National Healthcare Quality and Disparities Report
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Search All Research Studies
Topics
- (-) Asthma (14)
- Care Management (1)
- Children/Adolescents (6)
- Clinical Decision Support (CDS) (2)
- Clinician-Patient Communication (1)
- Communication (1)
- Comparative Effectiveness (1)
- Electronic Health Records (EHRs) (2)
- Emergency Department (3)
- (-) Evidence-Based Practice (14)
- Guidelines (3)
- Healthcare Delivery (1)
- Health Information Technology (HIT) (2)
- Hospitalization (2)
- Hospitals (1)
- Implementation (1)
- Inpatient Care (1)
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- Outcomes (4)
- Patient-Centered Healthcare (1)
- Patient-Centered Outcomes Research (9)
- Patient Self-Management (1)
- Prevention (2)
- Quality Improvement (2)
- Quality of Care (2)
- Racial and Ethnic Minorities (1)
- Registries (1)
- Research Methodologies (1)
- Respiratory Conditions (7)
- Treatments (1)
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 14 of 14 Research Studies DisplayedKrishnan JA, Margellos-Anast H, Kumar R
Coordinated Health Care Interventions for Childhood Asthma Gaps in Outcomes (CHICAGO) plan.
The purpose of this clinical trial was to compare an emergency-department- (ED) only intervention and home visits by community health workers for 6 months (ED-plus-home) and enhanced usual care (UC). The study enrolled children aged 5 to 11 years with uncontrolled asthma. The primary outcomes were change over 6 months in the Patient-Reported Outcomes Measurement Information System Asthma Impact Scale score in children and Satisfaction with Participation in Social Roles score in caregivers. The secondary outcomes included guideline-recommended ED discharge care and self-management. The study found that of the 373 children recruited, only 63% completed the 6-month follow-up visit. Differences in Asthma Impact Scores or caregivers' Satisfaction with Participation in Social Roles scores were not significant. However, in the intervention groups guideline-recommended ED discharge care improved significantly versus in the UC group, and self-management behaviors were significantly improved in the ED-plus-home group versus in the ED-only and UC groups.
AHRQ-funded; HS027804.
Citation: Krishnan JA, Margellos-Anast H, Kumar R .
Coordinated Health Care Interventions for Childhood Asthma Gaps in Outcomes (CHICAGO) plan.
J Allergy Clin Immunol Glob 2023 Aug; 2(3). doi: 10.1016/j.jacig.2023.100100..
Keywords: Children/Adolescents, Asthma, Respiratory Conditions, Outcomes, Patient-Centered Outcomes Research, Evidence-Based Practice, Emergency Department, Clinical Decision Support (CDS), Health Information Technology (HIT), Racial and Ethnic Minorities
Shero ST, Ammary-Risch NJ, Lomotan EA
AHRQ Author: Lomotan EA
Creating implementable clinical practice guidelines: the 2020 focused updates to the National Heart, Lung, and Blood Institute's Asthma Management Guidelines.
The authors developed evidence-based clinical practice guideline updates for asthma management focused on six topic areas. Their guideline development processes, and the implementation and dissemination activities undertaken, sought to enhance implementation ability by focusing on intrinsic factors. They concluded that enhanced collaboration during guideline development between authors, informaticists, and scientists may facilitate development of tools to support the application of recommendations to further improve guideline implementation.
AHRQ-authored.
Citation: Shero ST, Ammary-Risch NJ, Lomotan EA .
Creating implementable clinical practice guidelines: the 2020 focused updates to the National Heart, Lung, and Blood Institute's Asthma Management Guidelines.
Implement Sci Commun 2023 Mar 31; 4(1):36. doi: 10.1186/s43058-023-00417-3..
Keywords: Asthma, Respiratory Conditions, Guidelines, Evidence-Based Practice
Fleischer DM, Chan ES, Venter C
A consensus approach to the primary prevention of food allergy through nutrition: guidance from the American Academy of Allergy, Asthma, and Immunology; American College of Allergy, Asthma, and Immunology; and the Canadian Society for Allergy and Clinical
This paper provides a consensus approach to the primary prevention of pediatric food allergy through nutrition using data from a number of high-impact randomized controlled trials. Recommendations from the American Academy of Allergy, Asthma, and Immunology, American College of Allergy, Asthma, and Immunology, and the Canadian Society for Allergy and Clinical Immunology are to introduce peanut and egg around age 6 months, but not before 4 months as well as introducing other allergens. Maternal exclusion of allergens during pregnancy and/or breastfeeding to prevent food allergy is not recommended. No association was found between exclusive breast-feeding and the primary prevention of any specific food allergy.
AHRQ-funded; HS024599.
Citation: Fleischer DM, Chan ES, Venter C .
A consensus approach to the primary prevention of food allergy through nutrition: guidance from the American Academy of Allergy, Asthma, and Immunology; American College of Allergy, Asthma, and Immunology; and the Canadian Society for Allergy and Clinical
J Allergy Clin Immunol Pract 2021 Jan;9(1):22-43.e4. doi: 10.1016/j.jaip.2020.11.002..
Keywords: Asthma, Respiratory Conditions, Prevention, Guidelines, Evidence-Based Practice
Kaiser SV, Johnson MD, Walls TA
Pathways to improve pediatric asthma care: a multisite, national study of emergency department asthma pathway implementation.
This quality improvement study’s aim was to determine the effects of pediatric asthma pathway implementation in a diverse, national sample of emergency departments (EDs). Desired outcomes included systemic corticosteroid administration within 60 minutes (primary), assessment of severity at ED triage, chest radiograph use, hospital admission or transfer for higher level of care, and ED length of stay. Charts were reviewed each month by EDs for children ages 2-17 years with a primary diagnosis of asthma. A total of 83 EDs were enrolled, with 37 of them children’s hospitals, and 46 community hospitals. Seventy-three percent completed the study (n = 22,963). There was a significant increase in systematic corticosteroid administration within 60 minutes of arrival as well as increased odds of severity assessment at triage and decreased rate of change in odds of hospital admission/transfer. Chest radiograph or ED length of stay was not associated with pathway implementation.
AHRQ-funded; HS024592.
Citation: Kaiser SV, Johnson MD, Walls TA .
Pathways to improve pediatric asthma care: a multisite, national study of emergency department asthma pathway implementation.
J Pediatr 2020 Aug;223:100-07.e2. doi: 10.1016/j.jpeds.2020.02.080..
Keywords: Children/Adolescents, Emergency Department, Asthma, Quality Improvement, Quality of Care, Care Management, Healthcare Delivery, Patient-Centered Outcomes Research, Evidence-Based Practice, Outcomes
Kaiser SV, Lam Cabana, MD
Best practices in implementing inpatient pediatric asthma pathways: a qualitative study.
The objective of this study was to identify potential best practices in pathway implementation. Building upon a previous observational study in which the researchers identified higher and lower performing children's hospitals based on hospital-level changes in asthma patient length of stay after implementation of a pathway, they conducted semi-structured interviews with a sample of healthcare providers involved in pathway implementation at these hospitals. They identified several potential best practices to support pathway implementation. They recommended that hospitals implementing pathways consider applying these strategies to ensure success in improving quality of asthma care for children.
AHRQ-funded; HS024592.
Citation: Kaiser SV, Lam Cabana, MD .
Best practices in implementing inpatient pediatric asthma pathways: a qualitative study.
J Asthma 2020 Jul;57(7):744-54. doi: 10.1080/02770903.2019.1606237..
Keywords: Children/Adolescents, Asthma, Respiratory Conditions, Hospitals, Inpatient Care, Guidelines, Evidence-Based Practice, Implementation, Quality Improvement, Quality of Care
Gliklich RE, Castro M, Leavy MB
Harmonized outcome measures for use in asthma patient registries and clinical practice.
The purpose of this project was to develop a minimum set of patient and provider relevant standardized outcome measures that could be collected in asthma patient registries and clinical practice. Categorizing outcome measures using AHRQ’s supported Outcome Measures Framework (OMF), a minimum set of 21 broadly relevant measures from 13 registries was identified. Routine and consistent collection of these measures in registries and in other systems would support creation of a national research infrastructure to efficiently address new questions and improve patient management and outcomes.
AHRQ-funded; 290201400004C.
Citation: Gliklich RE, Castro M, Leavy MB .
Harmonized outcome measures for use in asthma patient registries and clinical practice.
J Allergy Clin Immunol 2019 Sep;144(3):671-81.e1. doi: 10.1016/j.jaci.2019.02.025..
Keywords: Asthma, Registries, Patient-Centered Outcomes Research, Outcomes, Evidence-Based Practice
Toy D, Braga MS, Greenhawt M
An update on allergic emergencies.
The purpose of this review was to provide an updated framework of management for allergic emergencies. The authors suggest that although fatalities resulting from anaphylaxis and asthma are rare, patient education serves an important role in preparing for unexpected emergencies, instituting prompt and appropriate treatment, and incorporating effective strategies into the lives of children and families.
AHRQ-funded; HS024599.
Citation: Toy D, Braga MS, Greenhawt M .
An update on allergic emergencies.
Curr Opin Pediatr 2019 Jun;31(3):426-32. doi: 10.1097/mop.0000000000000769..
Keywords: Children/Adolescents, Asthma, Respiratory Conditions, Emergency Department, Patient-Centered Outcomes Research, Evidence-Based Practice
Patel MR, Smith A, Leo H
Improving patient-provider communication and therapeutic practice through better integration of electronic health records in the exam room: a pilot study.
This study assessed the effectiveness of providing physicians who use electronic health records (EHRs) education for communication strategies and its impact on patient outcomes. The evidence-based Physician Asthma Care Education (PACE) program was extended in a pilot program using 18 providers and 126 adult patients with persistent asthma. Outcomes were assessed at baseline and 3- and 6-month postintervention intervals. Providers who completed the EHR-PACE program felt more confident in communicating with their patients, but there was no significant changes in patient asthma outcomes or their perceptions of their provider’s communication skills.
AHRQ-funded; HS023786.
Citation: Patel MR, Smith A, Leo H .
Improving patient-provider communication and therapeutic practice through better integration of electronic health records in the exam room: a pilot study.
Health Educ Behav 2019 Jun;46(3):484-93. doi: 10.1177/1090198118796879..
Keywords: Asthma, Clinician-Patient Communication, Communication, Electronic Health Records (EHRs), Evidence-Based Practice, Health Information Technology (HIT), Outcomes, Patient-Centered Healthcare, Patient-Centered Outcomes Research
Wheatley LM, Wood R, Nadeau K
Mind the gaps: clinical trial concepts to address unanswered questions in aeroallergen immunotherapy-an NIAID/AHRQ workshop.
A joint AHRQ and National Institute of Allergy and Infectious Diseases (NIAAD) workshop was held to develop trial concepts that could improve the use and effectiveness of aeroallergen immunotherapy (AAIT). Four different expert groups were formed to propose different study designs. These study designs would create clinical trials of long duration and would need highly characterized patient populations.
AHRQ-funded; 290200710061I.
Citation: Wheatley LM, Wood R, Nadeau K .
Mind the gaps: clinical trial concepts to address unanswered questions in aeroallergen immunotherapy-an NIAID/AHRQ workshop.
J Allergy Clin Immunol 2019 May;143(5):1711-26. doi: 10.1016/j.jaci.2019.01.032..
Keywords: Asthma, Comparative Effectiveness, Evidence-Based Practice, Prevention, Research Methodologies, Respiratory Conditions
Lin SY, Azar A, Suarez-Cuervo C
Role of sublingual immunotherapy in the treatment of asthma: an updated systematic review.
This systematic review analyzed a number of studies on sublingual immunotherapy treatment (SLIT) for asthma caused by allergies. Fourteen randomized control trials (RCTs) studies were identified to analyze effective for allergies of house mites, birch, and grasses. However, a total of 20 RCTs and 10 observational studies were identified and used in this review. The review showed moderate-to-high strength evidence that SLIT is effective in improving allergic asthma symptoms. It also reduced long-term medication use and improved FEV1.
AHRQ-funded; 290201500006I.
Citation: Lin SY, Azar A, Suarez-Cuervo C .
Role of sublingual immunotherapy in the treatment of asthma: an updated systematic review.
Int Forum Allergy Rhinol 2018 Sep;8(9):982-92. doi: 10.1002/alr.22152..
Keywords: Asthma, Evidence-Based Practice, Patient-Centered Outcomes Research, Treatments
Kaiser SV, Rodean J, Bekmezian A
Effectiveness of pediatric asthma pathways for hospitalized children: a multicenter, national analysis.
The purpose of this retrospective, multicenter cohort study was to determine if clinical pathways affect care and outcomes for children hospitalized with asthma, using an administrative database, the Pediatric Health Information System. The investigators found that clinical pathways can decrease length of stay, costs, and unnecessary antibiotic use without increasing rates of readmissions, leading to higher value care.
AHRQ-funded; HS024554.
Citation: Kaiser SV, Rodean J, Bekmezian A .
Effectiveness of pediatric asthma pathways for hospitalized children: a multicenter, national analysis.
J Pediatr 2018 Jun;197:165-71.e2. doi: 10.1016/j.jpeds.2018.01.084..
Keywords: Asthma, Children/Adolescents, Evidence-Based Practice, Hospitalization, Patient-Centered Outcomes Research, Children/Adolescents
Sobieraj DM, Baker WL, Nguyen E
Association of inhaled corticosteroids and long-acting muscarinic antagonists with asthma control in patients with uncontrolled, persistent asthma: a systematic review and meta-analysis.
The authors conducted a systematic review and meta-analysis of the effects associated with long-acting muscarinic antagonists (LAMAs) vs placebo or vs other controllers as an add-on therapy to inhaled corticosteroids. They concluded that use of LAMA compared with placebo as add-on therapy to inhaled corticosteroids was associated with a lower risk of asthma exacerbations.
AHRQ-funded; 290201500012I.
Citation: Sobieraj DM, Baker WL, Nguyen E .
Association of inhaled corticosteroids and long-acting muscarinic antagonists with asthma control in patients with uncontrolled, persistent asthma: a systematic review and meta-analysis.
JAMA 2018 Apr 10;319(14):1473-84. doi: 10.1001/jama.2018.2757.
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Keywords: Asthma, Evidence-Based Practice, Medication, Patient-Centered Outcomes Research, Respiratory Conditions
Nkoy F, Fassl B, Stone B
Improving pediatric asthma care and outcomes across multiple hospitals.
This study aimed to assess the impact of an evidence-based care process model 5 years after implementation at Primary Children's Hospital, a tertiary care facility, and after its dissemination to 7 community hospitals. The intervention resulted in sustained, long-term improvement in asthma care and outcomes at the tertiary care hospital and successful dissemination to community hospitals.
AHRQ-funded; HS018166; HS018678.
Citation: Nkoy F, Fassl B, Stone B .
Improving pediatric asthma care and outcomes across multiple hospitals.
Pediatrics 2015 Dec;136(6):e1602-10. doi: 10.1542/peds.2015-0285..
Keywords: Children/Adolescents, Asthma, Hospitalization, Evidence-Based Practice, Patient-Centered Outcomes Research
Kuhn L, Reeves K, Taylor Y
Planning for action: the impact of an asthma action plan decision support tool integrated into an electronic health record (EHR) at a large health care system.
This project aimed to embed an electronic asthma action plan decision support tool (eAAP) into the medical record to streamline evidence-based guidelines for providers at the point of care, create individualized patient handouts, and evaluate effects on disease outcomes. Its findings supports existing evidence that patient self-management plays an important role in reducing asthma exacerbations.
AHRQ-funded; HS019946.
Citation: Kuhn L, Reeves K, Taylor Y .
Planning for action: the impact of an asthma action plan decision support tool integrated into an electronic health record (EHR) at a large health care system.
J Am Board Fam Med 2015 May-Jun;28(3):382-93. doi: 10.3122/jabfm.2015.03.140248..
Keywords: Electronic Health Records (EHRs), Clinical Decision Support (CDS), Asthma, Patient Self-Management, Evidence-Based Practice