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 141 Research Studies DisplayedGuillory J, Chang P, Henderson CR
Piloting a text message-based social support intervention for patients with chronic pain: establishing feasibility and preliminary efficacy.
This pilot study examined the effectiveness of a short message service (SMS) text message–based social support intervention through mobile technology for pain attenuation and improving positive affect in a sample of patients with chronic noncancer pain. Findings show that this novel social support intervention reduced perceptions of pain and pain interference and improved positive affect among patients randomized to the intervention condition.
AHRQ-funded; HS020648.
Citation: Guillory J, Chang P, Henderson CR .
Piloting a text message-based social support intervention for patients with chronic pain: establishing feasibility and preliminary efficacy.
Clin J Pain 2015 Jun;31(6):548-56. doi: 10.1097/ajp.0000000000000193..
Keywords: Comparative Effectiveness, Chronic Conditions, Health Information Technology (HIT), Social Media
Goldberg DS, Forde KA, Carbonari DM
Population-representative incidence of drug-induced acute liver failure based on an analysis of an integrated health care system.
The researchers conducted an assessment of the incidence and outcomes of acute drug-induced liver failure within a large, integrated healthcare system that approximates a population-representative cohort. They found the incident of acute drug-induced liver failure to be 1.61 per million person years with the overwhelming majority being due to over-the-counter medications or products.
AHRQ-funded; HS018372.
Citation: Goldberg DS, Forde KA, Carbonari DM .
Population-representative incidence of drug-induced acute liver failure based on an analysis of an integrated health care system.
Gastroenterology 2015 Jun;148(7):1353-61.e3. doi: 10.1053/j.gastro.2015.02.050..
Keywords: Medication, Chronic Conditions, Patient Safety
Wisk LE, Finkelstein JA, Sawicki GS
Predictors of timing of transfer from pediatric- to adult-focused primary care.
The researchers examined the timing of transfer to adult-focused primary care providers (PCPs), the time between last pediatric-focused and first adult-focused PCP visits, and the predictors of transfer timing. They found that most youths are transferring care later than recommended and with gaps of more than a year. They further noted that while youths with chronic conditions have shorter gaps, they may need even shorter transfer intervals to ensure continuous access to care.
AHRQ-funded; HS000063; HS020513.
Citation: Wisk LE, Finkelstein JA, Sawicki GS .
Predictors of timing of transfer from pediatric- to adult-focused primary care.
JAMA Pediatr 2015 Jun;169(6):e150951. doi: 10.1001/jamapediatrics.2015.0951.
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Keywords: Children/Adolescents, Chronic Conditions, Primary Care, Transitions of Care, Young Adults
Merlin JS, Westfall AO, Chamot E
Quantitative evaluation of an instrument to identify chronic pain in HIV-infected individuals.
The researchers assessed the construct validity of the two-question Brief Chronic Pain Questionnaire (BCPQ) in HIV-infected patients by assessing the association between BCPQ responses and known correlates of chronic pain. Their study provides preliminary evidence for the BCPQ as a brief questionnaire to identify the presence of chronic pain in HIV care settings.
AHRQ-funded; HS021694.
Citation: Merlin JS, Westfall AO, Chamot E .
Quantitative evaluation of an instrument to identify chronic pain in HIV-infected individuals.
AIDS Res Hum Retroviruses 2015 Jun;31(6):623-7. doi: 10.1089/aid.2014.0362..
Keywords: Chronic Conditions, Human Immunodeficiency Virus (HIV), Pain
Juckett DA, Davis FN, Gostine M
Patient-reported outcomes in a large community-based pain medicine practice: evaluation for use in phenotype modeling.
The researchers aimed to build a phenotype-to-outcome model targeting chronic pain to be used to drive clinical decision support for pain medicine in the community setting. Exploratory factor analysis of the intake Pain Health Assessment revealed 15 orthogonal factors representing pain levels; physical, social, and emotional functions; the effects of pain on these functions; vitality and health; and measures of outcomes and satisfaction.
AHRQ-funded; HS022335.
Citation: Juckett DA, Davis FN, Gostine M .
Patient-reported outcomes in a large community-based pain medicine practice: evaluation for use in phenotype modeling.
BMC Med Inform Decis Mak 2015 May 28;15:41. doi: 10.1186/s12911-015-0164-4..
Keywords: Care Management, Chronic Conditions, Community-Based Practice, Electronic Health Records (EHRs), Health Information Technology (HIT), Outcomes, Pain
Santos CA, Brennan DC, Chapman WC
Delayed-onset cytomegalovirus disease coded during hospital readmission in a multicenter, retrospective cohort of liver transplant recipients.
The researchers sought to determine the risk factors and outcomes associated with delayed-onset cytomegalovirus (CMV) disease among liver transplant recipients. Data from a group of 7,229 adult liver transplant recipients showed that delayed onset CMV disease was twice as likely as early onset CMV disease, with transplant failure or rejection being a risk factor.
AHRQ-funded; HS019455
Citation: Santos CA, Brennan DC, Chapman WC .
Delayed-onset cytomegalovirus disease coded during hospital readmission in a multicenter, retrospective cohort of liver transplant recipients.
Liver Transpl. 2015 May;21(5):581-90. doi: 10.1002/lt.24089..
Keywords: Outcomes, Transplantation, Quality of Care, Chronic Conditions
Valdez RS, Brennan PF
Exploring patients' health information communication practices with social network members as a foundation for consumer health IT design.
The purpose of this study was to inform the broader design of consumer health IT by characterizing patients’ existing health information communication practices with their social network members. It found that participants’ rationales for health information communication reflected various themes including characteristics and circumstances of the person, characteristics and circumstances of the relationship, and structure and composition of the social network.
AHRQ-funded; HS018809.
Citation: Valdez RS, Brennan PF .
Exploring patients' health information communication practices with social network members as a foundation for consumer health IT design.
Int J Med Inform 2015 May;84(5):363-74. doi: 10.1016/j.ijmedinf.2015.01.014..
Keywords: Chronic Conditions, Communication, Education: Patient and Caregiver, Health Information Technology (HIT)
Witt WP, Park H, Wisk LE
Neighborhood disadvantage, preconception stressful life events, and infant birth weight.
This study investigated the impact of neighborhood conditions on the association between stressful life events prior to pregnancy and birth weight in a national sample of women living in the United States. It found that women who experienced preconception stressful life events, who had chronic conditions, or were racial/ethnic minorities had the greatest risk of having very low birth weight infants if they lived in disadvantaged neighborhoods.
AHRQ-funded; HS000083; HS000063
Citation: Witt WP, Park H, Wisk LE .
Neighborhood disadvantage, preconception stressful life events, and infant birth weight.
Am J Public Health 2015 May;105(5):1044-52. doi: 10.2105/ajph.2015.302566.
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Keywords: Pregnancy, Social Determinants of Health, Chronic Conditions
Makris UE, Higashi RT, Marks EG
Ageism, negative attitudes, and competing co-morbidities--why older adults may not seek care for restricting back pain: a qualitative study.
The objective of this study was to understand older adults’ beliefs and perspectives regarding care-seeking for restricting back pain (back pain that restricts activity). Using data from a diverse sample of 93 older adults who reported restricting back pain, it found that illness perceptions (including pain-related beliefs), and interactions with providers may influence older adults’ willingness to seek care for restricting back pain.
AHRQ-funded; HS020648.
Citation: Makris UE, Higashi RT, Marks EG .
Ageism, negative attitudes, and competing co-morbidities--why older adults may not seek care for restricting back pain: a qualitative study.
BMC Geriatr 2015 Apr 8;15:39. doi: 10.1186/s12877-015-0042-z..
Keywords: Elderly, Back Health and Pain, Chronic Conditions
Merlin JS, Walcott M, Kerns R
Pain self-management in HIV-infected individuals with chronic pain: a qualitative study.
The objective of this investigation is to develop an understanding of self-management strategies already used by persons living with these conditions. It found that the primary pain self-management strategies articulated by participants were: physical activity; cognitive and spiritual strategies; spending time with family and friends and social support; avoidance of physical/social activity; medication-centric pain management; and substance use.
AHRQ-funded; HS021694.
Citation: Merlin JS, Walcott M, Kerns R .
Pain self-management in HIV-infected individuals with chronic pain: a qualitative study.
Pain Med 2015 Apr;16(4):706-14. doi: 10.1111/pme.12701..
Keywords: Chronic Conditions, Human Immunodeficiency Virus (HIV), Pain, Patient Self-Management
Ringwalt C, Roberts AW, Gugelmann H
Racial disparities across provider specialties in opioid prescriptions dispensed to Medicaid beneficiaries with chronic noncancer pain.
The purpose of this study was to examine differences across providers’ specialties in prescriptions filled by white and black Medicaid beneficiaries with chronic noncancer pain (CNCP). It found that race-based differences in beneficiaries’ dispensed opioid prescriptions were more prominent among patients of specialists in obstetrics and gynecology and internal medicine, as well as general practitioners/family medicine physicians.
AHRQ-funded; HS000032.
Citation: Ringwalt C, Roberts AW, Gugelmann H .
Racial disparities across provider specialties in opioid prescriptions dispensed to Medicaid beneficiaries with chronic noncancer pain.
Pain Med 2015 Apr;16(4):633-40. doi: 10.1111/pme.12555..
Keywords: Chronic Conditions, Disparities, Medicaid, Medication, Opioids, Pain, Racial and Ethnic Minorities
Magnan EM, Gittelson R, Bartels CM
Establishing chronic condition concordance and discordance with diabetes: a Delphi study.
This study aimed to provide more information for the future research and clinical use of the concordant/discordant framework by increasing the number of conditions that can be characterized as concordant or discordant with diabetes. By finding that 12 conditions were concordant with diabetes care and 50 were discordant, the study significantly adds to the number of conditions for which there is information on concordance and discordance for diabetes care.
AHRQ-funded; HS018368; HS007646; HS021899.
Citation: Magnan EM, Gittelson R, Bartels CM .
Establishing chronic condition concordance and discordance with diabetes: a Delphi study.
BMC Fam Pract 2015 Mar 28;16:42. doi: 10.1186/s12875-015-0253-6..
Keywords: Chronic Conditions, Diabetes, Primary Care, Practice Patterns
Agwu AL, Lee L, Fleishman JA
AHRQ Author: Fleishman JA
Aging and loss to follow-up among youth living with human immunodeficiency virus in the HIV Research Network.
The researchers sought to evaluate loss to follow-up in the year after each birthday from the 18th through the 25th in a large multisite HIV cohort in the United States. Among the 647 21-year-old youth who were engaged in care, 20 percent were lost to follow-up in the year after their 21st birthday.
AHRQ-authored; AHRQ-funded; 2901100007.
Citation: Agwu AL, Lee L, Fleishman JA .
Aging and loss to follow-up among youth living with human immunodeficiency virus in the HIV Research Network.
J Adolesc Health 2015 Mar;56(3):345-51. doi: 10.1016/j.jadohealth.2014.11.009..
Keywords: Care Management, Chronic Conditions, Human Immunodeficiency Virus (HIV), Patient Adherence/Compliance, Young Adults
Bateman BT, Huybrechts KF, Fischer MA
Chronic hypertension in pregnancy and the risk of congenital malformations: a cohort study.
The researchers sought to examine the effect of chronic hypertension on the risk of congenital malformations in a large cohort of pregnancies in Medicaid beneficiaries. In a cohort of 878,126 pregnancies, they found that both treated and untreated maternal chronic hypertension were associated with a similar 20-30 percent increase in the risk of congenital malformations in the infant after adjusting for confounding factors as compared with normotensive controls.
AHRQ-funded; HS018533.
Citation: Bateman BT, Huybrechts KF, Fischer MA .
Chronic hypertension in pregnancy and the risk of congenital malformations: a cohort study.
Am J Obstet Gynecol 2015 Mar;212(3):337.e1-14. doi: 10.1016/j.ajog.2014.09.031..
Keywords: Blood Pressure, Chronic Conditions, Pregnancy, Risk, Maternal Care, Women
Gross CP, Fried TR, Tinetti ME
Decision-making and cancer screening: a qualitative study of older adults with multiple chronic conditions.
The researchers sought to understand how older persons with multiple chronic conditions (MCC) approach decisions about cancer screenings. They found that some older persons with MCC employ heuristics which circumvent the traditional quantitative comparison of risks and benefits, providing an important challenge to informed decision making.
AHRQ-funded; HS018598.
Citation: Gross CP, Fried TR, Tinetti ME .
Decision-making and cancer screening: a qualitative study of older adults with multiple chronic conditions.
J Geriatr Oncol 2015 Mar;6(2):93-100. doi: 10.1016/j.jgo.2014.12.001..
Keywords: Cancer, Chronic Conditions, Shared Decision Making, Elderly, Screening
Bayliss EA, Ellis JL, Shoup JA
Effect of continuity of care on hospital utilization for seniors with multiple medical conditions in an integrated health care system.
The researchers investigated the effects of interpersonal continuity of care on rates of hospital utilization in a population of seniors with multiple chronic conditions (MCCs) in an integrated health care delivery system. They found that in an integrated delivery system with high informational continuity, greater continuity of care is independently associated with lower hospital utilization for seniors with MCCs.
AHRQ-funded; HS018404.
Citation: Bayliss EA, Ellis JL, Shoup JA .
Effect of continuity of care on hospital utilization for seniors with multiple medical conditions in an integrated health care system.
Ann Fam Med 2015 Mar;13(2):123-9. doi: 10.1370/afm.1739..
Keywords: Chronic Conditions, Elderly, Hospitalization
Hansen RA, Voils CI, Farley JF
Prescriber continuity and medication adherence for complex patients.
The purpose of this study was to examine the relationship between number of prescribers, number of conditions, and refill adherence to oral medications among 7,933 veterans who were identified with 1 to 4 cardiometabolic conditions: diabetes, hypertension, dyslipidemia, and/or heart failure. It found that for veterans taking antihypertensive or lipid-lowering medications, having more prescribers involved in care modestly decreased the likelihood of being adherent.
AHRQ-funded; HS019445.
Citation: Hansen RA, Voils CI, Farley JF .
Prescriber continuity and medication adherence for complex patients.
Ann Pharmacother 2015 Mar;49(3):293-302. doi: 10.1177/1060028014563266..
Keywords: Patient Adherence/Compliance, Medication, Chronic Conditions
Dauw CA, Alruwaily AF, Bierlein MJ
Provider variation in the quality of metabolic stone management.
The researchers quantified the degree of variation in repeat 24-hour urine testing attributable to providers and assessed differences in repeat testing rates between specialist and primary care physicians. They found, that, while most variation in follow-up testing was attributable to the patient, the provider contribution was nontrivial (18 percent). The specialty of the ordering provider was also important.
AHRQ-funded; HS020927.
Citation: Dauw CA, Alruwaily AF, Bierlein MJ .
Provider variation in the quality of metabolic stone management.
J Urol 2015 Mar;193(3):885-90. doi: 10.1016/j.juro.2014.09.111..
Keywords: Care Management, Chronic Conditions, Practice Patterns
Neff JM, Clifton H, Popalisky J
Stratification of children by medical complexity.
The investigators stratified children using the software, Clinical Risk Groups (CRGs), in a tertiary children's hospital and a state's Medicaid claims data into 3 condition groups: complex chronic disease; noncomplex chronic disease, and nonchronic disease. They concluded that CRGs can be used to stratify children receiving care at a tertiary care hospital according to complexity in both hospital and Medicaid administrative data.
AHRQ-funded; HS020506.
Citation: Neff JM, Clifton H, Popalisky J .
Stratification of children by medical complexity.
Acad Pediatr 2015 Mar-Apr;15(2):191-6. doi: 10.1016/j.acap.2014.10.007.
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Keywords: Children/Adolescents, Chronic Conditions, Data, Electronic Health Records (EHRs), Children/Adolescents
Magnan EM, Palta M, Johnson HM
The impact of a patient's concordant and discordant chronic conditions on diabetes care quality measures.
The researchers sought to determine the impact of the number of concordant and discordant chronic conditions on diabetes care quality. Their findings suggest that the patients most at risk for suboptimal diabetes care are the patients with the fewest comorbidities, especially the fewest concordant comorbidities.
AHRQ-funded; HS018368; HS021899.
Citation: Magnan EM, Palta M, Johnson HM .
The impact of a patient's concordant and discordant chronic conditions on diabetes care quality measures.
J Diabetes Complications 2015 Mar;29(2):288-94. doi: 10.1016/j.jdiacomp.2014.10.003..
Keywords: Quality Measures, Diabetes, Chronic Conditions
Jones JB, Weiner JP, Shah NR
The wired patient: patterns of electronic patient portal use among patients with cardiac disease or diabetes.
The researchers described the types and patterns of portal users in an integrated delivery system. They found naturally occurring groups of EHR Web portal users within a population of adult primary care patients with chronic conditions. More than half of the patient cohort exhibited distinct patterns of portal use linked to key features.
AHRQ-funded; HS016228.
Citation: Jones JB, Weiner JP, Shah NR .
The wired patient: patterns of electronic patient portal use among patients with cardiac disease or diabetes.
J Med Internet Res 2015 Feb 20;17(2):e42. doi: 10.2196/jmir.3157..
Keywords: Health Information Technology (HIT), Electronic Health Records (EHRs), Primary Care, Healthcare Delivery, Chronic Conditions
Chou R, Turner JA, Devine EB
The effectiveness and risks of long-term opioid therapy for chronic pain: a systematic review for a National Institutes of Health Pathways to Prevention Workshop.
This systematic review evaluated evidence on the effectiveness and harms of long-term (more than 3 months) opiod therapy for chronic pain in adults. It concluded that evidence is insufficient to determine the effectiveness of this therapy for improving chronic pain and function.
AHRQ-funded; 290201200014I
Citation: Chou R, Turner JA, Devine EB .
The effectiveness and risks of long-term opioid therapy for chronic pain: a systematic review for a National Institutes of Health Pathways to Prevention Workshop.
Ann Intern Med. 2015 Feb 17;162(4):276-86. doi: 10.7326/M14-2559..
Keywords: Chronic Conditions, Comparative Effectiveness, Medication, Opioids, Outcomes, Pain, Patient-Centered Outcomes Research
Edwards JD, Vasilevskis EE, Yoo EJ
Adults with childhood-onset chronic conditions admitted to US pediatric and adult intensive care units.
The purpose of the study is to compare demographics, intensive care unit (ICU) admission characteristics, and ICU outcomes among adults with childhood-onset chronic conditions (COCCs) admitted to US pediatric and adult ICUs. It found that adults with COCCs admitted to pediatric units were significantly more likely to be younger, have lower functional status, and be nontrauma patients than those in adult units.
AHRQ-funded; HS017716.
Citation: Edwards JD, Vasilevskis EE, Yoo EJ .
Adults with childhood-onset chronic conditions admitted to US pediatric and adult intensive care units.
J Crit Care 2015 Feb;30(1):201-6. doi: 10.1016/j.jcrc.2014.10.016..
Keywords: Intensive Care Unit (ICU), Chronic Conditions, Critical Care
Sjoding MW, Cooke CR
Chronic critical illness: a growing legacy of successful advances in critical care*.
As the population ages, and advances in critical care continue to improve survival among the most severely ill patients, many assert that the incidence of chronic critical illness (CCI) will continue to rise. The authors discuss an article (Kahn, et al) in the same issue that highlights the growing incidence of CCI and the problems it poses.
AHRQ-funded; HS020672.
Citation: Sjoding MW, Cooke CR .
Chronic critical illness: a growing legacy of successful advances in critical care*.
Crit Care Med 2015 Feb;43(2):476-7. doi: 10.1097/ccm.0000000000000780..
Keywords: Critical Care, Chronic Conditions, Intensive Care Unit (ICU)
Thorpe RJ, Jr., Bell CN, Kennedy-Hendricks A
Disentangling race and social context in understanding disparities in chronic conditions among men.
This study compared survey data collected in 2003 from black and white men with similar incomes living in a racially integrated neighborhood of Baltimore to data from the 2003 National Health Interview Survey. The researchers found no race disparities in chronic conditions among low-income, urban men living in the same social environment, and they recommended that policies and interventions aiming to reduce disparities in chronic conditions focus on modifying social aspects of the environment.
AHRQ-funded; HS000029.
Citation: Thorpe RJ, Jr., Bell CN, Kennedy-Hendricks A .
Disentangling race and social context in understanding disparities in chronic conditions among men.
J Urban Health 2015 Feb;92(1):83-92. doi: 10.1007/s11524-014-9900-9.
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Keywords: Chronic Conditions, Disparities, Health Status, Racial and Ethnic Minorities, Social Determinants of Health