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AHRQ Research Studies Date
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- Ambulatory Care and Surgery (3)
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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 23 of 23 Research Studies DisplayedReistetter T, Hreha K, Dean JM
The pre-adaptation of a stroke-specific self-management program among older adults.
To understand the management of multimorbidity in aging stroke survivors and to examine the complex relationships between comorbidities, researchers used visual analytics to identify patient subgroup. Five significant subgroups of comorbidities such as obesity and cancer were identified. An interdisciplinary team constructed six vignettes that highlighted multimorbidity to customize a self-management program that fitted the needs of older adult stroke survivors.
AHRQ-funded; HS026133.
Citation: Reistetter T, Hreha K, Dean JM .
The pre-adaptation of a stroke-specific self-management program among older adults.
J Aging Health 2023 Oct; 35(9):632-42. doi: 10.1177/08982643231152520..
Keywords: Stroke, Cardiovascular Conditions, Elderly, Patient Self-Management
Hooper M, Reinhart M, Dusetzina SB
Trends in U.S. self-reported health and self-care behaviors during the COVID-19 pandemic.
The purpose of this study was to evaluate changes in self-reported health outcomes during the COVID-19 pandemic, and to examine trends in health-related behaviors that may be associated with the observed health changes. The researchers utilized an interrupted time series design stratified by age, gender, race/ethnicity, educational attainment, household income, and employment status. Health outcomes were self-reported by participants and included the number of days per month that respondents spent in poor mental health, physical health, or when poor health prevented their usual activities of daily living. The study found that the national rate of days spent in poor physical health decreased. The researchers also witnessed overall increases in average sleep hours per day, the percentage of adults who report any exercise activity, increased alcohol consumption days, and decreased prevalence of smoking.
AHRQ-funded; HS026395.
Citation: Hooper M, Reinhart M, Dusetzina SB .
Trends in U.S. self-reported health and self-care behaviors during the COVID-19 pandemic.
PLoS One 2023 Sep 19; 18(9):e0291667. doi: 10.1371/journal.pone.0291667..
Keywords: COVID-19, Patient Self-Management
Allende-Richter S, Benitez AD, Ramirez M
A patient portal intervention to promote adolescent and young adult self-management skills.
This study’s objective was to examine whether a patient portal educational intervention is acceptable and can improve adolescent and young adult (AYA) self-management skills toward transition readiness to adult care. The authors conducted a single site feasibility study using a mixed research method consisting of 1) a patient portal one-on-one educational intervention with pre- and postsurveys adapted from the Transition Readiness Assessment Questionnaire to assess participant self-management skills and portal user activity; 2) a portal user experience that was assessed through semistructured interviews until thematic saturation was reached. Study participants were 13 to 25 years old and received care at an academic-affiliated community pediatric clinic, of whom 78 (60%) completed the pre- and post-surveys. Following the educational intervention, they observed an increase in participants self-reporting knowing how to access their protected health information and in the proportion of participants self-reporting to strongly agree to know their medication. They also observed an increase in portal user access at 3 weeks. The median number of logins was 2 per participant.
AHRQ-funded; HS000063.
Citation: Allende-Richter S, Benitez AD, Ramirez M .
A patient portal intervention to promote adolescent and young adult self-management skills.
Acad Pediatr 2023 Aug; 23(6):1252-58. doi: 10.1016/j.acap.2023.02.003..
Keywords: Children/Adolescents, Young Adults, Patient Self-Management, Electronic Health Records (EHRs), Health Information Technology (HIT)
Shannon EM, Mueller SK, Schnipper JL
Patient, caregiver, and clinician experience with a technologically enabled pillbox: a qualitative study.
The purpose of this study was to explore whether medication safety could be improved by the use of a technologically-enabled pillbox prescribed to patients at hospital discharge. The study included semi-structured telephone interviews with patients, patient caregivers, and inpatient and outpatient clinicians who participated in the Smart Pillbox Transition Study. The researchers utilized the Systems Engineering Initiative for Patient Safety (SEIPS) framework to develop an interview guide, which included the a priori domains of 1) barriers to implementation, 2) facilitators of the intervention, and 3) general feedback regarding experience with the intervention. The study found patient-endorsed barriers in the theme of technology and tools included signal issues, inappropriate alarms, and portability. Barriers in the theme of logistics and tasks included coordination with pharmacists in the event of a prescription change. Barriers mentioned by clinicians included patients who were poor fits for the intervention and competing demands at discharge (under the themes of personnel and patients, and logistics and tasks, respectively). Facilitators that were reported often by patients and caregivers in the theme of technology and tools included useful alarms and ease of use. Clinicians reported that communication with pharmacy and study staff facilitated the intervention.
AHRQ-funded.
Citation: Shannon EM, Mueller SK, Schnipper JL .
Patient, caregiver, and clinician experience with a technologically enabled pillbox: a qualitative study.
ACI Open 2023 Jul; 7(2):e61-e70..
Keywords: Medication, Health Information Technology (HIT), Patient Self-Management, Hospital Discharge, Medication: Safety, Patient Safety
Wendel CL, LaPierre TA, Sullivan DL
"Anything that benefits the workers should benefit the client": opportunities and constraints in self-directed care during the COVID-19 pandemic.
The purpose of this study was to assess how self-directed care (SDC) models reacted to the COVID-19 pandemic and to examine the impact of COVID-19 on Home and Community Based Services (HCBS) services in Kansas. The study found that self-directed consumers carried levels of employer responsibility with limited resources and systemic barriers contributing to unmet care needs, stress, and burden. Flexibilities in policies related to the hiring of family members were helpful, but inadequate to address working conditions lacking in resources and labor shortages that were amplified by the pandemic.
AHRQ-funded; HS028172.
Citation: Wendel CL, LaPierre TA, Sullivan DL .
"Anything that benefits the workers should benefit the client": opportunities and constraints in self-directed care during the COVID-19 pandemic.
J Appl Gerontol 2023 Apr; 42(4):7334648221143604. doi: 10.1177/07334648221143604.
Keywords: COVID-19, Patient Self-Management
Schnall R, Sanabria G, Jia R, Sanabria G, Jia H
Efficacy of an mHealth self-management intervention for persons living with HIV: the WiseApp randomized clinical trial.
This study’s objective was to determine the efficacy of WiseApp, a user-centered design mHealth intervention to improve antiretroviral therapy (ART) adherence and viral suppression in persons living with HIV (PLWH). This randomized case-control trial had two study arms: a randomized controlled efficacy trial arm (n = 99) and an attention control intervention arm (n = 101) among PLWH living in New York City. The authors found a significant improvement in ART adherence in the intervention arm compared to the attention control arm from day 1 (69.7% vs 48.3%) to day 59 (51.2% vs 37.2%) of the study period. From day 60 to 120, the intervention had higher but not statistically significant adherence rates. Secondary analyses showed no difference in change from baseline to 3 or 6 months between the 2 study arms.
AHRQ-funded; HS025071.
Citation: Schnall R, Sanabria G, Jia R, Sanabria G, Jia H .
Efficacy of an mHealth self-management intervention for persons living with HIV: the WiseApp randomized clinical trial.
J Am Med Inform Assoc 2023 Feb 16; 30(3):418-26. doi: 10.1093/jamia/ocac233..
Keywords: Telehealth, Patient Self-Management, Human Immunodeficiency Virus (HIV), Chronic Conditions, Health Information Technology (HIT)
Weiner M, Adeoye P, Boeh MJ
Continuous glucose monitoring and other wearable devices to assess hypoglycemia among older adult outpatients with diabetes mellitus.
The purpose of this study was to assess whether vulnerable older adults could use wearable devices, and explore Hypoglycemia frequency over a two week period. The researchers recruited 10 participants with diabetes mellitus to pilot test a continuous glucometer, physical activity monitor, electronic medication bottles, and smartphones which that provided prompts about medications, behaviors, and symptoms. A sample of 70 then wore glucometers and activity monitors and used the smartphone and bottles for a duration of 2 weeks and provided feedback. The study found that patients were interested in assistance with the interpretation of graphs, had challenges with keeping the glucometers attached. Nearly 23% of respondents indicated that they never check their blood sugars. In two weeks of monitoring, 73% had HG and 42% had serious, clinically significant HG.
AHRQ-funded; HS024384.
Citation: Weiner M, Adeoye P, Boeh MJ .
Continuous glucose monitoring and other wearable devices to assess hypoglycemia among older adult outpatients with diabetes mellitus.
Appl Clin Inform 2023 Jan; 14(1):37-44. doi: 10.1055/a-1975-4136..
Keywords: Elderly, Diabetes, Chronic Conditions, Ambulatory Care and Surgery, Patient Self-Management, Medical Devices
Cherrington AL, Khodneva Y, Richman JS
Impact of peer support on acute care visits and hospitalizations for individuals with diabetes and depressive symptoms: a cluster-randomized controlled trial.
This study examined the impact of peer support on the number of acute care visits and hospitalizations for individuals with diabetes with and without depressive symptoms. This randomized controlled trial was conducted from 2010-2012. One year of peer support was given to intervention participants, and the usual care to control participants. A Patient Health Questionnaire (PHQ-8) was given to participants to assess depression symptoms at the beginning of the trial, at 6 months and then at 12 months. There was a lower rate of acute care visits and hospitalizations in those patients with depressive symptoms in the intervention group, but it made no difference for individuals without depressive symptoms.
AHRQ-funded; HS013852.
Citation: Cherrington AL, Khodneva Y, Richman JS .
Impact of peer support on acute care visits and hospitalizations for individuals with diabetes and depressive symptoms: a cluster-randomized controlled trial.
Diabetes Care 2018 Dec;41(12):2463-70. doi: 10.2337/dc18-0550..
Keywords: Ambulatory Care and Surgery, Chronic Conditions, Depression, Diabetes, Hospitalization, Behavioral Health, Patient Self-Management
Ostby PL, Armer JM, Smith K
Patient perceptions of barriers to self-management of breast cancer-related lymphedema.
This article reports on results from a study which used an IRB-approved focus group and mailed surveys to identify barriers to lymphedema self-management, definitions of education and support from breast cancer survivors with lymphedema, types of education and support they had received, what kind of education and support they wanted. Lack of education about lymphedema treatment and risk reduction was identified as a main barrier. Women’s responses also make it unclear whether or not they were exposed to support options other than medical treatment.
AHRQ-funded; HS022140.
Citation: Ostby PL, Armer JM, Smith K .
Patient perceptions of barriers to self-management of breast cancer-related lymphedema.
West J Nurs Res 2018 Dec;40(12):1800-17. doi: 10.1177/0193945917744351..
Keywords: Cancer: Breast Cancer, Education: Patient and Caregiver, Patient Self-Management
Chudy-Onwugaje K, Abutaleb A, Buchwald A
Age modifies the association between depressive symptoms and adherence to self-testing with telemedicine in patients with inflammatory bowel disease.
This study researched the association between age and increased depressive symptoms and adherence to self-testing with telemedicine in patients with inflammatory bowel disease (IBD). It was found that patients 40 and older had worse adherence than patients younger than 40 with depressive symptoms.
AHRQ-funded; HS018975.
Citation: Chudy-Onwugaje K, Abutaleb A, Buchwald A .
Age modifies the association between depressive symptoms and adherence to self-testing with telemedicine in patients with inflammatory bowel disease.
Inflamm Bowel Dis 2018 Nov 29;24(12):2648-54. doi: 10.1093/ibd/izy194..
Keywords: Chronic Conditions, Depression, Digestive Disease and Health, Patient Adherence/Compliance, Patient Self-Management, Telehealth
Sterling MR, Silva AF, Robbins L
Let's talk numbers: a qualitative study of community-dwelling US adults to understand the role of numeracy in the management of heart failure.
This qualitative study examined the role of numeracy (basic number skills) in the management of patients with heart failure (HF). Thirty men and women aged 47-89 years with a history of HF were recruited from an urban academic primary care practice. Participants all had a history of HF within the past year, were seen at the practice within the last year, and had been hospitalized for HF within the last 6 months. They were interviewed about their numeracy to help manage monitoring weight, maintaining a low-salt diet, and monitoring blood pressure. A wide range of knowledge and understanding was found and fear served as a barrier and facilitator to carrying out HF self-care tasks involving numbers. If the patient has a caregiver who also lacks those skills or does not have HF care training, patients may not be managing their HF as well as they should.
AHRQ-funded; HS000066.
Citation: Sterling MR, Silva AF, Robbins L .
Let's talk numbers: a qualitative study of community-dwelling US adults to understand the role of numeracy in the management of heart failure.
BMJ Open 2018 Sep 19;8(9):e023073. doi: 10.1136/bmjopen-2018-023073..
Keywords: Patient Self-Management, Education: Patient and Caregiver, Care Management, Heart Disease and Health, Nutrition, Lifestyle Changes, Obesity: Weight Management, Obesity, Blood Pressure, Cardiovascular Conditions
Winkler SL, Kairalla JA, Cooper R
Comparison of functional benefits of self-management training for amputees under virtual world and e-learning conditions.
This project used a randomized design to compare two methods of disseminating an evidence-based self-management intervention for amputees, which included, avatar-based virtual world and e-learning environments. The investigators found that the virtual world group had a significantly higher dropout rate than the e-learning group.
AHRQ-funded; HS022021.
Citation: Winkler SL, Kairalla JA, Cooper R .
Comparison of functional benefits of self-management training for amputees under virtual world and e-learning conditions.
Journal of Alternative Medicine Research 2018;10(1):65-72..
Keywords: Communication, Education: Patient and Caregiver, Evidence-Based Practice, Health Information Technology (HIT), Patient Self-Management, Training
Kline SE, Neaton JD, Lynfield R
Randomized controlled trial of a self-administered five-day antiseptic bundle versus usual disinfectant soap showers for preoperative eradication of Staphylococcus aureus colonization.
The objective of this study was to determine the efficacy in eradicating Staphylococcus aureus (SA) carriage of a 5-day preoperative decolonization bundle compared to 2 disinfectant soap showers, with both regimens self-administered at home. The investigators concluded that an outpatient preoperative antiseptic decolonization bundle aimed at 4 body sites was significantly more effective in eradicating SA than the usual disinfectant showers (ie, the control).
AHRQ-funded; HS022912.
Citation: Kline SE, Neaton JD, Lynfield R .
Randomized controlled trial of a self-administered five-day antiseptic bundle versus usual disinfectant soap showers for preoperative eradication of Staphylococcus aureus colonization.
Infect Control Hosp Epidemiol 2018 Sep;39(9):1049-57. doi: 10.1017/ice.2018.151..
Keywords: Antimicrobial Stewardship, Infectious Diseases, Patient Self-Management, Prevention, Surgery, Patient Safety
Cho H, Porras T, Baik D
Understanding the predisposing, enabling, and reinforcing factors influencing the use of a mobile-based HIV management app: a real-world usability evaluation.
In this study, the authors conducted an in-depth analysis of users' experiences using an HIV self-management app. Usability evaluation in a real-world setting enabled the investigators to measure users' actual experiences when interacting with the app during their everyday lives. They suggest that their work highlighted the importance of using mobile technology for persons living with HIV, specifically those with low income/housing instability.
AHRQ-funded; HS023963.
Citation: Cho H, Porras T, Baik D .
Understanding the predisposing, enabling, and reinforcing factors influencing the use of a mobile-based HIV management app: a real-world usability evaluation.
Int J Med Inform 2018 Sep;117:88-95. doi: 10.1016/j.ijmedinf.2018.06.007..
Keywords: Health Information Technology (HIT), Human Immunodeficiency Virus (HIV), Patient-Centered Outcomes Research, Patient Self-Management
Werner NE, Jolliff AF, Casper G, et al.
Home is where the head is: a distributed cognition account of personal health information management in the home among those with chronic illness.
Researchers combined distributed cognition theory and a patient work-system model to investigate how characteristics of the home interact with the cognitive work of personal health information management (PHIM) for chronic illness. A 3D cave automatic virtual-reality environment (CAVE) enabled participants diagnosed with diabetes to describe how they would perform PHIM within a home context. The researchers found that PHIM is ‘distinctly cognitive work,’ and that features of the physical environment - tasks, people, tools and technologies - continuously shape/are shaped by the PHIM process. They suggest that approaches in which the individual is considered relevant for analysis overlook the role of environment in shaping PHIM.
AHRQ-funded; HS022548.
Citation: Werner NE, Jolliff AF, Casper G, et al..
Home is where the head is: a distributed cognition account of personal health information management in the home among those with chronic illness.
Ergonomics 2018 Aug;61(8):1065-78. doi: 10.1080/00140139.2018.1435910..
Keywords: Chronic Conditions, Diabetes, Patient Self-Management
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
Mogul DB, Henderson ML, Bridges JFP
Expanding the Facebook platform to engage and educate online communities.
This article discusses the development and use of a mobile application (app) called Liver Space that was developed through Facebook’s platform. This app is for the pediatric liver community including patients and caregivers. Unlike most Facebook health groups, this one is vetted by healthcare providers who are specialists. The app provides up-to-date information and includes emerging news, summaries from important scholarly journals and human interest stories. There is an “ask an expert” function incorporated into Liver Space. Also included in the app is the ability for users to track their labs and weight and to graph the data.
AHRQ-funded; HS023876.
Citation: Mogul DB, Henderson ML, Bridges JFP .
Expanding the Facebook platform to engage and educate online communities.
Am J Gastroenterol 2018 Apr;113(4):457-58. doi: 10.1038/ajg.2017.450..
Keywords: Social Media, Education: Patient and Caregiver, Clinician-Patient Communication, Communication, Health Information Technology (HIT), Patient and Family Engagement, Patient Self-Management
Egan M, Greenhawt M
Common questions in food allergy avoidance.
Allergists must be able to provide avoidance advice while suggesting age and nutritionally appropriate substitutions. This review therefore focuses on providing an understanding of identifying potential myths that may surround certain aspects of food allergy management, with a focus on redirecting misconceptions, and enhancing communications that can improve how patients live life with disease.
AHRQ-funded; HS024599.
Citation: Egan M, Greenhawt M .
Common questions in food allergy avoidance.
Ann Allergy Asthma Immunol 2018 Mar;120(3):263-71. doi: 10.1016/j.anai.2017.09.078.
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Keywords: Chronic Conditions, Nutrition, Patient and Family Engagement, Clinician-Patient Communication, Patient Self-Management
Misra-Hebert AD, Hu B, Le PH
Effect of health plan financial incentive offering on employees with prediabetes.
Researchers studied the effect of employee health plan financial incentives on health outcomes for employees with prediabetes. They found that employees who participated in disease management lost more weight than those who did not. A worksite wellness program offering health plan financial incentives for participation and outcomes was associated with improvements not only in weight but also in HbA1c.
AHRQ-funded; HS024128.
Citation: Misra-Hebert AD, Hu B, Le PH .
Effect of health plan financial incentive offering on employees with prediabetes.
Am J Med 2018 Mar;131(3):293-99. doi: 10.1016/j.amjmed.2017.09.024.
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Keywords: Healthcare Costs, Patient-Centered Outcomes Research, Patient Self-Management, Obesity: Weight Management, Diabetes, Health Status
Greenhawt M, Oppenheimer JJ
Is the better part of valor truly discretion?
The authors argue that the current model for managing peanut allergy is broken, and this fracture is hallmarked by the rapid increase in poor quality of life and poor empowerment of patients. The risk of fatality is often overblown in the face of data that suggest food allergy fatality is exceedingly low. However, the horizon is bright for future therapies and additional risk modeling, which can better arm decision making and means to inform patients about how to personalize management of their food allergy going forward.
AHRQ-funded; HS024599.
Citation: Greenhawt M, Oppenheimer JJ .
Is the better part of valor truly discretion?
Ann Allergy Asthma Immunol 2018 Feb;120(2):111-12. doi: 10.1016/j.anai.2017.11.003.
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Keywords: Shared Decision Making, Mortality, Patient-Centered Outcomes Research, Patient Self-Management, Quality of Life
Pellegrini CA, Conroy DE, Phillips SM
Daily and seasonal influences on dietary self-monitoring using a smartphone application.
Researchers examined within-person variation in dietary self-monitoring during a 6-month technology-supported weight loss trial as a function of time-varying factors including time in the study, day of the week, and month of the year. They found that participants recorded less as time in the study progressed. Fewer foods were reported on the weekends compared with weekdays. More foods were self-monitored in January compared with October; however, a seasonal effect was not observed.
AHRQ-funded; HS023011.
Citation: Pellegrini CA, Conroy DE, Phillips SM .
Daily and seasonal influences on dietary self-monitoring using a smartphone application.
J Nutr Educ Behav 2018 Jan;50(1):56-61.e1. doi: 10.1016/j.jneb.2016.12.004.
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Keywords: Health Information Technology (HIT), Nutrition, Patient Adherence/Compliance, Patient Self-Management, Obesity: Weight Management
Greenhawt M, DunnGalvin A
Preliminary psychometric analyses and clinical performance of a caregiver self-efficacy scale for food allergy self-management.
The researchers examined the preliminary reliability, validity, and clinical performance of a novel 8-item Food Allergy Self-Efficacy Questionnaire (FASEQ). They present preliminary evidence that the FASEQ is a valid tool to assess caregiver food allergy self-efficacy.
AHRQ-funded; HS024599.
Citation: Greenhawt M, DunnGalvin A .
Preliminary psychometric analyses and clinical performance of a caregiver self-efficacy scale for food allergy self-management.
Ann Allergy Asthma Immunol 2018 Jan;120(1):73-79. doi: 10.1016/j.anai.2017.09.060.
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Keywords: Caregiving, Nutrition, Patient Self-Management, Tools & Toolkits