National Healthcare Quality and Disparities Report
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Search All Research Studies
Topics
- Ambulatory Care and Surgery (1)
- Blood Pressure (1)
- Cardiovascular Conditions (1)
- Case Study (3)
- Children/Adolescents (2)
- Chronic Conditions (6)
- Community-Based Practice (1)
- Comparative Effectiveness (3)
- Cultural Competence (2)
- (-) Diabetes (18)
- Education: Patient and Caregiver (1)
- Elderly (1)
- (-) Evidence-Based Practice (18)
- Guidelines (6)
- Health Information Technology (HIT) (1)
- Heart Disease and Health (1)
- Kidney Disease and Health (2)
- Medication (4)
- Medication: Safety (1)
- Obesity (1)
- Obesity: Weight Management (1)
- Outcomes (3)
- Patient-Centered Healthcare (3)
- Patient-Centered Outcomes Research (7)
- Patient and Family Engagement (2)
- Patient Self-Management (3)
- Practice Patterns (1)
- Pregnancy (2)
- Prevention (7)
- Primary Care (3)
- Provider (1)
- Provider: Clinician (1)
- Provider: Physician (1)
- Racial and Ethnic Minorities (3)
- Registries (1)
- Risk (1)
- Screening (6)
- Shared Decision Making (2)
- Telehealth (1)
- U.S. Preventive Services Task Force (USPSTF) (5)
- Women (2)
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 18 of 18 Research Studies DisplayedChu CD, Xia F, Du Y
Estimated prevalence and testing for albuminuria in US adults at risk for chronic kidney disease.
The purpose of this cohort study was to assess the extent of albuminuria underdetection from lack of testing and examine its association with CKD treatment. Researchers examined records of adults with hypertension or diabetes, utilizing data from the 2007 to 2018 National Health and Nutrition Examination Surveys (NHANES) and the Optum deidentified electronic health record (EHR) data set of US health care organizations. The total EHR study population included 192,108 patients; 96.6% with hypertension, and 26.2% with diabetes. The study found that 17.5% of patients had albuminuria testing; of whom 34.3% had albuminuria. Among 158,479 patients who were untested, the estimated albuminuria prevalence rate was 13.4%. Thus, only 35.2% of the projected population with albuminuria had been tested. Albuminuria testing was associated with higher adjusted odds of receiving ACEi or ARB treatment, SGLT2i treatment, and having blood pressure controlled to less than 140/90 mm Hg. The researchers concluded that approximately two-thirds of patients with albuminuria were undetected due to lack of testing.
AHRQ-funded; HS026383.
Citation: Chu CD, Xia F, Du Y .
Estimated prevalence and testing for albuminuria in US adults at risk for chronic kidney disease.
JAMA Netw Open 2023 Jul; 6(7):e2326230. doi: 10.1001/jamanetworkopen.2023.26230..
Keywords: Kidney Disease and Health, Chronic Conditions, Diabetes, Blood Pressure, Evidence-Based Practice
Mills J, Barnhart H
AHRQ Author: Mills J
Screening for prediabetes and type 2 diabetes in children and adolescents.
This Putting Prevention into Practice case study is used to increase understanding of the USPSTF final recommendation on screening for prediabetes and type 2 diabetes in children and adolescents. A case study was presented using a 12-year-old-patient with no specific concerns but had gained 18 pounds since their last wellness visit and lives a sedentary lifestyle. The patient’s family history of type 2 diabetes mellitus in maternal and paternal grandparents is described. Three multiple-choice questions are presented regarding harms and benefits of screening for prediabetes and type 2 diabetes for that patient.
AHRQ-authored.
Citation: Mills J, Barnhart H .
Screening for prediabetes and type 2 diabetes in children and adolescents.
Am Fam Physician 2023 Jan; 107(1):79-80..
Keywords: U.S. Preventive Services Task Force (USPSTF), Children/Adolescents, Diabetes, Screening, Evidence-Based Practice, Guidelines, Prevention, Chronic Conditions, Case Study
Jonas DE, Vander Schaaf EB, Riley S
Screening for prediabetes and type 2 diabetes in children and adolescents: evidence report and systematic review for the US Preventive Services Task Force.
The purpose of this study was to explore the evidence on the benefits and harms of screening children and adolescents for prediabetes and type 2 diabetes to inform the US Preventive Services Task Force (USPSTF). The researchers utilized references; experts; literature surveillance, and PubMed/MEDLINE, Cochrane Library, and trial registries. The final review included 8 publications with 856 participants with a mean age of 14 years. The researchers found that none of the eligible studies directly assessed the benefits or harms of preventive screening. The limited eligible clinical trials reported few health outcomes and found no difference between groups.
AHRQ-funded; 290201500007I.
Citation: Jonas DE, Vander Schaaf EB, Riley S .
Screening for prediabetes and type 2 diabetes in children and adolescents: evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2022 Sep 13;328(10):968-79. doi: 10.1001/jama.2022.7957..
Keywords: U.S. Preventive Services Task Force (USPSTF), Children/Adolescents, Diabetes, Screening, Prevention, Evidence-Based Practice, Guidelines
Tracer H, Mohnot S
Screening for prediabetes and type 2 diabetes mellitus.
In this “Putting Prevention Into Practice An Evidence-Based Approach”, the authors provide a case study with questions and answers related to Screening for Prediabetes and Type 2 Diabetes Mellitus.
AHRQ-authored.
Citation: Tracer H, Mohnot S .
Screening for prediabetes and type 2 diabetes mellitus.
Screening for prediabetes and type 2 diabetes mellitus.
Am Fam Physician 2022 Jan 1;105(1):73-74..
Am Fam Physician 2022 Jan 1;105(1):73-74..
Keywords: Diabetes, Screening, Prevention, Evidence-Based Practice, Guidelines, Case Study
Mills J, Mohnot S
AHRQ Author: Mills J
Screening for gestational diabetes.
This “Putting Prevention into Practice: An Evidence Based Approach” paper is a case study with questions and answers related to a patient with gestational diabetes.
AHRQ-authored.
Citation: Mills J, Mohnot S .
Screening for gestational diabetes.
Am Fam Physician 2021 Dec 1;104(6):641-42..
Keywords: U.S. Preventive Services Task Force (USPSTF), Diabetes, Pregnancy, Screening, Prevention, Women, Evidence-Based Practice, Guidelines, Case Study
Pillay J, Donovan L, Guitard S
Screening for gestational diabetes: updated evidence report and systematic review for the US Preventive Services Task Force.
The objective of this study was to update the 2012 review on screening for gestational diabetes to inform the US Preventive Services Task Force. The investigators concluded that direct evidence on screening vs no screening remained limited. One- vs 2-step screening was not significantly associated with improved health outcomes. At or after 24 weeks of gestation, treatment of gestational diabetes was significantly associated with improved health outcomes.
Citation: Pillay J, Donovan L, Guitard S .
Screening for gestational diabetes: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2021 Aug 10;326(6):539-62. doi: 10.1001/jama.2021.10404..
Keywords: U.S. Preventive Services Task Force (USPSTF), Diabetes, Pregnancy, Screening, Evidence-Based Practice, Women, Prevention, Guidelines
Rosas LG, Lv N, Xiao L
Effect of a culturally adapted behavioral intervention for Latino adults on weight loss over 2 years: a randomized clinical trial.
Identifying effective weight loss interventions for Latino adults at risk of diabetes is of critical public health importance. The purpose of this study was to determine whether a culturally adapted behavioral intervention for Latino adults was more effective than usual care for weight loss over 24 months. The investigators concluded that among Latino adults with high diabetes risk, a culturally adapted behavioral lifestyle intervention was effective for weight loss over 12 months but not 24 months.
AHRQ-funded; HS022702.
Citation: Rosas LG, Lv N, Xiao L .
Effect of a culturally adapted behavioral intervention for Latino adults on weight loss over 2 years: a randomized clinical trial.
JAMA Netw Open 2020 Dec;3(12):e2027744. doi: 10.1001/jamanetworkopen.2020.27744..
Keywords: Racial and Ethnic Minorities, Obesity: Weight Management, Obesity, Cultural Competence, Diabetes, Primary Care, Outcomes, Patient-Centered Outcomes Research, Comparative Effectiveness, Evidence-Based Practice
Presley C, Agne A, Shelton T
Mobile-enhanced peer support for African Americans with Type 2 diabetes: a randomized controlled trial.
This study compared the effectiveness of a community-based diabetes self-management education (DSME) plus mobile health (mHealth)-enhanced peer support intervention to community-based DSME alone for African American adults with poorly controlled type 2 diabetes. This randomized controlled trial took place in Jefferson County, Alabama within a safety-net healthcare system with a group diagnosed with type 2 diabetes and hemoglobin A1C ≥ 7.5%. The intervention group reviewed community-based DSME plus 6 months of mHealth-enhanced peer support, including 12 weekly phone calls, then 3 monthly calls from community health workers. The control group received community based DSME only. Primary outcomes were lower A1C and secondary outcomes were lower diabetes distress, depressive symptoms, self-efficacy or confidence in their ability to manage diabetes, and social support. Of 120 participants selected, 97 completed the study. Both groups experienced clinical meaning reduction in A1C. Participants in the intervention group experienced a significantly larger reduction in diabetes distress compared to the control group.
AHRQ-funded; HS019465.
Citation: Presley C, Agne A, Shelton T .
Mobile-enhanced peer support for African Americans with Type 2 diabetes: a randomized controlled trial.
J Gen Intern Med 2020 Oct;35(10):2889-96. doi: 10.1007/s11606-020-06011-w..
Keywords: Telehealth, Health Information Technology (HIT), Patient Self-Management, Diabetes, Chronic Conditions, Racial and Ethnic Minorities, Community-Based Practice, Comparative Effectiveness, Patient-Centered Outcomes Research, Evidence-Based Practice, Outcomes, Education: Patient and Caregiver
Obinwa U, Pérez A, Lingvay I
Multilevel variation in diabetes screening within an integrated health system.
Variation in diabetes screening in clinical practice is poorly described. In this study, the investigators examined the interplay of patient, provider, and clinic factors explaining variation in diabetes screening within an integrated health care system in the U.S. They concluded that screening practices varied widely and were only partially explained by patient, provider, and clinic factors available in the EHR.
AHRQ-funded; HS022418.
Citation: Obinwa U, Pérez A, Lingvay I .
Multilevel variation in diabetes screening within an integrated health system.
Diabetes Care 2020 May;43(5):1016-24. doi: 10.2337/dc19-1622..
Keywords: U.S. Preventive Services Task Force (USPSTF), Diabetes, Screening, Primary Care, Prevention, Evidence-Based Practice, Chronic Conditions
McCoy RG, Lipska KJ, Van Houten HK
Paradox of glycemic management: multimorbidity, glycemic control, and high-risk medication use among adults with diabetes.
Researchers examined contemporary patterns of glycemic control and use of medications known to cause hypoglycemia among adults with diabetes across age and multimorbidity. They found that the proportion of patients achieving low HbA1c levels was highest among older and multimorbid patients. Older patients and patients with higher comorbidity burden were more likely to be treated with insulin to achieve these HbA1c levels despite the potential for hypoglycemia and uncertain long-term benefit.
AHRQ-funded; HS024075.
Citation: McCoy RG, Lipska KJ, Van Houten HK .
Paradox of glycemic management: multimorbidity, glycemic control, and high-risk medication use among adults with diabetes.
BMJ Open Diabetes Res Care 2020 Feb;8(1). doi: 10.1136/bmjdrc-2019-001007..
Keywords: Diabetes, Medication, Patient-Centered Outcomes Research, Patient-Centered Healthcare, Evidence-Based Practice, Risk, Chronic Conditions
Moin T, Schmittdiel JA, Flory JH
Review of metformin use for type 2 diabetes prevention.
This evidence review summarizes the use of metform for type 2 diabetes prevention. Articles published between 1998 and 2017 were analyzed, and forty articles met inclusion criteria. Metformin was associated with reduced relative risk of type 2 diabetes, with the strongest evidence for use with those higher-risk patients. These patients are aged 60 years or more, BMI greater or equal to 35, and women with histories of gestational diabetes. It was also deemed cost-effective in 11 economic analyses.
AHRQ-funded; HS023898.
Citation: Moin T, Schmittdiel JA, Flory JH .
Review of metformin use for type 2 diabetes prevention.
Am J Prev Med 2018 Oct;55(4):565-74. doi: 10.1016/j.amepre.2018.04.038..
Keywords: Diabetes, Evidence-Based Practice, Medication, Prevention
Havele SA, Pfoh ER, Yan C
Physicians' views of self-monitoring of blood glucose in patients with type 2 diabetes not on insulin.
This qualitative study examines to what extent and why physicians still prescribe self-monitoring of blood glucose in patients with non-insulin-treated type 2 diabetes when the evidence shows it increases cost without improving hemoglobin A1c, general well-being, or health-related quality of life.
AHRQ-funded; HS024128.
Citation: Havele SA, Pfoh ER, Yan C .
Physicians' views of self-monitoring of blood glucose in patients with type 2 diabetes not on insulin.
Ann Fam Med 2018 Jul;16(4):349-52. doi: 10.1370/afm.2244..
Keywords: Diabetes, Evidence-Based Practice, Ambulatory Care and Surgery, Patient-Centered Outcomes Research, Patient Self-Management
Veazie S, Winchell K, Gilbert J
Rapid evidence review of mobile applications for self-management of diabetes.
The study authors conducted a rapid evidence review to examine features, clinical efficacy, and usability of apps for self-management of type 1 and type 2 diabetes in adults. The investigators found limited evidence suggesting that use of some commercially available apps, when combined with additional support from a healthcare provider or study staff, may improve some short-term diabetes-related outcomes. The impact of these apps on longer-term outcomes was unclear.
AHRQ-funded; 29020120004C; 290201700003C.
Citation: Veazie S, Winchell K, Gilbert J .
Rapid evidence review of mobile applications for self-management of diabetes.
J Gen Intern Med 2018 Jul;33(7):1167-76. doi: 10.1007/s11606-018-4410-1..
Keywords: Diabetes, Evidence-Based Practice, Patient-Centered Outcomes Research, Patient Self-Management
Rosas LG, Lv N, Lewis MA
A Latino patient-centered, evidence-based approach to diabetes prevention.
Cultural tailoring of evidence-based diabetes prevention program (DPP) interventions is needed to effectively address obesity and its related chronic diseases among Latinos in primary care. This article described the patient-centered process used to adapt the DPP and reported cultural adaptations. The investigators concluded that the 2-stage approach actively engaging patients, family members, providers, and health care system leaders reinforced the cultural congruence of the existing intervention while further strengthening it with adaptations promoting Latino family and community support.
AHRQ-funded; HS022702.
Citation: Rosas LG, Lv N, Lewis MA .
A Latino patient-centered, evidence-based approach to diabetes prevention.
J Am Board Fam Med 2018 May-Jun;31(3):364-74. doi: 10.3122/jabfm.2018.03.170280..
Keywords: Cultural Competence, Diabetes, Evidence-Based Practice, Patient and Family Engagement, Patient-Centered Healthcare, Racial and Ethnic Minorities
McCreedy EM, Kane RL, Gollust SE
Patient-centered guidelines for geriatric diabetes care: potential missed opportunities to avoid harm.
Clinicians strive to deliver individualized, patient-centered care. However, these intentions are understudied. This research explored how patient characteristics associated with a high risk-to-benefit ratio with hypoglycemia medications affected decision making by primary care clinicians. The investigators found that primary care clinicians often chose to intensify glycemic control despite individual patient factors that warranted higher glycemic targets based on existing guidelines.
AHRQ-funded; HS000011.
Citation: McCreedy EM, Kane RL, Gollust SE .
Patient-centered guidelines for geriatric diabetes care: potential missed opportunities to avoid harm.
J Am Board Fam Med 2018 Mar-Apr;31(2):192-200. doi: 10.3122/jabfm.2018.02.170141..
Keywords: Diabetes, Elderly, Patient-Centered Healthcare, Guidelines, Evidence-Based Practice, Shared Decision Making, Medication, Primary Care, Practice Patterns, Provider: Physician, Provider: Clinician, Provider
Cooper LB, Lippmann SJ, Greiner MA
Use of mineralocorticoid receptor antagonists in patients with heart failure and comorbid diabetes mellitus or chronic kidney disease.
Perceived risks of hyperkalemia and acute renal insufficiency may limit use of mineralocorticoid receptor antagonist (MRA) therapy in patients with heart failure, especially those with diabetes mellitus or chronic kidney disease. In their study, the investigators found that among patients with heart failure and diabetes mellitus or chronic kidney disease, MRA use was associated with lower risk of all-cause readmission despite greater risk of hyperkalemia and acute renal insufficiency.
AHRQ-funded; HS021092.
Citation: Cooper LB, Lippmann SJ, Greiner MA .
Use of mineralocorticoid receptor antagonists in patients with heart failure and comorbid diabetes mellitus or chronic kidney disease.
J Am Heart Assoc 2017 Dec 23;6(12):pii: e006540. doi: 10.1161/jaha.117.006540..
Keywords: Cardiovascular Conditions, Chronic Conditions, Diabetes, Evidence-Based Practice, Heart Disease and Health, Kidney Disease and Health, Outcomes, Patient-Centered Outcomes Research, Registries
Makam AN, Nguyen OK
An evidence-based medicine approach to antihyperglycemic therapy in diabetes mellitus to overcome overtreatment.
This article discusses the importance of (1) using absolute rather than relative estimates of benefits to inform treatment decisions; (2) considering the time horizon to benefit of treatments; (3) balancing potential harms and benefits; and (4) using shared decision making by physicians to incorporate the patient's values and preferences into treatment decisions.
AHRQ-funded; HS022418.
Citation: Makam AN, Nguyen OK .
An evidence-based medicine approach to antihyperglycemic therapy in diabetes mellitus to overcome overtreatment.
Circulation 2017 Jan 10;135(2):180-95. doi: 10.1161/circulationaha.116.022622.
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Keywords: Shared Decision Making, Diabetes, Evidence-Based Practice, Patient and Family Engagement, Patient-Centered Outcomes Research
Maruther NM, Tseng E, Huftless S
Diabetes medications as monotherapy or metformin-based combination therapy for type 2 diabetes: A systematic review and meta-analysis.
The purpose of this study was to evaluate the comparative effectiveness and safety of monotherapy and selected metformin-based combinations in adults with type 2 diabetes. It found that the evidence supports metformin as first-line therapy for type 2 diabetes, given its relative safety and beneficial effects on hemoglobin A1c, weight, and cardiovascular mortality (compared with sulfonylureas). AHRQ-funded; 290-201-200007.
AHRQ-funded; 290201200007I.
Citation: Maruther NM, Tseng E, Huftless S .
Diabetes medications as monotherapy or metformin-based combination therapy for type 2 diabetes: A systematic review and meta-analysis.
Ann Intern Med 2016 Jun 7;164(11):740-51. doi: 10.7326/m15-2650.
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Keywords: Comparative Effectiveness, Medication, Diabetes, Evidence-Based Practice, Medication: Safety