National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Behavioral Health (1)
- Blood Pressure (2)
- Chronic Conditions (4)
- Community-Based Practice (1)
- COVID-19 (1)
- (-) Diabetes (6)
- Electronic Health Records (EHRs) (2)
- (-) Health Information Technology (HIT) (6)
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- Screening (1)
- Social Determinants of Health (1)
- Telehealth (3)
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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 6 of 6 Research Studies DisplayedMehta S, Lyles CR, Rubinsky AD
Social determinants of health documentation in structured and unstructured clinical data of patients with diabetes: comparative analysis.
It is not clear how accurately Electronic health records (HER) data reflect patients' lived experience of social determinants of health (SDOH). The process of manually reviewing clinical notes to retrieve SDOH information is not feasible. The purpose of this study was to apply two tools, PatientExploreR and Electronic Medical Record Search Engine (EMERSE), to identify SDOH mappings for structured and unstructured patient data. The researchers included 4,283 adult patients receiving primary care for diabetes at UCSF. The study results revealed that SDOH may be more significant in the lives of patients with diabetes than is evident from structured data recorded on EHRs. When researchers applied EMERSE NLP rules, additional information was uncovered from patient clinical notes on problems related to social connections isolation, employment, financial insecurity, housing insecurity, food insecurity, education, and stress.
AHRQ-funded; HS026383.
Citation: Mehta S, Lyles CR, Rubinsky AD .
Social determinants of health documentation in structured and unstructured clinical data of patients with diabetes: comparative analysis.
JMIR Med Inform 2023 Aug 22; 11:e46159. doi: 10.2196/46159..
Keywords: Social Determinants of Health, Diabetes, Chronic Conditions, Electronic Health Records (EHRs), Health Information Technology (HIT)
Narindrarangkura P, Alafaireet PE, Khan U
Predicting suicide attempts among people with diabetes using a large multicenter electronic health records dataset.
This study’s goal was to determine the risk factors for suicidal behaviors of people with diabetes as they have a higher risk than the general population. The authors investigated risk factors and predicted suicide attempts in people with diabetes using the Least Absolute Shrinkage and Selection Operator (LASSO) regression. They used data from Cerner Real-World Data™ and included over 3 million diabetes patients in the study. They analyzed gender-, diabetes-type, and depression-specific LASSO regression models. The study included 7764 subjects diagnosed with suicide attempts with an average age of 45. They found risk factors for suicide attempts in diabetes patients, such as being an American Indian or Alaska Native, atypical agents, benzodiazepines, and antihistamines. Amyotrophy had a negative coefficient for suicide attempts with males with diabetes but had a positive coefficient for females. Using MAOI had a negative coefficient for suicide attempts in T1DM patients. Patients less than 20 years of age had a positive coefficient for suicide in depressed and non-depressed patients with diabetes.
AHRQ-funded; HS028032.
Citation: Narindrarangkura P, Alafaireet PE, Khan U .
Predicting suicide attempts among people with diabetes using a large multicenter electronic health records dataset.
Int J Psychiatry Med 2023 Jul; 58(4):302-24. doi: 10.1177/00912174231162477..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Behavioral Health, Diabetes, Chronic Conditions
AA Payán, DD Brown, TT
AHRQ Author: Tierney
Telehealth use, care continuity, and quality: diabetes and hypertension care in community health centers before and during the COVID-19 pandemic.
In a cohort study, researchers examined the association of care continuity with diabetes and hypertension care quality in community health centers (CHCs) before and during COVID-19, and the mediating effect of telehealth. Patients with diabetes and/or hypertension with at least 2 encounters per year during 2019 and 2020 were identified via electronic health record data from 166 CHCs; multivariable logistic regression models estimated the association of care continuity with telehealth use and care processes. The results showed that higher care continuity was associated with telehealth use and A1c testing, and lower A1c and blood pressure. The researchers concluded that care continuity might facilitate telehealth use and resilient performance on process measures.
AHRQ-funded; HS022241.
Citation: AA Payán, DD Brown, TT .
Telehealth use, care continuity, and quality: diabetes and hypertension care in community health centers before and during the COVID-19 pandemic.
Med Care 2023 Apr 1;61(Suppl 1):S62-s69. doi: 10.1097/mlr.0000000000001811.
Keywords: COVID-19, Telehealth, Health Information Technology (HIT), Diabetes, Blood Pressure, Community-Based Practice, Public Health
Lenoir KM, Sandberg JC, Miller DP
Patient perspectives on a targeted text messaging campaign to encourage screening for diabetes: qualitative study.
This study investigated whether patients would be receptive to receiving text messages that alert them to a risk of having an elevated HbA(1c) in direct-to-patient alerts that use cold texting. A total of 6 focus groups were conducted at Wake Forest Baptist Health (WFBH) between September 2019 and February 2020. The participants were adult patients without diabetes who had completed an in-person visit at the Family and Community Medicine Clinic within the previous year. The investigators displayed a series of text messages and asked the participants to react to the message content and suggest improvements. Participants (n = 36) were generally receptive to the idea of receiving a text-based alert for HbA(1c) screening. The use of plain and positive language, integrating elements of personalization, and defining new processes clearly were identified by participants as modifiable content elements that could act as facilitators that would help overcome barriers to engagement with these messages. The patients’ relationship with their providers and the financial costs associated with texts and screening may affect receptiveness and engagement in this process.
AHRQ-funded; HS026803.
Citation: Lenoir KM, Sandberg JC, Miller DP .
Patient perspectives on a targeted text messaging campaign to encourage screening for diabetes: qualitative study.
JMIR Form Res 2023 Jan 17; 7:e41011. doi: 10.2196/41011..
Keywords: Diabetes, Screening, Prevention, Health Information Technology (HIT)
Fareed N, Swoboda C, Singh P
Developing and testing an integrated patient mHealth and provider dashboard application system for type 2 diabetes management among Medicaid-enrolled pregnant individuals based on a user-centered approach: mixed-methods study.
The objective of this study was to develop user specifications for a tailored and integrated technology, patient application (mHealth) and provider dashboard, that provides a complete view of Medicaid-enrolled patients with type 2 diabetes (T2D) during pregnancy and to develop prototypes based on users’ needs. Participating patients and providers stated a core set of expectations for the mHealth and dashboard applications. Participants then provided feedback to improve these applications. The authors concluded that digital health tools could transform health care among Medicaid-enrolled patients with T2D during pregnancy, with the goal of managing their blood glucose levels. Refining the stated needs and preferences of patients and providers to develop applications holds potential for tackling complicated health care issues.
AHRQ-funded; HS028822.
Citation: Fareed N, Swoboda C, Singh P .
Developing and testing an integrated patient mHealth and provider dashboard application system for type 2 diabetes management among Medicaid-enrolled pregnant individuals based on a user-centered approach: mixed-methods study.
Digit Health 2023 Jan-Dec; 9:20552076221144181. doi: 10.1177/20552076221144181..
Keywords: Patient-Centered Healthcare, Telehealth, Diabetes, Pregnancy, Chronic Conditions, Women, Health Information Technology (HIT)
Rodriguez HP, Ciemins EL, Rubio K
Health systems and telemedicine adoption for diabetes and hypertension care.
This study examined differences in telemedicine use for adults with diabetes and/or hypertension across 10 health systems and analyzed practice and patient characteristics associated with greater use. Encounter-level data from the AMGA Optum Data Warehouse for March 13, 2020 to December 31, 2020 were analyzed. This included 3,016,761 clinical encounters from 764,521 adults with diabetes and/or hypertension attributed to 1 of 1207 practice sites with at least 50 system-attributed patients. Telemedicine use time was divided into adoption (weeks 0-4), de-adoption (weeks 5-12), and maintenance (weeks 13-42) periods. Telemedicine use peaked after 4 weeks at 11-42% of weekly encounters. Small practices had lower telemedicine use for adults with diabetes during the maintenance period compared with larger practices, with ownership showing no association with telemedicine use. Practices with higher proportions of Black patients continued their expansion of telemedicine use during the de-adoption and maintenance periods.
Citation: Rodriguez HP, Ciemins EL, Rubio K .
Health systems and telemedicine adoption for diabetes and hypertension care.
Am J Manag Care 2023 Jan; 29(1):42-49. doi: 10.37765/ajmc.2023.89302..
Keywords: Telehealth, Health Information Technology (HIT), Diabetes, Blood Pressure, Chronic Conditions