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
1 to 25 of 62 Research Studies DisplayedReimer T, Lee SJC, Garcia S
Cancer center clinic and research team perceptions of identity and interactions.
The purpose of this study was to determine perceptions of roles of cancer center clinic and research teams. The researchers developed and administered survey to research and clinic staff at a National Cancer Institute-designated comprehensive cancer center. Although there are many similarities between clinic and research teams, the researchers also identified key differences, including perceptions of goal clarity and sharing, understanding and alignment with cancer center goals, and importance of outcomes.
AHRQ-funded; HS022418.
Citation: Reimer T, Lee SJC, Garcia S .
Cancer center clinic and research team perceptions of identity and interactions.
J Oncol Pract 2017 Dec;13(12):e1021-e29. doi: 10.1200/jop.2017.024349..
Keywords: Cancer, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Research Methodologies
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
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
Khandelwal N, Curtis JR, Freedman VA
How often is end-of-life care in the United States inconsistent with patients' goals of care?
The purpose of this study was to document the proportion of bereaved respondents who reported care inconsistent with patients' wishes and characterize the predictors of end-of-life care associated with inconsistent care. The study found that one in eight respondents stated care in the last months of life was inconsistent with patients' wishes; such care was associated with worse ratings of care, pain management, and communication with clinicians.
AHRQ-funded; HS022982.
Citation: Khandelwal N, Curtis JR, Freedman VA .
How often is end-of-life care in the United States inconsistent with patients' goals of care?
J Palliat Med 2017 Dec;20(12):1400-04. doi: 10.1089/jpm.2017.0065..
Keywords: Care Management, Healthcare Delivery, Elderly, Palliative Care, Patient-Centered Healthcare, Quality of Care
Oakes AH, Garmo VS, Bone LR
Identifying and prioritizing the barriers and facilitators to the self-management of type 2 diabetes mellitus: a community-centered approach.
The researchers sought to develop and test an instrument to identify and quantify the barriers and facilitators to self-management of type 2 diabetes. The study concluded that factors impacting self-management can be quantified and categorized as barriers and facilitators. Further refinement to some factors and investigation into alternative prioritization methods is necessary.
AHRQ-funded; HS000029.
Citation: Oakes AH, Garmo VS, Bone LR .
Identifying and prioritizing the barriers and facilitators to the self-management of type 2 diabetes mellitus: a community-centered approach.
Patient 2017 Dec;10(6):773-83. doi: 10.1007/s40271-017-0248-6..
Keywords: Diabetes, Health Services Research (HSR), Patient-Centered Healthcare, Patient Self-Management
Tamirisa NP, Goodwin JS, Kandalam A
Patient and physician views of shared decision making in cancer.
The aim of the study was to explore patient and physician perceptions of shared decision making in clinical encounters for cancer care. Among the study’s multiple conclusions was that most physicians reported providing patients with written information, however, most patients reported that written information was too detailed and felt that the physicians did not assess the level of information they wished to receive.
AHRQ-funded; HS022134.
Citation: Tamirisa NP, Goodwin JS, Kandalam A .
Patient and physician views of shared decision making in cancer.
Health Expect 2017 Dec;20(6):1248-53. doi: 10.1111/hex.12564..
Keywords: Cancer, Shared Decision Making, Patient-Centered Healthcare, Patient Experience, Clinician-Patient Communication
Kohler-Forsberg O, Madsen T, Behrendt-Moller I
Trajectories of suicidal ideation over 6 months among 482 outpatients with bipolar disorder.
The researchers aimed to investigate 6-months trajectories of suicidal ideation among adults with bipolar disorder. Using data from the Bipolar CHOICE study, they identified four distinct trajectories and found that more than one in ten adult outpatients with bipolar disorder had moderately increased suicidal ideation throughout 6 months of pharmacotherapy. They recommended that the identified predictors may help clinicians to identify those with additional need for treatment against suicidal thoughts, and future studies need to investigate whether targeted treatment may improve the course of persistent suicidal ideation.
AHRQ-funded; HS019371.
Citation: Kohler-Forsberg O, Madsen T, Behrendt-Moller I .
Trajectories of suicidal ideation over 6 months among 482 outpatients with bipolar disorder.
J Affect Disord 2017 Dec 1;223:146-52. doi: 10.1016/j.jad.2017.07.038.
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Keywords: Behavioral Health, Medication, Ambulatory Care and Surgery, Patient-Centered Healthcare
Prochaska MT, Newcomb R, Block G
Association between anemia and fatigue in hospitalized patients: does the measure of anemia matter?
This study assessed multiple Hb-based measures of anemia in hospitalized patients and test whether these are associated with fatigue. Mean Hb had a less robust association with fatigue than minimum Hb, and no other measure of Hb was associated with patients' fatigue levels. Minimum Hb is associated with fatigue while hospitalized and may help identify patients for interventions to address anemia-related fatigue.
AHRQ-funded; HS023007.
Citation: Prochaska MT, Newcomb R, Block G .
Association between anemia and fatigue in hospitalized patients: does the measure of anemia matter?
J Hosp Med 2017 Nov;12(11):898-904. doi: 10.12788/jhm.2832.
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Keywords: Hospitalization, Patient-Centered Healthcare, Risk
Kelly G, Wang SY, Lucas G
Facilitating meaningful engagement on community advisory committees in patient-centered outcome research.
In this study, the investigators conducted a process evaluation of ongoing activities of a Patient Advisory Committee (PAC) formed around the development of an individualized decision aid for older women with early stage breast cancer. They indicated that their results suggested that engaging committee members in a process of evaluation and collective reflection during a research collaboration can break down barriers to collaboration, build relationships, create opportunities for co-learning and strengthen researchers' capacity to engage meaningfully with stakeholders.
AHRQ-funded; HS023900.
Citation: Kelly G, Wang SY, Lucas G .
Facilitating meaningful engagement on community advisory committees in patient-centered outcome research.
Prog Community Health Partnersh 2017;11(3):243-51. doi: 10.1353/cpr.2017.0029..
Keywords: Cancer, Cancer: Breast Cancer, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Research Methodologies
Wolinsky FD, Lou Y, Edmonds SW
Activating patients with a tailored bone density test results letter and educational brochure: the PAADRN Randomized Controlled Trial.
This study examined whether a tailored patient-activation letter communicating bone mineral density (BMD) test results plus an educational brochure improved patient activation scores and levels at 12 and 52 wk post-baseline as the mechanism leading to enhanced bone healthcare.
AHRQ-funded; HS023009.
Citation: Wolinsky FD, Lou Y, Edmonds SW .
Activating patients with a tailored bone density test results letter and educational brochure: the PAADRN Randomized Controlled Trial.
J Clin Densitom 2017 Oct/Dec;20(4):464-71. doi: 10.1016/j.jocd.2016.08.012..
Keywords: Education: Patient and Caregiver, Health Literacy, Patient-Centered Healthcare, Patient and Family Engagement, Clinician-Patient Communication
Ray KN, Ashcraft LE, Mehrotra A
Family perspectives on telemedicine for pediatric subspecialty care.
The researchers sought to understand how subspecialty telemedicine is perceived and to identify design elements with the potential to improve telemedicine uptake and impact. They found that although informants saw the potential value of using telemedicine to replace in-person subspecialty visits, they were more enthusiastic about using telemedicine to complement rather than replace in-person visits.
AHRQ-funded; HS022989.
Citation: Ray KN, Ashcraft LE, Mehrotra A .
Family perspectives on telemedicine for pediatric subspecialty care.
Telemed J E Health 2017 Oct;23(10):852-62. doi: 10.1089/tmj.2016.0236.
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Keywords: Children/Adolescents, Healthcare Delivery, Patient-Centered Healthcare, Children/Adolescents, Telehealth
Lieberthal RD, Payton C, Sarfaty M
Measuring the cost of the patient-centered medical home: a cost-accounting approach.
To explore the cost for individual practices to become more patient-centered, this study inventoried and calculated costly activities involved in implementing the Patient-Centered Medical Home (PCMH) as defined by the National Committee for Quality Assurance.
AHRQ-funded; HS022630.
Citation: Lieberthal RD, Payton C, Sarfaty M .
Measuring the cost of the patient-centered medical home: a cost-accounting approach.
J Ambul Care Manage 2017 Oct/Dec;40(4):327-38. doi: 10.1097/jac.0000000000000196..
Keywords: Healthcare Delivery, Healthcare Costs, Patient-Centered Healthcare
Fisher KA, Mazor KM
Patient and family complaints in cancer care: what can we learn from the tip of the iceberg?
This paper comments on the Mack et al. article “Evaluation of Patient and Family Outpatient Complaints as a Strategy to Prioritize Efforts to Improve Cancer Care Delivery”, published in 2017 in The Joint Commission Journal on Quality and Patient Safety, in which Mack et al. categorized all complaints filed at a large outpatient cancer center during a two-year period, put forth a preliminary rating system for assessing complaint severity, and catalogued the actions taken in response to the complaints.
AHRQ-funded; HS024596; HS022757.
Citation: Fisher KA, Mazor KM .
Patient and family complaints in cancer care: what can we learn from the tip of the iceberg?
Jt Comm J Qual Patient Saf 2017 Oct;43(10):495-97. doi: 10.1016/j.jcjq.2017.07.003..
Keywords: Cancer, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Patient Experience, Patient Safety, Quality of Care, Quality Improvement
Ndefo UA, Moultry AM, Davis PN
Provision of medication therapy management by pharmacists to patients with type-2 diabetes mellitus in a federally qualified health center.
This article describes a medication therapy management (MTM) pilot program that was implemented at a federally qualified health center. This program was implemented at three clinics involving patients with uncontrolled diabetes, defined as hemoglobin A1c (HbA1c) greater than 8 percent. Fifty-seven patients met the established criteria and were enrolled in the six-month program. Thirty-seven patients completed the program and had an average 15 percent reduction in HbA1c.
AHRQ-funded; 290201100001C.
Citation: Ndefo UA, Moultry AM, Davis PN .
Provision of medication therapy management by pharmacists to patients with type-2 diabetes mellitus in a federally qualified health center.
P&T 2017 Oct;42(10):632-37.
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Keywords: Diabetes, Medication, Chronic Conditions, Patient-Centered Healthcare, Provider: Pharmacist
Cottrell EK, Hall JD, Kautz G
Reporting from the front lines: implementing Oregon's alternative payment methodology in federally qualified health centers.
Alternative payment models have been proposed as a way to facilitate patient-centered medical home model implementation, yet little is known about how payment reform translates into changes in care delivery. This study conducted site visits, observed operations, and conducted interviews within 3 Federally Qualified Health Center organizations. They identified several care delivery changes during the early stages of implementation, as well as challenges associated with this new model of payment.
AHRQ-funded; HS022651.
Citation: Cottrell EK, Hall JD, Kautz G .
Reporting from the front lines: implementing Oregon's alternative payment methodology in federally qualified health centers.
J Ambul Care Manage 2017 Oct/Dec;40(4):339-46. doi: 10.1097/jac.0000000000000198..
Keywords: Healthcare Delivery, Payment, Patient-Centered Healthcare, Policy, Primary Care
Wong MS, Jones-Smith JC, Colantuoni E
The longitudinal association between early childhood obesity and fathers' involvement in caregiving and decision-making.
This study assessed the longitudinal association between changes in obesity among children aged 2 to 4 years and changes in fathers' involvement with raising children. Children whose fathers increased their frequency of taking children outside and involvement with physical childcare experienced a decrease in their odds of obesity from age 2 to age 4.
AHRQ-funded; HS000029.
Citation: Wong MS, Jones-Smith JC, Colantuoni E .
The longitudinal association between early childhood obesity and fathers' involvement in caregiving and decision-making.
Obesity 2017 Oct;25(10):1754-61. doi: 10.1002/oby.21902.
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Keywords: Caregiving, Children/Adolescents, Family Health and History, Obesity, Patient-Centered Healthcare
Williams CN, Kirby A, Piantino J
If you build it, they will come: Initial experience with a multi-disciplinary pediatric neurocritical care follow-up clinic.
To address morbidities in Pediatric Neurocritical Care survivors, collaboration between Pediatric Neurology and Pediatric Critical Care created a multidisciplinary follow-up clinic providing specialized evaluations after discharge. Clinic referrals applied to all Pediatric Neurocritical Care patients regardless of admission severity of illness. Here, the authors report an initial case series, which revealed a population that is heterogenous in age, ranging from 1 month to 18 years, and in diagnoses.
AHRQ-funded; HS022981.
Citation: Williams CN, Kirby A, Piantino J .
If you build it, they will come: Initial experience with a multi-disciplinary pediatric neurocritical care follow-up clinic.
Children 2017 Sep 19;4(9). doi: 10.3390/children4090083.
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Keywords: Brain Injury, Critical Care, Neurological Disorders, Patient-Centered Healthcare, Children/Adolescents
Bobb JF, Lee AK, Lapham GT
Evaluation of a pilot implementation to integrate alcohol-related care within primary care.
Researchers and clinical leaders at Kaiser Permanente Washington partnered to design a high-quality Program of Sustained Patient-centered Alcohol-related Care (SPARC). The authors describe the SPARC pilot implementation, evaluate its effectiveness within three large pilot sites, and describe the qualitative findings on barriers and facilitators. They found that alcohol screening increased from 8.9 percent of patients pre-implementation to 62 percent post-implementation.
AHRQ-funded; HS023173.
Citation: Bobb JF, Lee AK, Lapham GT .
Evaluation of a pilot implementation to integrate alcohol-related care within primary care.
Int J Environ Res Public Health 2017 Sep 8;14(9). doi: 10.3390/ijerph14091030.
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Keywords: Alcohol Use, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Primary Care
Franklin P, Chenok K, Lavalee D
Framework to guide the collection and use of patient-reported outcome measures in the learning healthcare system.
Web-based collection of patient-reported outcome measures (PROMs) in clinical practice is expanding rapidly as electronic health records include web portals for patients to report standardized assessments of their symptoms. As the value of PROMs in patient care expands, a framework to guide the implementation planning, collection, and use of PROs to serve multiple goals and stakeholders is needed. In this study, researchers identified diverse clinical, quality, and research settings where PROMs have been successfully integrated into care and routinely collected and analyzed drivers of successful implementation.
AHRQ-funded; HS022789.
Citation: Franklin P, Chenok K, Lavalee D .
Framework to guide the collection and use of patient-reported outcome measures in the learning healthcare system.
eGEMS 2017 Sep 4;5(1):17. doi: 10.5334/egems.227..
Keywords: Learning Health Systems, Health Systems, Electronic Health Records (EHRs), Health Information Technology (HIT), Web-Based, Patient-Centered Healthcare
Pham R, Cross S, Fernandez B
"Finding the right FIT": rural patient preferences for fecal immunochemical test (FIT) characteristics.
This community-led study was conducted to assess patient preferences for fecal immunochemical tests (FIT) characteristics and to use study findings in concert with clinical effectiveness data to inform regional FIT selection. The authors concluded that FIT characteristics influenced patient's perceptions of test acceptability and feasibility and indicated that health system leaders, payers, and clinicians should select FITs that are both clinically effective and incorporate patient preferred test characteristics.
AHRQ-funded; HS022981.
Citation: Pham R, Cross S, Fernandez B .
"Finding the right FIT": rural patient preferences for fecal immunochemical test (FIT) characteristics.
J Am Board Fam Med 2017 Sep-Oct;30(5):632-44. doi: 10.3122/jabfm.2017.05.170151..
Keywords: Cancer: Colorectal Cancer, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Rural Health, Screening
Nagykaldi ZJ, Scheid D, Zhao D
An innovative community-based model for improving preventive care in rural counties.
This quasi-experimental pilot study aimed to implement and evaluate a sustainable, rural community-based patient outreach model for preventive care provided through primary care practices (PCPs) located in a rural county in Oklahoma. Six of the 7 PCPs in the county expressed interest in the project with the result that three of these practices fully implemented the 1-year outreach program starting in mid-2015.
AHRQ-funded; HS023237.
Citation: Nagykaldi ZJ, Scheid D, Zhao D .
An innovative community-based model for improving preventive care in rural counties.
J Am Board Fam Med 2017 Sep-Oct;30(5):583-91. doi: 10.3122/jabfm.2017.05.170035.
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Keywords: Community Partnerships, Patient-Centered Healthcare, Prevention, Primary Care, Rural Health
Rhoten BA
Conceptual issues surrounding body image for oncology nurses.
This paper discusses conceptual issues surrounding cancer survivors’ body image. It targets oncology nurses so they may have a better understanding of the historic overview of body image conceptualization, as well as a more contemporary, cancer-specific approach to understanding how this population of patients may be particularly affected.
AHRQ-funded; HS022990.
Citation: Rhoten BA .
Conceptual issues surrounding body image for oncology nurses.
Oncol Nurs Forum 2017 Sep 1;44(5):534-36. doi: 10.1188/17.onf.534-536..
Keywords: Cancer, Patient-Centered Healthcare, Provider, Quality of Life
Yasui M, Pottick KJ, Chen Y
Conceptualizing culturally infused engagement and its measurement for ethnic minority and immigrant children and families.
The authors systematically reviewed 119 existing instruments that measure the multi-dimensional and developmental process of engagement for ethnic minority and immigrant children and families. Its findings highlight the variety of tools that are used to measure behavioral and attitudinal dimensions of engagement, showing the limitations of their application for ethnic minority and immigrant children and families.
AHRQ-funded; HS023007.
Citation: Yasui M, Pottick KJ, Chen Y .
Conceptualizing culturally infused engagement and its measurement for ethnic minority and immigrant children and families.
Clin Child Fam Psychol Rev 2017 Sep;20(3):250-332. doi: 10.1007/s10567-017-0229-2.
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Keywords: Children/Adolescents, Cultural Competence, Behavioral Health, Patient and Family Engagement, Patient-Centered Healthcare
Shaughnessy AF, Vaswani A, Andrews BK
Developing a clinician friendly tool to identify useful clinical practice guidelines: G-TRUST.
The goal of this project was to develop a simple, easy-to-use checklist for clinicians to use to identify trustworthy, relevant, and useful practice guidelines, the Guideline Trustworthiness, Relevance, and Utility Scoring Tool (G-TRUST). They concluded that the 8-item G-TRUST developed by the project is potentially helpful as a tool for clinicians to identify useful guidelines.
AHRQ-funded; HS022940.
Citation: Shaughnessy AF, Vaswani A, Andrews BK .
Developing a clinician friendly tool to identify useful clinical practice guidelines: G-TRUST.
Ann Fam Med 2017 Sep;15(5):413-18. doi: 10.1370/afm.2119.
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Keywords: Evidence-Based Practice, Guidelines, Quality of Care, Patient-Centered Healthcare
Cook SC, Gunter KE, Lopez FY
Establishing effective health care partnerships with sexual and gender minority patients: recommendations for obstetrician gynecologists.
Sexual and gender minority patients have historically experienced high rates of inappropriate and low-quality care, disrespect, and discrimination in health care settings, as well as significant health disparities. This article documented multiple suggestions and resources that health care teams can use to improve the health and health care of their sexual and gender minority patients.
AHRQ-funded; HS023050.
Citation: Cook SC, Gunter KE, Lopez FY .
Establishing effective health care partnerships with sexual and gender minority patients: recommendations for obstetrician gynecologists.
Semin Reprod Med 2017 Sep;35(5):397-407. doi: 10.1055/s-0037-1604464..
Keywords: Racial and Ethnic Minorities, Patient-Centered Healthcare, Clinician-Patient Communication, Women