance use disorder (SUD) treatment prior to COVID-19 for people who use drugs in rural areas. The authors used data from the Rural Opioid Initiative (January 2018-March 2020), which was a cross-sectional study of people with prior 30-day injection drug or nonprescribed opioid use from rural areas of 10 states. They found that out of 3,026 participants, 71% used heroin and 76% used methamphetamine with 35% having no cell phone and 10% having no prior 30-day Internet use. Having both a cell phone and the internet was associated with increased days of medication for opioid use disorder (MOUD) use and a higher likelihood of SUD counseling in the prior 30 days. Lack of cell phone was associated with decreased days of MOUD and a lower likelihood of prior 30-day SUD counseling.
AHRQ-funded; HS026370.
Citation: Button D, Levander XA, Cook RR .
Substance use disorder treatment and technology access among people who use drugs in rural areas of the United States: a cross-sectional survey.
J Rural Health 2023 Sep; 39(4):772-79. doi: 10.1111/jrh.12737..
Keywords: Substance Abuse, Behavioral Health, Rural Health, Telehealth, Health Information Technology (HIT), Opioids, Rural/Inner-City Residents
Beetham T, Fiellin DA, Busch SH
Physician response to COVID-19-driven telehealth flexibility for opioid use disorder.
This study surveyed physicians who provide opioid use disorder (OUD) treatment on their preferences and practices regarding telehealth that have evolved during the COVID-19 pandemic. A total of 1141 physicians who were publicly listed buprenorphine-prescribing physicians were surveyed. Most respondents found telehealth to be effective, with 54% who found it more effective than expected. Overall, 85% were in favor of temporary telehealth flexibility being permanently extended, and 77% would be likely to use telehealth after the COVID-19 pandemic is over.
AHRQ-funded; HS017589.
Citation: Beetham T, Fiellin DA, Busch SH .
Physician response to COVID-19-driven telehealth flexibility for opioid use disorder.
Am J Manag Care 2022 Sep;28(9):456-63. doi: 10.37765/ajmc.2022.89221..
Keywords: COVID-19, Telehealth, Health Information Technology (HIT), Opioids, Substance Abuse, Behavioral Health, Medication
Kagarmanova A, Sparkman H, Laiteerapong N
Improving the management of chronic pain, opioid use, and opioid use disorder in older adults: study protocol for i-cope study.
This article describes a protocol for an upcoming study on the planned implementation and evaluation of I-COPE (Improving Chicago Older Adult Opioid and Pain Management through Patient-centered Clinical Decision Support and Project ECHO®) to improve care for older adults with chronic pain, opioid use, and opioid use disorder (OUD). The study will be implemented in 35 clinical sites across the metropolitan Chicago area for patients aged ≥ 65 with chronic pain, opioid use, or OUD who receive primary care at one of the clinics. I-COPE includes the integration of patient-reported data on symptoms and preferences, clinical decision support tools and shared decision making into routine primary care. Primary care providers will be trained on the tools through web-based videos and an optional Project ECHO® course, entitled "Pain Management and OUD in Older Adults." A framework called RE-AIM will be used to assess the I-COPE implementation. Outcomes considered effective include an increased variety of recommended pain treatments, decreased prescriptions of higher-risk pain treatments, and decreased patient pain scores. Outcomes will be evaluated at 6 and 12 months after implementation, and PCPs participating in Project ECHO® will be evaluated on changes in knowledge, attitudes, and self-efficacy using pre- and post-course surveys.
AHRQ-funded; HS027910.
Citation: Kagarmanova A, Sparkman H, Laiteerapong N .
Improving the management of chronic pain, opioid use, and opioid use disorder in older adults: study protocol for i-cope study.
Trials 2022 Jul 27;23(1):602. doi: 10.1186/s13063-022-06537-w..
Keywords: Elderly, Pain, Chronic Conditions, Opioids, Medication, Substance Abuse, Behavioral Health, Clinical Decision Support (CDS), Shared Decision Making, Health Information Technology (HIT)
Tang LA, Jeffery AD, Leech AA
A comparison of methods to identify antenatal substance use within electronic health records.
This study described the development of a natural-language-processing-based algorithm for detecting antenatal substance use among individuals receiving perinatal care. Findings showed that the accuracy of antenatal substance use detection was improved with more stringent case definitions; however, the overall proportion of true cases confirmed by manual chart review decreased.
AHRQ-funded; HS026395.
Citation: Tang LA, Jeffery AD, Leech AA .
A comparison of methods to identify antenatal substance use within electronic health records.
Am J Obstet Gynecol MFM 2022 Mar;4(2):100535. doi: 10.1016/j.ajogmf.2021.100535..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Substance Abuse, Pregnancy, Women, Behavioral Health
Thompson HM, Sharma B, Bhalla S
Bias and fairness assessment of a natural language processing opioid misuse classifier: detection and mitigation of electronic health record data disadvantages across racial subgroups.
The objective of this study was to assess fairness and bias of a previously validated machine learning opioid misuse classifier. Two experiments were conducted with the classifier's original and external validation datasets from 2 health systems. Bias was assessed via testing for differences in type II error rates across racial/ethnic subgroups (Black, Hispanic/Latinx, White, Other) using bootstrapped 95% confidence intervals. The investigators concluded that standardized, transparent bias assessments were needed to improve trustworthiness in clinical machine learning models.
AHRQ-funded; HS026385.
Citation: Thompson HM, Sharma B, Bhalla S .
Bias and fairness assessment of a natural language processing opioid misuse classifier: detection and mitigation of electronic health record data disadvantages across racial subgroups.
J Am Med Inform Assoc 2021 Oct 12;28(11):2393-403. doi: 10.1093/jamia/ocab148..
Keywords: Opioids, Substance Abuse, Electronic Health Records (EHRs), Health Information Technology (HIT), Racial and Ethnic Minorities
Yang J, Landrum MB, Zhou L
Disparities in outpatient visits for mental health and/or substance use disorders during the COVID surge and partial reopening in Massachusetts.
The purpose of this study was to examine changes in outpatient visits for mental health and/or substance use disorders (MH/SUD) in an integrated healthcare organization during the initial Massachusetts COVID-19 surge and partial state reopening. The investigators concluded that MH/SUD visit volume increased during the COVID surge and was supported by rapidly-scaled telemedicine.
AHRQ-funded; HS025375.
Citation: Yang J, Landrum MB, Zhou L .
Disparities in outpatient visits for mental health and/or substance use disorders during the COVID surge and partial reopening in Massachusetts.
Gen Hosp Psychiatry 2020 Nov-Dec;67:100-06. doi: 10.1016/j.genhosppsych.2020.09.004..
Keywords: Behavioral Health, Substance Abuse, COVID-19, Disparities, Access to Care, Ambulatory Care and Surgery, Telehealth, Health Information Technology (HIT)
Burner E, Zhang M, Terp S
Feasibility and acceptability of a text message-based intervention to reduce overuse of alcohol in emergency department patients: controlled proof-of-concept trial.
The objective of this study was to assess the feasibility of and patient satisfaction with a text-based mHealth extension of an emergency department (ED) screening program to reduce risky alcohol use in low-income, urban patients. A case-control study was designed using a SMS text message-capable phones to receive mROAD (mobilizing to Reduce Overuse of Alcohol in the ED), an SMS text message-based extension of the ED screening program. mROAD is a 7-day program of twice-daily SMS text messages based on the NIH Health Rethinking Drinking campaign. Of 1028 patients screened, 9.2% exhibited risky alcohol use based on the Alcohol Use Disorders Identification Test (AUDIT) in the ED. Almost a quarter of the patients did not have an SMS text-messaging capable phone, leaving 76% eligible patients. Changes in behavior were similar between the two groups. The number of drinking days reported in the prior 30 days decreased by 5 and the number of heavy drinking days decreased by 4.1. Patients reported an 11-point increase in motivation to change alcohol use via the Change Questionnaire.
AHRQ-funded; HS022402.
Citation: Burner E, Zhang M, Terp S .
Feasibility and acceptability of a text message-based intervention to reduce overuse of alcohol in emergency department patients: controlled proof-of-concept trial.
JMIR Mhealth Uhealth 2020 Jun 4;8(6):e17557. doi: 10.2196/17557..
Keywords: Alcohol Use, Substance Abuse, Emergency Department, Telehealth, Health Information Technology (HIT), Screening, Prevention
Salvador J, Bhatt S, Fowler R
Engagement with Project ECHO to increase medication-assisted treatment in rural primary care.
The purpose of this study was to understand the barriers and facilitators that affect engagement with Project ECHO (Extension for Community Healthcare Outcomes) to implement medication-assisted treatment (MAT) in primary care settings. This brief report identified key systematic challenges that may directly limit primary care providers' engagement in telementoring models such as Project ECHO.
AHRQ-funded; HS025345.
Citation: Salvador J, Bhatt S, Fowler R .
Engagement with Project ECHO to increase medication-assisted treatment in rural primary care.
Psychiatr Serv 2019 Dec;70(12):1157-60. doi: 10.1176/appi.ps.201900142..
Keywords: Opioids, Medication, Substance Abuse, Primary Care, Rural Health, Telehealth, Health Information Technology (HIT)
Kazemi DM, Borsari B, Levine MJ
Real-time demonstration of a mHealth app designed to reduce college students hazardous drinking.
The authors developed a smartphone application (SmarTrek) that targets college students and aims to reduce risky alcohol use. They found that the majority of participants agreed that SmarTrek was easy to use and that the information provided was useful and had a positive effect on decreasing their drinking.
AHRQ-funded; HS023875.
Citation: Kazemi DM, Borsari B, Levine MJ .
Real-time demonstration of a mHealth app designed to reduce college students hazardous drinking.
Psychol Serv 2019 May;16(2):255-59. doi: 10.1037/ser0000310..
Keywords: Alcohol Use, Behavioral Health, Lifestyle Changes, Health Information Technology (HIT), Substance Abuse, Telehealth, Young Adults
Marshall BDL, Green TC, Elston B
The effectiveness of internet- and field-based methods to recruit young adults who use prescription opioids nonmedically.
This study researched the effectiveness of field- and Internet-based methods to recruit young adults who are nonmedical prescription opioid (NMPO) users into intervention and treatment. Data was analyzed from the Rhode Island Young Adult Prescription Drug Study (RAPiDS). Internet-based recruitment was more successful (60.1%). Out of 198 eligible participants, median age was 25, and the majority were male, white, and resided in an urban area. Field-based recruited participants were more likely to be homeless, have been incarcerated and engage in daily NMPO use.
AHRQ-funded; HS024021.
Citation: Marshall BDL, Green TC, Elston B .
The effectiveness of internet- and field-based methods to recruit young adults who use prescription opioids nonmedically.
Subst Use Misuse 2018 Aug 24;53(10):1688-99. doi: 10.1080/10826084.2018.1425725.
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Keywords: Health Information Technology (HIT), Medication, Opioids, Substance Abuse, Young Adults
Molfenter T, Brown R, O'Neill A
Use of telemedicine in addiction treatment: current practices and organizational implementation characteristics.
Telemedicine applications offer innovative approaches for treating and reducing the effects of substance use disorders (SUDs). This analysis assessed the interest in and use of 11 telemedicine applications in a sample of 363 SUD organizations. The top three self-reported telemedicine applications being used were (1) computerized screening/assessments (44.6 percent), (2) telephone-based recovery supports (29.5 percent), and (3) telephone-based therapy (28.37 percent).
AHRQ-funded; HS024086.
Citation: Molfenter T, Brown R, O'Neill A .
Use of telemedicine in addiction treatment: current practices and organizational implementation characteristics.
Int J Telemed Appl. 2018 Mar 11;2018:3932643. doi: 10.1155/2018/3932643. .
Keywords: Health Information Technology (HIT), Substance Abuse, Telehealth
Komaromy M, Duhigg D, Metcalf A
Project ECHO (Extension for Community Healthcare Outcomes): a new model for educating primary care providers about treatment of substance use disorders.
ECHO is a distance education model that connects specialists with numerous PCPs via simultaneous video link for the purpose of facilitating case-based learning. This article describes a teleECHO clinic that is focused on treatment of substance use disorders (SUDs) and behavioral health disorders. It concluded that the ECHO model can promote expansion of access to treatment for opioid use disorder and other SUDs, particularly in underserved areas.
AHRQ-funded; HS016510.
Citation: Komaromy M, Duhigg D, Metcalf A .
Project ECHO (Extension for Community Healthcare Outcomes): a new model for educating primary care providers about treatment of substance use disorders.
Subst Abus 2016;37(1):20-4. doi: 10.1080/08897077.2015.1129388.
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Keywords: Community-Based Practice, Primary Care, Substance Abuse, Training, Health Information Technology (HIT)
Lapham GT, Rubinsky AD, Shortreed SM
Comparison of provider-documented and patient-reported brief intervention for unhealthy alcohol use in VA outpatients.
This study sought to determine if differences in how brief intervention (BI) was implemented across health systems could lead to differences in the proportion of documented BI recalled and reported by patients across health systems. It found that the association between documented BI and patient-reported BI did not vary across VA networks in adjusted logistic regression models.
AHRQ-funded; HS022800.
Citation: Lapham GT, Rubinsky AD, Shortreed SM .
Comparison of provider-documented and patient-reported brief intervention for unhealthy alcohol use in VA outpatients.
Drug Alcohol Depend 2015 Aug 1;153:159-66. doi: 10.1016/j.drugalcdep.2015.05.027..
Keywords: Alcohol Use, Electronic Health Records (EHRs), Health Information Technology (HIT), Substance Abuse
Quanbeck A, Chih MY, Isham A
Mobile delivery of treatment for alcohol use disorders: A review of the literature.
This article explores questions about mobile applications intended for patients dealing with alcohol-use disorders (AUD) s including: What mHealth applications to treat AUDs exist that have been evaluated in the peer-reviewed literature and how can they be categorized? What are common features of these applications? How effective are currently commercially available mHealth applications for AUDs? What are the characteristics, benefits, and limitations of mHealth applications for AUDs?
AHRQ-funded; HS01991702.
Citation: Quanbeck A, Chih MY, Isham A .
Mobile delivery of treatment for alcohol use disorders: A review of the literature.
Alcohol Res 2014;36(1):111-22..
Keywords: Alcohol Use, Health Information Technology (HIT), Substance Abuse, Telehealth