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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 21 of 21 Research Studies DisplayedZuo SW, Ackenbom MF, Harris J
Racial differences in urinary catheter use among female nursing home residents.
This study assessed racial differences in prevalence of indwelling urinary catheterization and intermittent catheterization among female nursing home (NH) residents in the US. This cross-sectional analysis used the 2019 Minimum Data Set 3.0 and looked at a cohort of 597,966 women predominantly White race with a median age of 80 years. Eight percent of female residents had indwelling catheters, and 0.5% used intermittent catheterization. Black residents had a 7% lower odds of having an indwelling catheter, and a 38% lower odds of utilizing intermittent catheterization compared to White residents when controlling for common factors associated with catheter use.
AHRQ-funded; HS026943.
Citation: Zuo SW, Ackenbom MF, Harris J .
Racial differences in urinary catheter use among female nursing home residents.
Urology 2023 Feb; 172:105-10. doi: 10.1016/j.urology.2022.11.026..
Keywords: Elderly, Racial and Ethnic Minorities, Nursing Homes, Women
Ross RL, Rubio K, Rodriguez HP
Mammography and decision aid use for breast cancer screening in older women.
This study examines the association between practice-level decision-aid use and mammography use among older women. Physician practice responses to the 2017/2018 National Survey of Healthcare Organizations and Systems were linked to 2016-17 Medicare fee-for-service beneficiary data from eligible beneficiaries aged 65-74 years. Findings showed that health information technology-enabled automation of mammography reminders and other advanced health information technology functions may support mammography, whereas breast cancer decision aids may reduce patients' propensities to be screened through the alignment of their preferences and screening decision.
AHRQ-funded; HS022241; HS024075.
Citation: Ross RL, Rubio K, Rodriguez HP .
Mammography and decision aid use for breast cancer screening in older women.
Am J Prev Med 2022 Oct;63(4):630-35. doi: 10.1016/j.amepre.2022.04.014..
Keywords: Imaging, Screening, Shared Decision Making, Cancer: Breast Cancer, Women, Prevention, Cancer, Elderly
Bredbeck BC, Mott NM, Wang T
Facility-level variation of low-value breast cancer treatments in older women with early-stage breast cancer: analysis of a statewide claims registry.
The goal of this retrospective cohort study was to determine facility-level variation of sentinel lymph node biopsy (SLNB) and adjuvant radiotherapy in older women with early-stage, hormone receptor-positive (HR+) breast cancer who were undergoing breast-conserving surgery (BCS). Researchers used a statewide registry of claims data and included a cohort of women aged 70 or older who were diagnosed with breast cancer and who underwent BCS at 80 hospitals in the Michigan Value Collaborative. They concluded that SLNB and radiotherapy rates remain high with significant variation in utilization at the facility level, and that high utilizers of SLNB are also likely to be high utilizers of radiotherapy.
AHRQ-funded; HS026030.
Citation: Bredbeck BC, Mott NM, Wang T .
Facility-level variation of low-value breast cancer treatments in older women with early-stage breast cancer: analysis of a statewide claims registry.
Ann Surg Oncol 2022 Jul; 29(7):4155-64. doi: 10.1245/s10434-022-11631-z..
Keywords: Cancer: Breast Cancer, Cancer, Elderly, Women
Dossett LA, Mott NM, Bredbeck BC
Using tailored messages to target overuse of Low-Value breast cancer care in older women.
The purpose of this study was to examine the role that an individual’s maximizing-minimizing trait, an inherent preference for more or less medical care, may influence the preference for low-value care in the omission of sentinel lymph node biopsy (SLNB) and post-lumpectomy radiotherapy in women 70 years of age or higher with early-stage, hormone-receptor positive invasive breast cancer. The researchers recruited women 70 years of age or higher (n=1600) who were maximizers (515), minimizers (550), or neutral (535), and presented them with a hypothetical breast cancer diagnosis and then randomized exposure to one of three follow-up messages. Messages included: 1) maximizer-tailored, 2) minimizer-tailored, or 3) neutral. The study reported that higher maximizing tendency correlated positively with electing both SLNB and radiotherapy on logistic regression. Any maximizer- or minimizer-tailoring decreased preference for SLNB in maximizing and neutral women but had no effect in minimizing women. Tailoring had no impact on radiotherapy decision, except for an increased probability of minimizers electing radiotherapy when presented with maximizer-tailored messaging. The study concluded that among women facing a hypothetical breast cancer diagnosis, tendencies for maximizing-minimizing are correlated with preferences for treatment.
AHRQ-funded; HS026030.
Citation: Dossett LA, Mott NM, Bredbeck BC .
Using tailored messages to target overuse of Low-Value breast cancer care in older women.
J Surg Res 2022 Feb;270:503-12. doi: 10.1016/j.jss.2021.10.005..
Keywords: Elderly, Cancer: Breast Cancer, Cancer, Women, Shared Decision Making, Clinician-Patient Communication, Communication
Baskin AS, Wang T, Mott NM
Gaps in online breast cancer treatment information for older women.
This study’s goal was to assess the availability of web-based educational materials targeting older women facing early-stage breast cancer treatment. Routine use of sentinel lymph node biopsy (SLNB) and adjuvant radiotherapy offers no overall survival benefit and may not be perceived as desirable by older women. National guidelines allow omission of these treatments for older women. The authors systematically reviewed the top 25 hospital websites ranked as “Best Hospitals for Cancer” by U.S. News & World Report, as well as the websites of four prominent national cancer organizations. Only one national organization and no hospital websites included the recommendation to avoid routine SLNB. Only 2 hospitals and 2 national organizations included information for patients older than 70 years suggesting possible omission of adjuvant radiotherapy.
AHRQ-funded; HS026030.
Citation: Baskin AS, Wang T, Mott NM .
Gaps in online breast cancer treatment information for older women.
Ann Surg Oncol 2021 Feb;28(2):950-57. doi: 10.1245/s10434-020-08961-1..
Keywords: Elderly, Education: Patient and Caregiver, Health Information Technology (HIT), Cancer: Breast Cancer, Cancer, Women
Mott N, Wang T, Miller J
Medical maximizing-minimizing preferences in relation to low-value services for older women with hormone receptor-positive breast cancer: a qualitative study.
In this qualitative study, researchers conducted 30 semi-structured interviews with women age 70 or older without a previous diagnosis of breast cancer in order to elicit perspectives on breast cancer treatment in relation to their medical maximizing-minimizing preferences, as determined by the single-item maximizer-minimizer elicitation question (MM1). They found that medical maximizing-minimizing preferences in older women corresponded with preferences for breast cancer treatment options that guidelines identify as potentially unnecessary.
AHRQ-funded; HS026030.
Citation: Mott N, Wang T, Miller J .
Medical maximizing-minimizing preferences in relation to low-value services for older women with hormone receptor-positive breast cancer: a qualitative study.
Ann Surg Oncol 2021 Feb;28(2):941-49. doi: 10.1245/s10434-020-08924-6..
Keywords: Elderly, Women, Cancer: Breast Cancer, Cancer
Wang T, Baskin A, Miller J
Trends in breast cancer treatment de-implementation in older patients with hormone receptor-positive breast cancer: a mixed methods study.
Guidelines allow for the omission of sentinel lymph node biopsy (SLNB) and post-lumpectomy radiotherapy in women >/= 70 years of age with hormone receptor-positive (HR +) breast cancer. Despite this, national data suggest these procedures have not been widely de-implemented. The objectives of this study were to evaluate trends in SLNB and post-lumpectomy radiotherapy utilization in patients who were eligible for omission and evaluate patient preferences as a target for de-implementation of low-value care.
AHRQ-funded; HS026030.
Citation: Wang T, Baskin A, Miller J .
Trends in breast cancer treatment de-implementation in older patients with hormone receptor-positive breast cancer: a mixed methods study.
Ann Surg Oncol 2021 Feb;28(2):902-13. doi: 10.1245/s10434-020-08823-w..
Keywords: Elderly, Cancer: Breast Cancer, Cancer, Healthcare Utilization, Practice Patterns, Women
Longacre CF, Neprash HT, Shippee ND
Evaluating travel distance to radiation facilities among rural and urban breast cancer patients in the Medicare population.
This study characterizes the actual distance older breast cancer patients traveled to radiation treatment and the minimum distance necessary to reach radiation care, and examines whether any patient demographic or clinical factors are associated with greater travel distance. Findings showed that patients living in rural areas traveled on average nearly 3 times as far as those from urban areas, and their nearest facility was more than 4 times farther away. Older age, being single or widowed, and lower household income were significantly associated with shorter actual travel distance, while increasing rurality was significantly associated with greater actual and minimum travel distance to radiation treatment.
AHRQ-funded; HS026660.
Citation: Longacre CF, Neprash HT, Shippee ND .
Evaluating travel distance to radiation facilities among rural and urban breast cancer patients in the Medicare population.
J Rural Health 2020 Jun;36(3):334-46. doi: 10.1111/jrh.12413..
Keywords: Rural Health, Cancer: Breast Cancer, Cancer, Elderly, Women, Access to Care, Disparities
Garcia-Albeniz X, Hernan MA, Logan RW
Continuation of annual screening mammography and breast cancer mortality in women older than 70 years.
This study examined whether discontinuing annual mammography screening in women older than 70 years results in an increased 8-year breast cancer mortality. The researchers used data from the Medicare program and looked at over 1 million beneficiaries aged 70 to 84 who had no previous breast cancer diagnosis, and who underwent screening mammography from 2000 to 20008. The 8-year risk difference for women aged 70 to 74 years was -1.0 death per 1000 women and for women aged 75 to 84 years it was 0.07. Neither of these show substantial reductions in 8-year breast cancer mortality compared with stopping screening.
AHRQ-funded; HS023128.
Citation: Garcia-Albeniz X, Hernan MA, Logan RW .
Continuation of annual screening mammography and breast cancer mortality in women older than 70 years.
Ann Intern Med 2020 Mar 17;172(6):381-89. doi: 10.7326/m18-1199..
Keywords: Cancer: Breast Cancer, Cancer, Screening, Prevention, Women, Elderly, Mortality
Killelea BK, Evans SB, Mougalian SS
Association between perceived benefits and receipt of radiotherapy among older breast cancer patients.
This study examined perceptions of older women with stage I estrogen-receptor-positive breast cancer who underwent lumpectomy and were considering or receiving radiotherapy. Perceptions among 63 older women was that radiotherapy would reduce their 10-year-risk of local recurrent by an average of 18.7% although the literature showed only an 8% risk reduction. Participants who had the perception of a larger benefit were more likely to receive radiotherapy treatment.
AHRQ-funded; HS023900.
Citation: Killelea BK, Evans SB, Mougalian SS .
Association between perceived benefits and receipt of radiotherapy among older breast cancer patients.
Breast J 2020 Feb;26(2):231-34. doi: 10.1111/tbj.13518..
Keywords: Elderly, Cancer: Breast Cancer, Cancer, Women, Patient-Centered Outcomes Research, Shared Decision Making
Marcum ZA, Vasan S, Tom S
Self-reported barriers to medication use in older women: findings from the Women's Health Initiative.
This study examined barriers to medication use in older women, using self-reported data from the Women’s Health Initiative from 2005-2010. The prevalence of one or more barriers was measured for women taking chronic medication in these 3 target classes: antilipemics, antihypertensives, and oral hypoglycemic. Criteria also included that they took the medication for at least 1 month and then answered questions about barriers at year 4. Among older women, approximately 20% reported at least 1 barrier to medication use, and 7% reporting multiple barriers. Barriers including concerns about adverse effects, not liking to take medications, and medication costs. Women with multiple barriers were more likely to have at least one of these characteristics: a lower age, Black race, Hispanic ethnicity, or have a poorer quality of health overall.
AHRQ-funded; HS022982.
Citation: Marcum ZA, Vasan S, Tom S .
Self-reported barriers to medication use in older women: findings from the Women's Health Initiative.
J Am Pharm Assoc 2019 Nov - Dec;59(6):842-47. doi: 10.1016/j.japh.2019.07.003..
Keywords: Medication, Women, Elderly, Patient Adherence/Compliance
Hoover DS, Pappadis MR, Housten AJ
Preferences for communicating about breast cancer screening among racially/ethnically diverse older women.
The purpose of this study was to examine preferences for communicating about screening mammography among racially/ethnically diverse older women. Through in-depth interviews, findings revealed that older women desire information about the benefits and harms of screening mammography and would prefer to learn this information through discussions with healthcare providers and multiple other formats. Results were consistent regardless of participants' age, race/ethnicity, or education.
AHRQ-funded; HS022134.
Citation: Hoover DS, Pappadis MR, Housten AJ .
Preferences for communicating about breast cancer screening among racially/ethnically diverse older women.
Health Commun 2019 Jun;34(7):702-06. doi: 10.1080/10410236.2018.1431026..
Keywords: Cancer, Cancer: Breast Cancer, Clinician-Patient Communication, Communication, Elderly, Women, Prevention, Racial and Ethnic Minorities, Screening
Pappadis MR, Volk RJ, Krishnan S
Perceptions of overdetection of breast cancer among women 70 years of age and older in the USA: a mixed-methods analysis.
The authors explored older women's perceptions about the concept of overdetection of breast cancer and its influence on future screening intentions. Semistructured interviews were conducted with 59 English-speaking women aged 70 years or older with no prior history of breast cancer. The authors found that many older women did not understand the concept of overdetection, in addition to being suspicious of or resistant to the concept. Providing older women with descriptions of overdetection may not be sufficient to influence screening intentions.
AHRQ-funded; HS022134.
Citation: Pappadis MR, Volk RJ, Krishnan S .
Perceptions of overdetection of breast cancer among women 70 years of age and older in the USA: a mixed-methods analysis.
BMJ Open 2018 Jun 14;8(6):e022138. doi: 10.1136/bmjopen-2018-022138..
Keywords: Cancer: Breast Cancer, Cancer, Elderly, Screening, Shared Decision Making, Women, Prevention, Imaging
Housten AJ, Pappadis MR, Krishnan S
Resistance to discontinuing breast cancer screening in older women: a qualitative study.
Screening mammography is associated with reduced breast cancer-specific mortality; however, among older women, evidence suggests that the potential harms of screening may outweigh the benefits. This study used a qualitative approach to examine the willingness of older women from different racial/ethnic groups to discontinue breast cancer screening. The authors found that among older women who planned to continue screening, intentions to continue breast cancer screening appear to be highly resilient and resistant to recommendations from physicians or expert/government panels.
AHRQ-funded; HS022134.
Citation: Housten AJ, Pappadis MR, Krishnan S .
Resistance to discontinuing breast cancer screening in older women: a qualitative study.
Psychooncology 2018 Jun;27(6):1635-41. doi: 10.1002/pon.4708..
Keywords: Cancer: Breast Cancer, Elderly, Screening, Prevention, Women
Sanses TV, Schiltz NK, Couri BM
Functional status in older women diagnosed with pelvic organ prolapse.
The aim of this study was to describe the prevalence of functional limitations based on health status in older women with pelvic organ prolapse (POP). They found that the prevalence of functional limitations was 76.2% in strength, 44.9% in upper and 65.8% in lower body mobility. They further discovered that the odds of all functional limitations increased significantly with advancing age.
AHRQ-funded; HS023113.
Citation: Sanses TV, Schiltz NK, Couri BM .
Functional status in older women diagnosed with pelvic organ prolapse.
Am J Obstet Gynecol 2016 May;214(5):613.e1-7. doi: 10.1016/j.ajog.2015.11.038.
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Keywords: Elderly, Health Status, Women
LaFleur J, Rillamas-Sun E, Colon-Emeric CS
Fracture rates and bone density among postmenopausal veteran and non-veteran women from the Women's Health Initiative.
The authors compared fracture rates and bone mineral density for veterans and non-veterans using Women's Health Initiative data. They found that veterans had higher 10-year probabilities for any major fracture and hip fracture compared with non-veterans, but that risk of fracture at other anatomic sites did not differ by veteran status. They concluded that female veterans had an increased hip fracture rate not explained by differences in well-recognized fracture risk factors.
AHRQ-funded; HS018582.
Citation: LaFleur J, Rillamas-Sun E, Colon-Emeric CS .
Fracture rates and bone density among postmenopausal veteran and non-veteran women from the Women's Health Initiative.
Gerontologist 2016 Feb;56 Suppl 1:S78-90. doi: 10.1093/geront/gnv677.
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Keywords: Elderly, Injuries and Wounds, Osteoporosis, Women
Thomas HN, Hess R, Thurston RC
Correlates of sexual activity and satisfaction in midlife and older women.
The authors gave updated prevalence estimates of sexual activity among women and elucidated factors associated with sexual activity and sexual satisfaction. Using the National Survey of Midlife Development in the United States, they found that a considerable proportion of midlife and older women remain sexually active if they have a partner available. Additionally, psychosocial factors matter more to sexual satisfaction than aging among midlife and older women.
AHRQ-funded; HS022989.
Citation: Thomas HN, Hess R, Thurston RC .
Correlates of sexual activity and satisfaction in midlife and older women.
Ann Fam Med 2015 Jul-Aug;13(4):336-42. doi: 10.1370/afm.1820.
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Keywords: Elderly, Women, Sexual Health, Quality of Life
Suskind AM, Clemens JQ, Zhang Y
Physician use of sacral neuromodulation among Medicare beneficiaries with overactive bladder and urinary retention.
This study identified physician-level factors associated with high rates of sacral neuromodulation testing. It found that, over time, physicians are testing more patients but are not implanting more devices. Additionally, there is an inverse relationship between rates of device testing and implantation, suggesting opportunities to improve efficiency and resource utilization.
AHRQ-funded; HS018726.
Citation: Suskind AM, Clemens JQ, Zhang Y .
Physician use of sacral neuromodulation among Medicare beneficiaries with overactive bladder and urinary retention.
Urology 2015 Jul;86(1):30-4. doi: 10.1016/j.urology.2015.04.003..
Keywords: Elderly, Medicare, Treatments, Women
Vyas A, Madhavan S, Sambamoorthi U
Association between persistence with mammography screening and stage at diagnosis among elderly women diagnosed with breast cancer.
The objective of this study is to determine the association between persistence with mammography screening and stage at breast cancer (BC) diagnosis among elderly women. It found that, as compared to women who were not persistent with mammography screening, women who were persistent with mammography screening were significantly more likely to be diagnosed at earlier stages of BC.
AHRQ-funded; HS018622.
Citation: Vyas A, Madhavan S, Sambamoorthi U .
Association between persistence with mammography screening and stage at diagnosis among elderly women diagnosed with breast cancer.
Breast Cancer Res Treat 2014 Dec;148(3):645-54. doi: 10.1007/s10549-014-3204-3..
Keywords: Cancer, Cancer: Breast Cancer, Diagnostic Safety and Quality, Elderly, Prevention, Screening, Women
Suskind AM, Clemens JQ, Dunn RL
Effectiveness of mesh compared with nonmesh sling surgery in Medicare beneficiaries.
This study assessed the effectiveness of mesh compared to nonmesh slings in the surgical treatment of female incontinence. It found that overall rates of complications were similar for patients undergoing either mesh or nonmesh sling procedures. However, patients undergoing the nonmesh procedure were more likely to require a subsequent intervention for bladder outlet obstruction.
AHRQ-funded; HS018726.
Citation: Suskind AM, Clemens JQ, Dunn RL .
Effectiveness of mesh compared with nonmesh sling surgery in Medicare beneficiaries.
Obstet Gynecol. 2013 Sep;122(3):546-52. doi: 10.1097/AOG.0b013e31829e8543..
Keywords: Comparative Effectiveness, Elderly, Patient-Centered Outcomes Research, Surgery, Women, Outcomes, Medicare, Evidence-Based Practice
Matthews CA, Whitehead WE, Townsend MK
Risk factors for urinary, fecal, or dual incontinence in the Nurses' Health Study.
This study estimating the prevalence of urinary incontinence, fecal incontinence, and dual incontinence in a group of 64,396 women aged 62-87 years found that 38 percent had urinary incontinence alone, 4 percent had fecal incontinence alone, and 7 percent had dual incontinence. Dual incontinence was primarily associated with advanced age, decompensating medical conditions, depression, and multiparity.
AHRQ-funded; HS018695.
Citation: Matthews CA, Whitehead WE, Townsend MK .
Risk factors for urinary, fecal, or dual incontinence in the Nurses' Health Study.
Obstet Gynecol. 2013 Sep;122(3):539-45. doi: 10.1097/AOG.0b013e31829efbff..
Keywords: Chronic Conditions, Elderly, Women