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 29 Research Studies DisplayedCibrian FL, Monteiro E, Ankrah E
Parents' perspectives on a smartwatch intervention for children with ADHD: rapid deployment and feasibility evaluation of a pilot intervention to support distance learning during COVID-19.
This paper explores how smartwatch technology, including timing notifications, can support children with ADHD during distance learning due to COVID-19. The researchers used a Digital Health Intervention which included a smartwatch and a smartphone. Their results demonstrated that children successfully adopted the use of the smartwatch, and parents believed that the intervention was helpful, especially in supporting the development of organizational skills in their children. The authors included suggestions to help professionals teach children with ADHD to use smartwatches to improve organization and task completion, especially as it applies to supporting remote instruction.
AHRQ-funded; HS026058.
Citation: Cibrian FL, Monteiro E, Ankrah E .
Parents' perspectives on a smartwatch intervention for children with ADHD: rapid deployment and feasibility evaluation of a pilot intervention to support distance learning during COVID-19.
PLoS One 2021 Oct 27;16(10):e0258959. doi: 10.1371/journal.pone.0258959..
Keywords: Children/Adolescents, COVID-19, Behavioral Health, Telehealth, Health Information Technology (HIT), Patient Adherence/Compliance
Morrone KA, Manwani D, Cabana MD
Efficient clinical counseling for sickle cell disease.
Sickle cell anemia (SCA) is a chronic illness that requires frequent health care visits for preventative management. Aims of this overview were to review challenges faced in outpatient subspecialty medicine and describe evidence-based techniques for more effective communication for patients with sickle cell anemia.
AHRQ-funded; HS025297.
Citation: Morrone KA, Manwani D, Cabana MD .
Efficient clinical counseling for sickle cell disease.
J Natl Med Assoc 2021 Aug;113(4):382-87. doi: 10.1016/j.jnma.2021.01.006..
Keywords: Sickle Cell Disease, Chronic Conditions, Clinician-Patient Communication, Communication, Patient Adherence/Compliance
Xu L, Xie D, Griffin KS
Objective adherence to dental device versus positive airway pressure treatment in adults with obstructive sleep apnea.
Although mandibular advancement device (MAD) treatment of adults with obstructive sleep apnea (OSA) is generally less efficacious than positive airway pressure (PAP), the two treatments are associated, with similar clinical outcomes. As a sub-analysis of a randomized trial comparing the effect of MAD versus PAP on blood pressure, this study compared objectively measured adherence to MAD versus PAP treatment in adults with OSA.
AHRQ-funded; HS019738.
Citation: Xu L, Xie D, Griffin KS .
Objective adherence to dental device versus positive airway pressure treatment in adults with obstructive sleep apnea.
J Sleep Res 2021 Aug;30(4):e13240. doi: 10.1111/jsr.13240..
Keywords: Sleep Problems, Patient Adherence/Compliance, Treatments, Dental and Oral Health, Respiratory Conditions
Lopez-Olivo MA, des Bordes JK, Lin H
A randomized controlled trial comparing two self-administered educational strategies for patients with knee osteoarthritis.
The authors conducted a randomized clinical trial in patients with knee osteoarthritis to assess the efficacy of providing a video for entertainment education, in combination with two booklets, compared with providing the booklets alone. They found that, although both education strategies were associated with improved knowledge and reduced decisional conflict at 6 months, receiving the video + booklets in combination, compared with receiving the booklets alone, proved to be more effective in changing behaviors and appeared to have some advantages for Spanish speakers and those who were less educated.
AHRQ-funded; HS019354.
Citation: Lopez-Olivo MA, des Bordes JK, Lin H .
A randomized controlled trial comparing two self-administered educational strategies for patients with knee osteoarthritis.
ACR Open Rheumatol 2021 Mar;3(3):185-95. doi: 10.1002/acr2.11222..
Keywords: Arthritis, Orthopedics, Education: Patient and Caregiver, Patient Self-Management, Patient Adherence/Compliance, Shared Decision Making, Health Promotion
Heneghan MB, Hussain T, Barrera L
Access to technology and preferences for an mHealth intervention to promote medication adherence in pediatric acute lymphoblastic leukemia: approach leveraging behavior change techniques.
This study’s objectives were to examine access to mobile technology and preferences for an mHealth intervention to improve medication adherence in pediatric acute lymphoblastic leukemia (ALL). Parents of children with ALL as well as adolescents and young adults (AYAs) with ALL who received maintenance chemotherapy were given a cross-sectional survey. Findings showed that parents, adolescents, and AYAs reported ubiquitous access to mobile technology and strong interest in multiple adherence-specific mHealth app features. Parents and AYAs provided valuable insight into preferred features for a multifunctional behavioral intervention to promote medication adherence in pediatric ALL.
AHRQ-funded; HS023011.
Citation: Heneghan MB, Hussain T, Barrera L .
Access to technology and preferences for an mHealth intervention to promote medication adherence in pediatric acute lymphoblastic leukemia: approach leveraging behavior change techniques.
J Med Internet Res 2021 Feb 18;23(2):e24893. doi: 10.2196/24893..
Keywords: Children/Adolescents, Young Adults, Caregiving, Cancer, Medication, Patient Adherence/Compliance, Health Information Technology (HIT), Treatments
Snyder ME, Chewning B, Kreling D
An evaluation of the spread and scale of PatientToc™ from primary care to community pharmacy practice for the collection of patient-reported outcomes: a study protocol.
Patient-reported outcomes (PROs), measuring adherence challenges pertaining to both remembering and intention to take medication, offer a rich data source for pharmacists and prescribers to use to resolve medication non-adherence. PatientToc™ is a PROs collection software developed to facilitate collection of PROs data from low-literacy and non-English speaking patients in Los Angeles. This study evaluated the spread and scale of PatientToc™ from primary care to community pharmacies for the collection and use of PROs data pertaining to medication adherence.
AHRQ-funded; HS025943.
Citation: Snyder ME, Chewning B, Kreling D .
An evaluation of the spread and scale of PatientToc™ from primary care to community pharmacy practice for the collection of patient-reported outcomes: a study protocol.
Res Social Adm Pharm 2021 Feb;17(2):466-74. doi: 10.1016/j.sapharm.2020.03.019..
Keywords: Medication, Patient Adherence/Compliance, Primary Care, Provider: Pharmacist, Provider, Health Information Technology (HIT)
Hill SC, Abdus S
AHRQ Author: Hill SC Abdus S
The effects of Medicaid on access to care and adherence to recommended preventive services.
Using MEPS data, the authors sought to quantify the impact of Medicaid enrollment on access to care and adherence to recommended preventive services. They found that Medicaid enrollment decreased the probability of having unmet needs for medical care and of experiencing delays getting prescription drugs. Medicaid enrollment increased the probability of having a usual source of care, of having a routine checkup, and of having a flu shot in past year.
AHRQ-authored.
Citation: Hill SC, Abdus S .
The effects of Medicaid on access to care and adherence to recommended preventive services.
Health Serv Res 2021 Feb;56(1):84-94. doi: 10.1111/1475-6773.13603..
Keywords: Medical Expenditure Panel Survey (MEPS), Medicaid, Access to Care, Prevention, Patient Adherence/Compliance
Oikonomidi T, Ravaud P, Cosson E
AHRQ Author: Montori V
Evaluation of patient willingness to adopt remote digital monitoring for diabetes management.
Investigators sought to identify the minimum effectiveness patients report they require to adopt 36 different remote digital monitoring (RDM) scenarios. Adults with type 1 or type 2 diabetes living in 30 countries assessed three randomly selected scenarios from a total of 36 that described different combinations of digital monitoring tools. The investigators found that patients required greater health benefits to adopt more intrusive RDM modalities, food monitoring, and real-time feedback by a health care professional. They recommended that patient monitoring devices be designed to be minimally intrusive.
AHRQ-authored.
Citation: Oikonomidi T, Ravaud P, Cosson E .
Evaluation of patient willingness to adopt remote digital monitoring for diabetes management.
JAMA Netw Open 2021 Jan;4(1):e2033115. doi: 10.1001/jamanetworkopen.2020.33115..
Keywords: Telehealth, Health Information Technology (HIT), Diabetes, Chronic Conditions, Care Management, Patient Self-Management, Patient Adherence/Compliance
Dakwar E, Levin FR, Olfson M
First treatment contact for ADHD: predictors of and gender differences in treatment seeking.
The investigators aimed to estimate ADHD treatment-seeking probabilities over the lifetime and to identify predictors of treatment seeking for ADHD separately for males and females. They found that a large proportion of persons with ADHD do not seek treatment, and that treatment seeking by males was affected by a greater number of identifiable characteristics, suggesting that males might be more responsive to efforts directed toward expediting treatment entry.
AHRQ-funded; HS016097.
Citation: Dakwar E, Levin FR, Olfson M .
First treatment contact for ADHD: predictors of and gender differences in treatment seeking.
Psychiatr Serv 2014 Dec;65(12):1465-73. doi: 10.1176/appi.ps.201300298.
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Keywords: Behavioral Health, Sex Factors, Patient Adherence/Compliance
Schmittdiel J, Raebel M, Dyer W
Medicare Star excludes diabetes patients with poor CVD risk factor control.
This study is designed to improve understanding of novel CMS quality measures (adherence to antihypertensives, antihyperlipidemics, and oral antihyperglycemics) by assessing the proportion of Medicare patients with diabetes who are excluded from the Medicare Star medication adherence metrics due to early nonadherence and insulin use. Medicare’s STAR measures are used to evaluate the performance of Medicare Advantage plans.
AHRQ-funded; HS019859
Citation: Schmittdiel J, Raebel M, Dyer W .
Medicare Star excludes diabetes patients with poor CVD risk factor control.
Am J Manag Care. 2014 Dec; 20(12):e573-81..
Keywords: Medicare, Diabetes, Quality Measures, Patient Adherence/Compliance
Kuntz JL, Safford MM, Singh JA
Patient-centered interventions to improve medication management and adherence: a qualitative review of research findings.
This review reports the current state of scientific research around interventions to improve medication management through four patient-centered domains. Out of 60 studies, the authors found the following types of intervention: patient education, augmented pharmacy services, decision aids, shared decision-making, and clinical review of patient adherence. They were unable to determine whether these interventions were more effective than traditional medication adherence interventions.
AHRQ-funded; HS021107.
Citation: Kuntz JL, Safford MM, Singh JA .
Patient-centered interventions to improve medication management and adherence: a qualitative review of research findings.
Patient Educ Couns 2014 Dec;97(3):310-26. doi: 10.1016/j.pec.2014.08.021.
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Keywords: Education: Patient and Caregiver, Shared Decision Making, Medication, Patient Adherence/Compliance, Patient-Centered Healthcare
Kendall L, Eschler J, Lozano P
Engineering for reliability in at-home chronic disease management.
The researchers examined how individuals responsible for managing their own or others’ chronic conditions integrate reminders and notification systems into their daily routines. Based on the participants’ experiences, they contend that many self-management failures should be viewed as systems failures, rather than individual failures and non-compliance.
AHRQ-funded; HS021590.
Citation: Kendall L, Eschler J, Lozano P .
Engineering for reliability in at-home chronic disease management.
AMIA Annu Symp Proc 2014 Nov 14;2014:777-86..
Keywords: Chronic Conditions, Patient Self-Management, Home Healthcare, Patient Adherence/Compliance
Albrecht JS, Gruber-Baldini AL, Hirshon JM
Hospital discharge instructions: comprehension and compliance among older adults.
The purpose of this prospective cohort study was to quantify the prevalence of non-comprehension and non-compliance with discharge instructions and to identify associated patient characteristics. The investigators concluded that non-comprehension of discharge instructions among older adults was prevalent, multi-factorial, and varies by domain.
AHRQ-funded; HS021068.
Citation: Albrecht JS, Gruber-Baldini AL, Hirshon JM .
Hospital discharge instructions: comprehension and compliance among older adults.
J Gen Intern Med 2014 Nov;29(11):1491-8. doi: 10.1007/s11606-014-2956-0..
Keywords: Elderly, Health Literacy, Hospital Discharge, Patient Adherence/Compliance
Zhang Y, Kaplan CM, Baik SH
Medication adherence and readmission after myocardial infarction in the Medicare population.
This study examines the relationship between 6-month medication adherence following a hospitalization for heart attack and a subsequent readmission occurring between 6 and 12 months after the heart attack. It found that the probability of having a preventable readmission 6 to 12 months after a heart attack discharge was much lower for Medicare beneficiaries with good adherence to all heart attack-related medications, compared to those with poor adherence.
AHRQ-funded; HS018657
Citation: Zhang Y, Kaplan CM, Baik SH .
Medication adherence and readmission after myocardial infarction in the Medicare population.
Am J Manag Care 2014 Nov; 20(11):e498-505..
Keywords: Heart Disease and Health, Medication, Patient Adherence/Compliance, Hospital Readmissions
Starner CI, Alexander GC, Bowen K
Specialty drug coupons lower out-of-pocket costs and may improve adherence at the risk of increasing premiums.
The investigators examined insurers' role in maintaining the affordability and accessibility of specialty drugs while maximizing their value. They found that drug coupons accounted for $21.2 million of patients' $35.3 million annual out-of-pocket costs. In the vast majority of cases, coupons reduced monthly cost sharing to less than $250, a point at which patients were far less likely to abandon therapy with biologic anti-inflammatory drugs or with drugs for multiple sclerosis. They highlighted that, by reducing cost sharing, coupons may also circumvent efforts to encourage patients to use the most cost-effective drugs.
AHRQ-funded; HS018960.
Citation: Starner CI, Alexander GC, Bowen K .
Specialty drug coupons lower out-of-pocket costs and may improve adherence at the risk of increasing premiums.
Health Aff 2014 Oct;33(10):1761-9. doi: 10.1377/hlthaff.2014.0497.
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Keywords: Healthcare Costs, Health Insurance, Medication, Patient Adherence/Compliance
Mixon AS, Neal E, Bell S
Care transitions: a leverage point for safe and effective medication use in older adults--a mini-review.
The authors discuss medication adherence in older adults across the continuum of care, describing reasons for nonadherence, methods to assess adherence, and tools to improve adherence, with particular focus on emerging techniques and technologies.
AHRQ-funded; HS019598.
Citation: Mixon AS, Neal E, Bell S .
Care transitions: a leverage point for safe and effective medication use in older adults--a mini-review.
Gerontology 2015;61(1):32-40. doi: 10.1159/000363765.
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Keywords: Elderly, Hospital Discharge, Medication: Safety, Medication, Patient Adherence/Compliance
Checchi KD, Huybrechts KF, Avorn J
Electronic medication packaging devices and medication adherence: a systematic review.
The authors conducted a systematic review of studies testing the effectiveness of electronic medication packaging (EMP) devices. From the 37 studies included in the review, they determined that although many varieties of EMP devices exist, data supporting their use are limited, with variability in the quality of studies testing EMP devices.
AHRQ-funded; HS18465
Citation: Checchi KD, Huybrechts KF, Avorn J .
Electronic medication packaging devices and medication adherence: a systematic review.
JAMA. 2014 Sep 24;312(12):1237-47. doi: 10.1001/jama.2014.10059..
Keywords: Medication, Health Information Technology (HIT), Patient Safety, Patient Adherence/Compliance
Kelly JD, Hartman C, Graham J
Social support as a predictor of early diagnosis, linkage, retention, and adherence to HIV care: results from the steps study.
The researchers studied 168 persons newly diagnosed with AIDS to determine if social support contributes to various aspects of HIV care. They found that higher social support scores were associated with earlier HIV diagnosis, linkage to care, and adherence to antiretroviral therapy (ART). However, social support did not contribute to use of ART or retention in HIV care.
AHRQ-funded; HS016093
Citation: Kelly JD, Hartman C, Graham J .
Social support as a predictor of early diagnosis, linkage, retention, and adherence to HIV care: results from the steps study.
J Assoc Nurses AIDS Care. 2014 Sep-Oct;25(5):405-13. doi: 10.1016/j.jana.2013.12.002..
Keywords: Human Immunodeficiency Virus (HIV), Patient Adherence/Compliance, Diagnostic Safety and Quality
Kesselheim AS, Bykov K, Avorn J
Burden of changes in pill appearance for patients receiving generic cardiovascular medications after myocardial infarction: cohort and nested case-control studies.
This study sought to determine whether nonpersistent use of generic drugs among patients with cardiovascular disease after a heart attack is associated with the different shapes or colors of generic medications. It found that patients who subsequently discontinued treatment with their cardiovascular medications were 30 percent more likely to have had a change in pill shape or color preceding the discontinuation.
AHRQ-funded; HS018465
Citation: Kesselheim AS, Bykov K, Avorn J .
Burden of changes in pill appearance for patients receiving generic cardiovascular medications after myocardial infarction: cohort and nested case-control studies.
Ann Intern Med. 2014 Jul 15;161(2):96-103. doi: 10.7326/M13-2381..
Keywords: Cardiovascular Conditions, Medication, Chronic Conditions, Patient Adherence/Compliance
Laws MB, Lee Y, Rogers WH
Provider-patient communication about adherence to anti-retroviral regimens differs by patient race and ethnicity.
This study directly examined differences in provider–patient communication about anti-retroviral therapy (ART) adherence by patient race or ethnicity. It found more ART adherence dialogue with Black and Hispanic patients than with White patients, even after controlling for indications, and a tendency for adherence dialogue to be more directive in Hispanics than in Whites.
AHRQ-funded; 290010012.
Citation: Laws MB, Lee Y, Rogers WH .
Provider-patient communication about adherence to anti-retroviral regimens differs by patient race and ethnicity.
AIDS Behav 2014 Jul;18(7):1279-87. doi: 10.1007/s10461-014-0697-z..
Keywords: Human Immunodeficiency Virus (HIV), Clinician-Patient Communication, Patient Adherence/Compliance, Racial and Ethnic Minorities
Voils CI, Gierisch JM, Yancy WS, Jr.
Differentiating behavior initiation and maintenance: theoretical framework and proof of concept.
The authors posited that health behavior initiation and maintenance require separate psychological processes and skills. They found evidence of improvement in dietary intake and of maintenance of physical activity and low-density lipoprotein cholesterol during the 4-month maintenance study. Participants found it helpful to plan for relapses, self-monitor, and obtain social support, but they had mixed reactions about reflecting on satisfaction with outcomes.
AHRQ-funded; HS000079.
Citation: Voils CI, Gierisch JM, Yancy WS, Jr. .
Differentiating behavior initiation and maintenance: theoretical framework and proof of concept.
Health Educ Behav 2014 Jun;41(3):325-36. doi: 10.1177/1090198113515242.
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Keywords: Nutrition, Patient Adherence/Compliance, Patient Self-Management, Lifestyle Changes
Singh JA
Facilitators and barriers to adherence to urate-lowering therapy in African-Americans with gout: a qualitative study.
The study aim was to assess the facilitators and barriers to adherence to urate-lowering therapy (ULT) in African-Americans with gout. It found that facilitators to ULT adherence included recognition of the need to take ULT regularly to prevent gout flares and the desire to have less dietary restriction. Barriers to optimal ULT adherence included doubts about effectiveness of ULT and concerns about cost and side effects.
AHRQ-funded; HS021110.
Citation: Singh JA .
Facilitators and barriers to adherence to urate-lowering therapy in African-Americans with gout: a qualitative study.
Arthritis Res Ther 2014 Mar 29;16(2):R82. doi: 10.1186/ar4524..
Keywords: Patient Adherence/Compliance, Medication, Racial and Ethnic Minorities
Yehia BR, French B, Fleishman JA
AHRQ Author: Fleishman JA
Retention in care is more strongly associated with viral suppression in HIV-infected patients with lower versus higher CD4 counts.
The investigators evaluated whether the association between retention in care and viral suppression differed by HIV disease severity. They found that retention in care is more strongly associated with viral suppression in patients with lower CD4 counts. They concluded that their results have important implications for improving the health of patients with advanced HIV disease and for test and treat approaches to HIV prevention.
AHRQ-authored; AHRQ-funded; 290201100007C.
Citation: Yehia BR, French B, Fleishman JA .
Retention in care is more strongly associated with viral suppression in HIV-infected patients with lower versus higher CD4 counts.
J Acquir Immune Defic Syndr 2014 Mar;65(3):333-9. doi: 10.1097/qai.0000000000000023.
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Keywords: Human Immunodeficiency Virus (HIV), Medication, Patient Adherence/Compliance
Nundy S, Dick JJ, Chou CH
Mobile phone diabetes project led to improved glycemic control and net savings for Chicago plan participants.
Mobile phones are a promising tool to use in engaging patients in behavior change and facilitating self-care between visits. The researchers examined the impact of a six-month mobile health (mHealth) demonstration project among adults with diabetes. In addition to pre-post improvements in glycemic control and patients’ satisfaction with overall care, they observed a net cost savings of 8.8 percent.
AHRQ-funded; HS000084.
Citation: Nundy S, Dick JJ, Chou CH .
Mobile phone diabetes project led to improved glycemic control and net savings for Chicago plan participants.
Health Aff 2014 Feb;33(2):265-72. doi: 10.1377/hlthaff.2013.0589..
Keywords: Diabetes, Health Information Technology (HIT), Patient Adherence/Compliance, Patient Self-Management, Telehealth
Norton BL, Person AK, Castillo C
Barriers to using text message appointment reminders in an HIV clinic.
The researchers conducted a randomized, controlled trial of text message reminders in a large HIV clinic. They found that there were no differences in clinic attendance rates between the group that received text reminders versus the group that did not (72 versus 81 percent). They concluded that barriers must be addressed before they are used as a universal approach to improve clinic attendance.
AHRQ-funded; HS000079.
Citation: Norton BL, Person AK, Castillo C .
Barriers to using text message appointment reminders in an HIV clinic.
Telemed J E Health 2014 Jan;20(1):86-9. doi: 10.1089/tmj.2012.0275..
Keywords: Communication, Health Information Technology (HIT), Human Immunodeficiency Virus (HIV), Patient Adherence/Compliance