National Healthcare Quality and Disparities Report
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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
101 to 125 of 229 Research Studies DisplayedStringer KL, Azuero A, Ott C
Feasibility and acceptability of real-time antiretroviral adherence monitoring among depressed women living with HIV in the deep south of the US.
The purpose of this study was to present feasibility and acceptability data on the use of an electronic adherence monitor (EAM) among African American women in remote areas of the Southeastern United States with HIV and co-occurring depression. EAM and self-reported antiretroviral therapy (ART) adherence was monitored among 25 participants recruited at four HIV clinics in Alabama. Intra-class correlation showed a low degree of concordance between EAM and self-reported adherence. 83% of data collected via EAM was transmitted in real-time; the remainder was delayed though technological failures or was lost entirely. The authors conclude that EAM monitoring is feasible in a rural US setting but that technological difficulties may impede the device's usefulness for just-in-time adherence interventions.
AHRQ-funded; HS013852.
Citation: Stringer KL, Azuero A, Ott C .
Feasibility and acceptability of real-time antiretroviral adherence monitoring among depressed women living with HIV in the deep south of the US.
AIDS Behav 2018 May;23(5):1306-14. doi: 10.1007/s10461-018-2322-z..
Keywords: Depression, Health Information Technology (HIT), Human Immunodeficiency Virus (HIV), Medication, Behavioral Health, Patient Adherence/Compliance, Rural Health, Telehealth, Women
Mishra SR, Miller AD, Haldar S
Supporting collaborative health tracking in the hospital: patients' perspectives.
Through interviews and design probes, the authors of this study investigated hospitalized patients' health data tracking activity and analyzed their results using the stage-based personal informatics model. Their findings uncovered new directions for HCI research and highlighted ways to support patients in tracking their care and improving patient safety.
AHRQ-funded; HS022894.
Citation: Mishra SR, Miller AD, Haldar S .
Supporting collaborative health tracking in the hospital: patients' perspectives.
Proc SIGCHI Conf Hum Factor Comput Syst 2018;2018. doi: 10.1145/3173574.3174224..
Keywords: Health Information Technology (HIT), Hospitals, Health Information Technology (HIT), Patient Adherence/Compliance, Patient and Family Engagement
Ratanawongsa N, Quan J, Handley MA
Language-concordant automated telephone queries to assess medication adherence in a diverse population: a cross-sectional analysis of convergent validity with pharmacy claims.
In a multilingual urban safety net population, the researchers examined the validity of assessing adherence using automated telephone self-management (ATSM) queries, when compared with non-adherence using continuous medication gap (CMG) on pharmacy claims. They concluded that language-concordant ATSM demonstrated modest potential for assessing adherence.
AHRQ-funded; HS022561; HS023558; HS017261; HS020684.
Citation: Ratanawongsa N, Quan J, Handley MA .
Language-concordant automated telephone queries to assess medication adherence in a diverse population: a cross-sectional analysis of convergent validity with pharmacy claims.
BMC Health Serv Res 2018 Apr 6;18(1):254. doi: 10.1186/s12913-018-3071-4.
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Keywords: Health Information Technology (HIT), Medication, Patient Adherence/Compliance, Racial and Ethnic Minorities, Urban Health
Karter AJ, Parker MM, Solomon MD
Effect of out-of-pocket cost on medication initiation, adherence, and persistence among patients with type 2 diabetes: the Diabetes Study of Northern California (DISTANCE).
This study estimated the effect of out-of-pocket (OOP) cost on nonadherence to classes of cardiometabolic medications among patients with diabetes. Primary nonadherence (never dispensed) increased monotonically with OOP cost after adjusting for demographics, neighborhood socioeconomic status, Medicare, medical financial assistance, OOP maximum, deductibles, mail order pharmacy incentive and use, drug type, generic or brand, day's supply, and comorbidity index.
AHRQ-funded; HS022408.
Citation: Karter AJ, Parker MM, Solomon MD .
Effect of out-of-pocket cost on medication initiation, adherence, and persistence among patients with type 2 diabetes: the Diabetes Study of Northern California (DISTANCE).
Health Serv Res 2018 Apr;53(2):1227-47. doi: 10.1111/1475-6773.12700.
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Keywords: Diabetes, Healthcare Costs, Health Insurance, Medication, Patient Adherence/Compliance
Nguyen OK, Higashi RT, Makam AN
The influence of financial strain on health decision-making.
This study sought to explore which unmet social needs are most influential and how these needs affect individuals’ decisions regarding medical treatment and self-management of health needs among community-dwelling low-income adults. It found that financial strain, rather than any single social need, was the most important factor in health decisionmaking among the underserved adults we studied, and may result in non-adherence to medical recommendations.
AHRQ-funded; HS022418.
Citation: Nguyen OK, Higashi RT, Makam AN .
The influence of financial strain on health decision-making.
J Gen Intern Med 2018 Apr;33(4):406-08. doi: 10.1007/s11606-017-4296-3.
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Keywords: Shared Decision Making, Healthcare Costs, Patient Adherence/Compliance, Patient-Centered Healthcare, Vulnerable Populations
Aysola J, Tahirovic E, Troxel AB
A randomized controlled trial of opt-in versus opt-out enrollment into a diabetes behavioral intervention.
This study compared an opt-out default recruitment strategy with a conventional opt-in strategy for enrollment in behavioral intervention for poorly controlled diabetic patients. The patients were put in a randomized controlled trial at the University of Pennsylvania-associated primary care practices. Enrollment rates were improved for the opt-out default patients.
AHRQ-funded; HS021706.
Citation: Aysola J, Tahirovic E, Troxel AB .
A randomized controlled trial of opt-in versus opt-out enrollment into a diabetes behavioral intervention.
Am J Health Promot 2018 Mar;32(3):745-52. doi: 10.1177/0890117116671673..
Keywords: Behavioral Health, Diabetes, Lifestyle Changes, Patient Adherence/Compliance
Hansen RA, Hohmann N, Maciejewski ML
Continuity of medication management among adults with schizophrenia and comorbid cardiometabolic conditions.
This study examined whether medication adherence, inpatient admissions, and emergency department (ED) visits vary by the number and types of prescribers seen by adults with schizophrenia and cardiometabolic conditions. Greater antipsychotic adherence for adults receiving prescriptions from multiple psychiatric specialists was counteracted by lower statin adherence and greater risk of ED and inpatient utilization.
AHRQ-funded; HS023099.
Citation: Hansen RA, Hohmann N, Maciejewski ML .
Continuity of medication management among adults with schizophrenia and comorbid cardiometabolic conditions.
J Pharm Health Serv Res 2018 Mar;9(1):13-20. doi: 10.1111/jphs.12201.
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Keywords: Chronic Conditions, Medication, Behavioral Health, Patient Adherence/Compliance, Patient-Centered Healthcare
Rasmussen E, Fosnacht Morgan AM, Munson R
Use of an electronic medical record to track adherence to the mediterranean diet in a US neurology clinical practice.
The authors of this paper describe their experience with routinely capturing and analyzing Mediterranean diet data via structured clinical documentation support tools built into the electronic medical record and describe adherence to the Mediterranean diet in patients at risk for either stroke or dementia in a US neurology clinical practice.
AHRQ-funded; HS024057.
Citation: Rasmussen E, Fosnacht Morgan AM, Munson R .
Use of an electronic medical record to track adherence to the mediterranean diet in a US neurology clinical practice.
Mayo Clin Proc Innov Qual Outcomes 2018 Mar;2(1):49-59. doi: 10.1016/j.mayocpiqo.2017.12.003..
Keywords: Electronic Health Records (EHRs), Nutrition, Patient Adherence/Compliance
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.
AHRQ-funded; HS023085.
Citation: Maciejewski ML, Hammill BG, Voils CI .
Prescriber continuity and medication availability in older adults with cardiometabolic conditions.
SAGE Open Med 2018 Feb 6;6:2050312118757388. doi: 10.1177/2050312118757388.
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Keywords: Chronic Conditions, Elderly, Medicare, Medication, Patient Adherence/Compliance
Wei YJ, Simoni-Wastila L, Albrecht JS
The association of antidepressant treatment with COPD maintenance medication use and adherence in a comorbid Medicare population: a longitudinal cohort study.
Researchers examined the association between antidepressant treatment and use of and adherence to chronic obstructive pulmonary disease (COPD) maintenance medications among patients with new-onset COPD and comorbid depression. They concluded that regularly treated depression may increase use of and adherence to necessary maintenance medications for COPD.
AHRQ-funded; HS024560.
Citation: Wei YJ, Simoni-Wastila L, Albrecht JS .
The association of antidepressant treatment with COPD maintenance medication use and adherence in a comorbid Medicare population: a longitudinal cohort study.
Int J Geriatr Psychiatry 2018 Feb;33(2):e212-e20. doi: 10.1002/gps.4772.
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Keywords: Medication, Respiratory Conditions, Elderly, Patient Adherence/Compliance
Shen C, Zhao B, Liu L
Adherence to tyrosine kinase inhibitors among Medicare Part D beneficiaries with chronic myeloid leukemia.
The authors of this study identified 836 patients with chronic myeloid leukemia (CML) with Medicare Part D insurance coverage who were new tyrosine kinase inhibitors (TKI) users and examined treatment nonadherence. They indicted that the current population-based study found a significantly higher rate of nonadherence among heavily subsidized patients with substantially lower out-of-pocket costs, which suggested that future research is needed to help lower the nonadherence rate among these individuals.
AHRQ-funded; HS020263.
Citation: Shen C, Zhao B, Liu L .
Adherence to tyrosine kinase inhibitors among Medicare Part D beneficiaries with chronic myeloid leukemia.
Cancer 2018 Jan 15;124(2):364-73. doi: 10.1002/cncr.31050.
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Keywords: Chronic Conditions, Medication, Medicare, Patient Adherence/Compliance
Lau BD, Streiff MB, Kraus PS
Missed doses of venous thromboembolism (VTE) prophylaxis at community hospitals: cause for alarm.
This study examined the rate of missed doses of venous thromboembolism (VTE) prophylaxis at community hospitals in the Washington, DC and greater Baltimore metropolitan areas. This retrospective study included four hospitals within the Johns Hopkins Health System. Non-administration of VTE prophylaxis was found 10.9% to 15.0% of the time among the three community hospitals. About 43.6% of patients missed at least one dose in all four hospitals. The investigators weren’t able to categorize patients by specialty, however it has been reported that more doses are missed with medically ill patients than other hospitalized patients.
AHRQ-funded; HS024547.
Citation: Lau BD, Streiff MB, Kraus PS .
Missed doses of venous thromboembolism (VTE) prophylaxis at community hospitals: cause for alarm.
J Gen Intern Med 2018 Jan;33(1):19-20. doi: 10.1007/s11606-017-4203-y..
Keywords: Blood Clots, Prevention, Blood Thinners, Patient Adherence/Compliance, Medication, Hospitals
Belenky N, Pence BW, Cole SR
Associations between Medicare Part D and out-of-pocket spending, HIV viral load, adherence, and ADAP use in dual eligibles with HIV.
This study estimated the effect of Medicare part D on self-reported out-of-pocket prescription drug spending, AIDS Drug Assistance Program (ADAP) use, antiretroviral adherence, and HIV viral load (VL) suppression among dual eligibles with HIV. It concluded that part D was associated with increased out-of-pocket spending, although the increased spending did not seem to compromise antiretroviral therapy adherence or HIV VL suppression.
AHRQ-funded; HS024858; HS000032.
Citation: Belenky N, Pence BW, Cole SR .
Associations between Medicare Part D and out-of-pocket spending, HIV viral load, adherence, and ADAP use in dual eligibles with HIV.
Med Care 2018 Jan;56(1):47-53. doi: 10.1097/mlr.0000000000000843.
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Keywords: Healthcare Costs, Human Immunodeficiency Virus (HIV), Medication, Patient Adherence/Compliance
Pellegrini CA, Conroy DE, Phillips SM
Daily and seasonal influences on dietary self-monitoring using a smartphone application.
Researchers examined within-person variation in dietary self-monitoring during a 6-month technology-supported weight loss trial as a function of time-varying factors including time in the study, day of the week, and month of the year. They found that participants recorded less as time in the study progressed. Fewer foods were reported on the weekends compared with weekdays. More foods were self-monitored in January compared with October; however, a seasonal effect was not observed.
AHRQ-funded; HS023011.
Citation: Pellegrini CA, Conroy DE, Phillips SM .
Daily and seasonal influences on dietary self-monitoring using a smartphone application.
J Nutr Educ Behav 2018 Jan;50(1):56-61.e1. doi: 10.1016/j.jneb.2016.12.004.
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Keywords: Health Information Technology (HIT), Nutrition, Patient Adherence/Compliance, Patient Self-Management, Obesity: Weight Management
Milata JL, Otte JL, Carpenter JS
Oral endocrine therapy nonadherence, adverse effects, decisional support, and decisional needs in women with breast cancer.
Adverse effects contribute to breast cancer survivors’ decisions to stop oral endocrine therapy (OET), yet there has been little investigation of the process through which that occurs. This review serves as a call to action for providers to provide support to breast cancer survivors experiencing OET adverse effects and facing decisions related to nonadherence.
AHRQ-funded; HS024241.
Citation: Milata JL, Otte JL, Carpenter JS .
Oral endocrine therapy nonadherence, adverse effects, decisional support, and decisional needs in women with breast cancer.
Cancer Nurs 2018 Jan/Feb;41(1):E9-E18. doi: 10.1097/ncc.0000000000000430..
Keywords: Adverse Events, Cancer: Breast Cancer, Shared Decision Making, Medication, Patient Adherence/Compliance
Turan B, Rogers AJ, Rice WS
Association between perceived discrimination in healthcare settings and HIV medication adherence: mediating psychosocial mechanisms.
There is insufficient research on the impact of perceived discrimination in healthcare settings on adherence to antiretroviral therapy (ART), particularly among women living with HIV, and even less is known about psychosocial mechanisms that may mediate this association. Cross-sectional analyses were conducted in a sample of diverse women living with HIV enrolled in the Women's Interagency HIV Study (WIHS), a multi-center cohort study to investigate these issues.
AHRQ-funded; HS013852.
Citation: Turan B, Rogers AJ, Rice WS .
Association between perceived discrimination in healthcare settings and HIV medication adherence: mediating psychosocial mechanisms.
AIDS Behav 2017 Dec;21(12):3431-39. doi: 10.1007/s10461-017-1957-5..
Keywords: Human Immunodeficiency Virus (HIV), Medication, Patient Adherence/Compliance, Social Stigma
Badawy SM, Morrone K, Thompson A
Computer and mobile technology interventions to promote medication adherence and disease management in people with thalassemia.
This study aims to identify and assess the effects of computer and mobile technology interventions designed to facilitate medication adherence and disease management in individuals with thalassemia.
AHRQ-funded; HS023011.
Citation: Badawy SM, Morrone K, Thompson A .
Computer and mobile technology interventions to promote medication adherence and disease management in people with thalassemia.
Cochrane Database Syst Rev 2017 Dec;2017(12)..
Keywords: Health Information Technology (HIT), Medication, Patient Adherence/Compliance, Patient-Centered Healthcare, Patient Self-Management
Crawford J, Beaton D, Almad F
AHRQ Author: Bierman AS
Cross-cultural survey development: the colon cancer screening behaviors survey for South Asian populations.
The objective of this work was to develop a survey that considered cultural relevance and diversity of South Asian populations, with the aim of describing or predicting factors that influence colorectal cancer screening intention and adherence. The initial development of the Colon Cancer Screening Behaviours Survey for South Asian populations was completed using a number of steps. This initial survey was later cross-culturally translated and adapted into the Urdu language.
AHRQ-authored.
Citation: Crawford J, Beaton D, Almad F .
Cross-cultural survey development: the colon cancer screening behaviors survey for South Asian populations.
BMC Res Notes 2017 Dec 28;10(1):770. doi: 10.1186/s13104-017-3098-3.
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Keywords: Cancer, Cancer: Colorectal Cancer, Colonoscopy, Patient Adherence/Compliance, Racial and Ethnic Minorities, Screening
Taira DA, Seto BK, Davis JW
Examining factors associated with nonadherence and identifying providers caring for nonadherent subgroups.
This study examined racial/ethnic and regional differences in medication adherence in patients with diabetes taking oral anti-diabetic, anti-hypertensive, and cholesterol lowering medications and to identify the pharmacies and prescribers who serve these communities. After adjustment for other factors, Filipinos, Native Hawaiians, and people of other race were significantly less adherent to anti-diabetic and anti-hypertensive medications than Japanese.
AHRQ-funded; HS023185.
Citation: Taira DA, Seto BK, Davis JW .
Examining factors associated with nonadherence and identifying providers caring for nonadherent subgroups.
J Pharm Health Serv Res 2017 Dec;8(4):247-53. doi: 10.1111/jphs.12193.
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Keywords: Diabetes, Medication, Patient Adherence/Compliance, Patient-Centered Healthcare, Racial and Ethnic Minorities
Rundell SD, Gold LS, Hansen RN
Impact of co-morbidities on resource use and adherence to guidelines among commercially insured adults with new visits for back pain.
The purpose of this study was to assess if co-morbidity is associated with higher use of back-related care and adherence to back pain guidelines. The investigators found that co-morbidity burden and the presence of specific chronic conditions, such as musculoskeletal conditions, were associated with high long-term use of back-related care and care inconsistent with guidelines.
AHRQ-funded; HS022982.
Citation: Rundell SD, Gold LS, Hansen RN .
Impact of co-morbidities on resource use and adherence to guidelines among commercially insured adults with new visits for back pain.
J Eval Clin Pract 2017 Dec;23(6):1218-26. doi: 10.1111/jep.12763..
Keywords: Back Health and Pain, Guidelines, Health Services Research (HSR), Healthcare Utilization, Patient Adherence/Compliance
Oates GR, Hamby BW, Stepanikova I
Social determinants of adherence to pulmonary rehabilitation for chronic obstructive pulmonary disease.
Adherence to pulmonary rehabilitation (PR) is low. Previous studies have focused on clinical predictors of PR completion. This study aimed to identify social determinants of adherence to PR. The findings showed that, relative to high adherence, low adherence is associated with limited functional capacity and current smoking, while moderate adherence is associated with socioeconomic disadvantage. The distinction highlights different pathways to suboptimal adherence and calls for tailored intervention approaches.
AHRQ-funded; HS023009.
Citation: Oates GR, Hamby BW, Stepanikova I .
Social determinants of adherence to pulmonary rehabilitation for chronic obstructive pulmonary disease.
Copd 2017 Dec;14(6):610-17. doi: 10.1080/15412555.2017.1379070..
Keywords: Respiratory Conditions, Racial and Ethnic Minorities, Patient Adherence/Compliance, Social Determinants of Health
Albrecht JS, Khokhar B, Huang TY
Adherence and healthcare utilization among older adults with COPD and depression.
The researchers quantified the independent effects of adherence to antidepressants and chronic obstructive pulmonary disease (COPD) maintenance medications on healthcare utilization among individuals co-diagnosed with COPD and depression. They found that, compared to no use,higher levels of adherence to COPD maintenance medications were associated with decreased risk of ED visits and hospitalizations. Similarly, higher levels of adherence to antidepressants resulted in decreased risk of ED visits and hospitalization.
AHRQ-funded; HS024560.
Citation: Albrecht JS, Khokhar B, Huang TY .
Adherence and healthcare utilization among older adults with COPD and depression.
Respir Med 2017 Aug;129:53-58. doi: 10.1016/j.rmed.2017.06.002.
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Keywords: Elderly, Healthcare Utilization, Respiratory Conditions, Depression, Patient Adherence/Compliance
Flory J, Gerhard T, Stempniewicz N
Comparative adherence to diabetes drugs: an analysis of electronic health records and claims data.
The objective of this brief report is to compare adherence rates for 6 major classes of diabetes medications: metformin, sulfonylurea, thiazolidinedione, basal insulin, DPP-4 inhibitors, and GLP-1 receptor agonists. The authors note that the rates at which diabetes drugs are prescribed, and the rates at which patients actually take them, differ substantially. The authors also note that the physicians should be aware of potentially significant challenges concerning adherence to newer agents.
AHRQ-funded; HS023898.
Citation: Flory J, Gerhard T, Stempniewicz N .
Comparative adherence to diabetes drugs: an analysis of electronic health records and claims data.
Diabetes Obes Metab 2017 Aug;19(8):1184-87. doi: 10.1111/dom.12931..
Keywords: Diabetes, Electronic Health Records (EHRs), Patient Adherence/Compliance, Practice Patterns, Medication
Bandi P, Goldmann E, Parikh NS
Age-related differences in antihypertensive medication adherence in Hispanics: a cross-sectional community-based survey in New York City, 2011-2012.
US Hispanics, particularly younger adults in New York City, have a higher prevalence of uncontrolled hypertension than do people of other racial/ethnic groups. This study found that in younger adults, heavy alcohol consumption, a longer duration of hypertension, and recent poor physical health were negatively associated with high adherence. In older adults, advancing age, higher education level, high knowledge of hypertension control, and insurance status were positively associated with high adherence.
AHRQ-funded; HS022961.
Citation: Bandi P, Goldmann E, Parikh NS .
Age-related differences in antihypertensive medication adherence in Hispanics: a cross-sectional community-based survey in New York City, 2011-2012.
Prev Chronic Dis 2017 Jul 13;14:E57. doi: 10.5888/pcd14.160512.
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Keywords: Blood Pressure, Medication, Patient Adherence/Compliance, Racial and Ethnic Minorities
Grove LR, Olesiuk WJ, Ellis AR
Evaluating the potential for primary care to serve as a mental health home for people with schizophrenia.
This study examined the annual primary care and specialty mental health service utilization of adult North Carolina Medicaid enrollees with schizophrenia and at least one comorbid chronic condition who were in a medical home during 2007-2010. It concluded that medical home enrollment was associated with increased use of primary care and specialty mental health care, as well as increased medication adherence.
AHRQ-funded; HS019659; HS000032.
Citation: Grove LR, Olesiuk WJ, Ellis AR .
Evaluating the potential for primary care to serve as a mental health home for people with schizophrenia.
Gen Hosp Psychiatry 2017 Jul;47:14-19. doi: 10.1016/j.genhosppsych.2017.03.002.
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Keywords: Medication, Behavioral Health, Patient-Centered Healthcare, Patient Adherence/Compliance, Primary Care