National Healthcare Quality and Disparities Report
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Topics
- Anxiety (1)
- (-) Asthma (21)
- Behavioral Health (1)
- Breast Feeding (1)
- Caregiving (1)
- Case Study (1)
- Children/Adolescents (13)
- Chronic Conditions (5)
- Clinician-Patient Communication (1)
- Communication (1)
- Comparative Effectiveness (1)
- Depression (1)
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- Influenza (1)
- Low-Income (3)
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- Newborns/Infants (1)
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- Patient-Centered Healthcare (2)
- Patient-Centered Outcomes Research (3)
- Patient Adherence/Compliance (1)
- Patient and Family Engagement (1)
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- Pregnancy (1)
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- Quality of Life (1)
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- Research Methodologies (1)
- Respiratory Conditions (11)
- Risk (1)
- Screening (1)
- Shared Decision Making (1)
- Social Determinants of Health (1)
- System Design (1)
- Teams (1)
- Transitions of Care (2)
- U.S. Preventive Services Task Force (USPSTF) (1)
- Urban Health (1)
- Vaccination (1)
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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 DisplayedParikh K, Perry K, Pantor C
Multidisciplinary engagement increases medications in-hand for patients hospitalized with asthma.
Asthma exacerbations in children are a leading cause of missed school days and health care use. Patients discharged from the hospital often do not fill discharge prescriptions and are at risk for future exacerbations. In this study, a multidisciplinary team aimed to increase the percentage of patients discharged from the hospital after an asthma exacerbation with their medications in-hand from 15% to 80%.
AHRQ-funded; HS024554.
Citation: Parikh K, Perry K, Pantor C .
Multidisciplinary engagement increases medications in-hand for patients hospitalized with asthma.
Pediatrics 2019 Dec;144(6). doi: 10.1542/peds.2019-0674..
Keywords: Children/Adolescents, Asthma, Medication, Patient Adherence/Compliance, Teams, Hospital Discharge, Transitions of Care
Jones YO, Hubbell BB, Thomson J
Things we do for no reason: systemic corticosteroids for wheezing in preschool-aged children.
This installment of the “Things We Do For No Reason” series presents and discusses a case study concerning the administration of systemic corticosteroids in a 4-year-old child presenting with wheezing, tachypnea, and respiratory distress. The authors conclude that current evidence does not support the routine use of systemic corticosteroids for preschool-aged children admitted for mild to moderate wheezing episodes, and that the patient in the introductory case would likely receive no clinical benefit from dexamethasone treatment.
AHRQ-funded; HS025138.
Citation: Jones YO, Hubbell BB, Thomson J .
Things we do for no reason: systemic corticosteroids for wheezing in preschool-aged children.
J Hosp Med 2019 Dec;14(12):774-76. doi: 10.12788/jhm.3255..
Keywords: Children/Adolescents, Respiratory Conditions, Asthma, Case Study, Shared Decision Making, Medication
Volerman A, Fierstein J, Boon K
Factors associated with effective inhaler technique among children with moderate to severe asthma.
Guidelines recommend that children and families receive education about and demonstration of effective inhaler technique as part of asthma self-management education. For youth, improved inhaler technique is associated with better quality of life and decreased health care use, yet technique remains suboptimal. To understand potential reasons for differences in inhaler skills, this study examined individual- and health care-level factors associated with effective inhaler technique among children.
AHRQ-funded; HS026385.
Citation: Volerman A, Fierstein J, Boon K .
Factors associated with effective inhaler technique among children with moderate to severe asthma.
Ann Allergy Asthma Immunol 2019 Nov;123(5):511-12.e1. doi: 10.1016/j.anai.2019.08.017.
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Keywords: Children/Adolescents, Asthma, Chronic Conditions, Patient Self-Management, Education: Patient and Caregiver, Medication, Quality of Life
Goldstein E, Finelli L, O'Halloran A
AHRQ Author: Karaca Z, Steiner C
Hospitalizations associated with respiratory syncytial virus and influenza in children, including children diagnosed with asthma.
This study examined hospitalization rates in children associated with respiratory syncytial virus (RSV) and influenza, including children with asthma. HCUP hospitalization data and additional data to estimate RSV and influenza-associated hospitalization with a respiratory cause was analyzed in different subpopulations of US children between 2003 and 2010. Annual rates of RSV-associated hospitalization was highest in infants and young children, and declined rapidly with age. Influenza hospitalizations also were highest in young children and declined by age 12-17 years. Higher rates of RSV-related and influenza hospitalization in the youngest children with a prior diagnosis of asthma was also found.
AHRQ-authored.
Citation: Goldstein E, Finelli L, O'Halloran A .
Hospitalizations associated with respiratory syncytial virus and influenza in children, including children diagnosed with asthma.
Epidemiology 2019 Nov;30(6):918-26. doi: 10.1097/ede.0000000000001092..
Keywords: Healthcare Cost and Utilization Project (HCUP), Children/Adolescents, Asthma, Influenza, Respiratory Conditions, Hospitalization, Chronic Conditions
Bardach NS, Neel C, Kleinman LC
Depression, anxiety, and emergency department use for asthma.
This study examined whether pediatric patients with asthma who use the emergency department (ED) experience increased depression and anxiety in the same way that adult asthma patients do. Out of 65,342 patients identified from the Massachusetts All-Payer Claims Database for 2014 to 2015 who had ED visits, 24.7% had a diagnosis of anxiety, depression, or both. Asthma rates were shown to be higher than those of patients who had no diagnosis of anxiety or depression.
AHRQ-funded; HS025297; HS020518.
Citation: Bardach NS, Neel C, Kleinman LC .
Depression, anxiety, and emergency department use for asthma.
Pediatrics 2019 Oct;144(4). doi: 10.1542/peds.2019-0856..
Keywords: Asthma, Depression, Anxiety, Children/Adolescents, Emergency Department, Behavioral Health
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
Parikh K, Hinds PS, Teach SJ
Using stakeholder engagement to develop a hospital-initiated, patient-centered intervention to improve hospital-to-home transitions for children with asthma.
The authors demonstrated that multidisciplinary stakeholder engagement can meaningfully influence intervention design. They presented a model of efficient yet substantive engagement of parents and health professionals in developing a hospital-to-home transition intervention for children hospitalized with asthma. Their results suggest that multidimensional stakeholder engagement can meaningfully shape intervention development, and they hope that these tools can be used or adapted to other hospital-based quality improvement, education, or research efforts.
AHRQ-funded; HS024554.
Citation: Parikh K, Hinds PS, Teach SJ .
Using stakeholder engagement to develop a hospital-initiated, patient-centered intervention to improve hospital-to-home transitions for children with asthma.
Hosp Pediatr 2019 Jun;9(6):460-63. doi: 10.1542/hpeds.2018-0261.
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Keywords: Children/Adolescents, Patient-Centered Healthcare, Patient and Family Engagement, Hospital Discharge, Transitions of Care, Asthma, Respiratory Conditions
Heintzman J, Kaufmann J, Ezekiel-Herrera D
Asthma/COPD disparities in diagnosis and basic care utilization among low-income primary care patients.
Obstructive pulmonary disease outcomes in the United States differ between Latinos and non-Hispanic whites. There is little objective data about diagnosis prevalence and primary care visit frequency in these disease processes. In this study, the investigators used electronic health record data to perform a retrospective cohort analysis of 34,849 low-income patients seen at Oregon community health centers between 2009 and 2013 to assess joint racial/ethnic and insurance disparities in diagnosis and visit rates between Latino and non-Hispanic white patients.
AHRQ-funded; HS021522.
Citation: Heintzman J, Kaufmann J, Ezekiel-Herrera D .
Asthma/COPD disparities in diagnosis and basic care utilization among low-income primary care patients.
J Immigr Minor Health 2019 Jun;21(3):659-63. doi: 10.1007/s10903-018-0798-2..
Keywords: Asthma, Respiratory Conditions, Chronic Conditions, Disparities, Healthcare Utilization, Low-Income, Primary Care
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
Forrest CB, Zorc JJ, Moon J
Evaluation of the PROMIS pediatric global health scale (PGH-7) in children with asthma.
The purpose of this study was to evaluate the reliability and validity of the PROMIS Pediatric Global Health scale, a 7-item measure of perceived physical, mental, and social health, in children with asthma. The investigators concluded that the PGH-7 is a reliable and valid patient-reported outcome for assessing general health among children with asthma. It is a useful complement to other asthma-specific outcome measures.
AHRQ-funded; HS020508.
Citation: Forrest CB, Zorc JJ, Moon J .
Evaluation of the PROMIS pediatric global health scale (PGH-7) in children with asthma.
J Asthma 2019 May;56(5):534-42. doi: 10.1080/02770903.2018.1471701..
Keywords: Children/Adolescents, Asthma, Respiratory Conditions, Health Status
Louisias M, Petty CR, Sheehan W
Use of a school-based survey to screen students for symptoms concerning for asthma.
Researchers sought early identification of asthma in minority children. Their goal was to determine if they could apply screening surveys to an inner-city, school-based cohort. They found a significant number of children with a positive asthma screen and no parent-reported asthma. Children with symptoms suggestive of asthma had elevated rates of hospital care for breathing problems and an atopic background. The researchers conclude that these children without known asthma, but who experience increased morbidity, can be easily identified with a school-based asthma screening survey and should be closely monitored.
AHRQ-funded; HS000063; HS022986.
Citation: Louisias M, Petty CR, Sheehan W .
Use of a school-based survey to screen students for symptoms concerning for asthma.
Clin Pediatr 2019 May;58(5):586-89. doi: 10.1177/0009922819832087..
Keywords: Children/Adolescents, Asthma, Screening, Education, Diagnostic Safety and Quality, Urban Health
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
Louisias M, Ramadan A, Naja AS
The effects of the environment on asthma disease activity.
This study discusses environmental factors that trigger or aggravate symptoms of asthma in children. Biological and physical factors include allergens, microbiome, endotoxin, genetics and pollution. Psychosocial environmental factors include stress, neighborhood safety, housing and discrimination. Control of these factors help to reduce prevalence and severity of asthma.
AHRQ-funded; HS022986.
Citation: Louisias M, Ramadan A, Naja AS .
The effects of the environment on asthma disease activity.
Immunol Allergy Clin North Am 2019 May;39(2):163-75. doi: 10.1016/j.iac.2018.12.005..
Keywords: Asthma, Children/Adolescents, Respiratory Conditions, Risk, Social Determinants of Health
Louisias M, Wright L, Phipatanakul W
Asthma in the melting pot.
This article highlights research advances related to asthma health disparities, and offers recommendations regarding innovative approaches to achieve equity and social justice for minority and low-income populations. Since traditional randomized controlled trials may not always be the most appropriate approach to health disparities research interventions, the authors suggest appropriate alternatives, such as the stepped-wedge design; or, because intervention trials are not always feasible, alternative analytic approaches such as mediation analysis or modeling could be used instead. Dissemination and implementation (D&I) research and the use of biomarkers to measure the social disadvantage impact of asthma outcomes are also discussed.
AHRQ-funded; HS022986.
Citation: Louisias M, Wright L, Phipatanakul W .
Asthma in the melting pot.
Ann Allergy Asthma Immunol 2019 Feb;122(2):136-39. doi: 10.1016/j.anai.2018.11.009.
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Keywords: Asthma, Disparities, Respiratory Conditions, Low-Income, Racial and Ethnic Minorities
Rudin RS, Fanta CH, Predmore Z
Core components for a clinically integrated mhealth app for asthma symptom monitoring.
The aim of the study was to apply user-centered design principles to efficiently identify core components for a mHealth-based asthma symptom-monitoring intervention using patient-reported outcomes (PROs).
AHRQ-funded; HS023960.
Citation: Rudin RS, Fanta CH, Predmore Z .
Core components for a clinically integrated mhealth app for asthma symptom monitoring.
Appl Clin Inform 2017 Oct;8(4):1031-43. doi: 10.4338/aci-2017-06-ra-0096.
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Keywords: Asthma, Chronic Conditions, Health Information Technology (HIT), System Design
Louisias M, Phipatanakul W
Managing asthma in low-income, underrepresented minority, and other disadvantaged pediatric populations: closing the gap.
The authors review current understanding of the epidemiology and etiology of disparities in asthma. They also highlight current and emerging literature on solutions to tackle disparities while underscoring gaps and pressing future directions. Tailored, multicomponent approaches including the home, school, and clinician-based interventions show great promise. Managing asthma in disadvantaged populations can be challenging as they tend to have disproportionately worse outcomes due to a multitude of factors.
AHRQ-funded; HS022986.
Citation: Louisias M, Phipatanakul W .
Managing asthma in low-income, underrepresented minority, and other disadvantaged pediatric populations: closing the gap.
Curr Allergy Asthma Rep 2017 Sep 15;17(10):68. doi: 10.1007/s11882-017-0734-x.
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Keywords: Asthma, Children/Adolescents, Low-Income, Racial and Ethnic Minorities, Vulnerable Populations
Kato E, Rajupet S
AHRQ Author: Kato E
Primary interventions to support breastfeeding.
This case study involves a 26-year-old woman, who presents for a routine prenatal visit at 28 weeks’ gestation. Her medical history is significant for poorly controlled asthma, and her family history is significant for breast cancer diagnosed in her mother. It poses three multiple choice questions together with the U.S. Preventive Services Task Force recommendations and related background information.
AHRQ-authored.
Citation: Kato E, Rajupet S .
Primary interventions to support breastfeeding.
Am Fam Physician 2017 Apr 15;95(8):517-18.
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Keywords: U.S. Preventive Services Task Force (USPSTF), Breast Feeding, Primary Care, Pregnancy, Asthma
duRivage N, Ross M, Mayne SL
Asthma Control Test.
In this study, the investigators compared results of a modified version of the Asthma Control Test using parent proxy report (PP-ACT) with results reported by children and parents using the validated Childhood-Asthma Control Test (C-ACT). ). The investigators indicate that that while the PP-ACT missed few children with uncontrolled asthma and may simplify reporting of asthma control in circumstances when child report is not feasible or creates barriers to survey receipt, limitations of proxy reporting should be considered.
AHRQ-funded; HS022689.
Citation: duRivage N, Ross M, Mayne SL .
Asthma Control Test.
Clin Pediatr 2017 Apr;56(4):341-47. doi: 10.1177/0009922816675013..
Keywords: Asthma, Caregiving, Children/Adolescents, Chronic Conditions, Patient Self-Management
Carroll KN, Gebretsadik T, Escobar GJ
Respiratory syncytial virus immunoprophylaxis in high-risk infants and development of childhood asthma.
This study sought to determine whether greater adherence to immunoprophylaxis in infants at high risk for severe respiratory syncytial virus (RSV) would be associated with decreased childhood asthma in a Medicaid population. The investigation of RSV immunoprophylaxis in high-risk children primarily found nonsignificant associations on prevention of asthma in specific preterm groups .
AHRQ-funded; HS018454.
Citation: Carroll KN, Gebretsadik T, Escobar GJ .
Respiratory syncytial virus immunoprophylaxis in high-risk infants and development of childhood asthma.
J Allergy Clin Immunol 2017 Jan;139(1):66-71.e3. doi: 10.1016/j.jaci.2016.01.055.
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Keywords: Asthma, Newborns/Infants, Children/Adolescents, Respiratory Conditions, Vaccination
Marshall GD, Jr., Bielory L, Walter Canonica G
The year in review: the best of 2016 in the Annals.
Last year brought a large increase in publications on the topics of rhinitis and rhinosinusitis. However, new therapeutics are always of great interest to the practicing clinician and thus top the list. Also discussed are significant articles on the topics of asthma and lower airway diseases, systemic allergic and immune disorders, and allergen immunotherapy.
AHRQ-funded; HS024599.
Citation: Marshall GD, Jr., Bielory L, Walter Canonica G .
The year in review: the best of 2016 in the Annals.
Ann Allergy Asthma Immunol 2017 Jan;118(1):4-9. doi: 10.1016/j.anai.2016.11.005.
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Keywords: Asthma, Respiratory Conditions, Respiratory Conditions