National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Ambulatory Care and Surgery (1)
- Arthritis (3)
- Asthma (3)
- Back Health and Pain (1)
- Behavioral Health (3)
- Blood Pressure (3)
- Cancer (1)
- Cancer: Colorectal Cancer (1)
- Cardiovascular Conditions (2)
- Care Management (3)
- Children/Adolescents (8)
- (-) Chronic Conditions (53)
- Clinician-Patient Communication (1)
- Comparative Effectiveness (7)
- Complementary and Alternative Medicine (2)
- Data (1)
- Dental and Oral Health (1)
- Depression (1)
- Diabetes (6)
- Diagnostic Safety and Quality (3)
- Digestive Disease and Health (1)
- Disparities (2)
- Elderly (5)
- Electronic Health Records (EHRs) (3)
- Emergency Medical Services (EMS) (1)
- Evidence-Based Practice (1)
- Falls (1)
- Guidelines (3)
- Healthcare Cost and Utilization Project (HCUP) (1)
- Healthcare Costs (5)
- Healthcare Delivery (2)
- Healthcare Utilization (1)
- Health Information Technology (HIT) (5)
- Health Insurance (3)
- Health Services Research (HSR) (3)
- Health Status (1)
- Heart Disease and Health (3)
- Home Healthcare (2)
- Hospitalization (1)
- Human Immunodeficiency Virus (HIV) (2)
- Imaging (1)
- Implementation (1)
- Kidney Disease and Health (3)
- Medical Devices (1)
- Medical Expenditure Panel Survey (MEPS) (3)
- Medicare (2)
- Medication (7)
- Mortality (2)
- Neurological Disorders (1)
- Obesity (1)
- Opioids (1)
- Outcomes (4)
- Pain (3)
- Palliative Care (1)
- Patient-Centered Healthcare (1)
- Patient-Centered Outcomes Research (8)
- Patient Adherence/Compliance (3)
- Patient Experience (1)
- Patient Safety (1)
- Patient Self-Management (4)
- Policy (1)
- Practice-Based Research Network (PBRN) (1)
- Prevention (2)
- Primary Care (2)
- Quality Measures (2)
- Quality of Care (4)
- Racial and Ethnic Minorities (1)
- Registries (2)
- Risk (2)
- Screening (1)
- Shared Decision Making (1)
- Social Determinants of Health (1)
- Surgery (2)
- Transitions of Care (2)
- Transplantation (2)
- Treatments (1)
- Women (1)
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 53 Research Studies DisplayedMold JW, Aspy CB, Smith PD
Leveraging practice-based research networks to accelerate implementation and diffusion of chronic kidney disease guidelines in primary care practices: a prospective cohort study.
This study was conducted to determine whether practice-based research networks (PBRNs) could increase dissemination, implementation, and diffusion of evidence-based treatment guidelines for chronic kidney disease by leveraging early adopter practices. After the intervention, the initial four PBRNs increased the use of ACEIs/ARBs, discontinuation of NSAIDs, testing for anemia, and testing and/or treatment for vitamin D deficiency. Most were able to recruit two additional practices, which also increased their use of ACEIs/ARBs and testing and/or treatment of vitamin D deficiency. The researchers concluded that, with some assistance, early adopter practices can facilitate the diffusion of evidence-based approaches to other practices.
AHRQ-funded; HS019945.
Citation: Mold JW, Aspy CB, Smith PD .
Leveraging practice-based research networks to accelerate implementation and diffusion of chronic kidney disease guidelines in primary care practices: a prospective cohort study.
Implement Sci 2014 Nov 23;9:169. doi: 10.1186/s13012-014-0169-x.
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Keywords: Practice-Based Research Network (PBRN), Primary Care, Kidney Disease and Health, Chronic Conditions, Guidelines, Implementation
Sumner W, Stwalley DL, Asaro PV
Adding flexible temporal constraints to identify chronic comorbid conditions in ambulatory claims data.
The researchers particularly wanted to increase the temporal flexibility of comorbidity definitions in response to common documentation patterns. They report the development and testing of a chronic disease list with temporal criteria for analyzing outpatient claims data. They concluded that temporal constraints applied to ambulatory claims may improve comorbid condition categorization.
AHRQ-funded; HS019455.
Citation: Sumner W, Stwalley DL, Asaro PV .
Adding flexible temporal constraints to identify chronic comorbid conditions in ambulatory claims data.
AMIA Annu Symp Proc 2014 Nov 14;2014:1088-97..
Keywords: Chronic Conditions, Data, Health Insurance
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
Merlin JS, Walcott M, Ritchie C
'Two pains together': patient perspectives on psychological aspects of chronic pain while living with HIV.
The researchers’ objective was to explore HIV-infected patients’ perspectives on psychological aspects of chronic pain using in-depth qualitative interviews. Key themes that emerged included the close relationship between mood and pain; mood and pain in the context of living with HIV; use of alcohol/drugs to self-medicate for pain; and the challenge of receiving prescription pain medications while dealing with substance use disorders.
AHRQ-funded; HS021694.
Citation: Merlin JS, Walcott M, Ritchie C .
'Two pains together': patient perspectives on psychological aspects of chronic pain while living with HIV.
PLoS One 2014 Nov 3;9(11):e111765. doi: 10.1371/journal.pone.0111765..
Keywords: Care Management, Chronic Conditions, Human Immunodeficiency Virus (HIV), Pain, Patient-Centered Outcomes Research, Patient Self-Management
Mohanan S, Tapp H, McWilliams A
Obesity and asthma: pathophysiology and implications for diagnosis and management in primary care.
This review summarizes existing data that support the pathophysiologic mechanisms underlying the association between obesity and asthma, as well as the current and future state of treatment for the obese patient with asthma. It suggests that evidence of chronic inflammatory response linking obesity and asthma indicates a need to address obesity during asthma management, possibly by using patient-centered approaches such as shared decisionmaking.
AHRQ-funded; HS019946
Citation: Mohanan S, Tapp H, McWilliams A .
Obesity and asthma: pathophysiology and implications for diagnosis and management in primary care.
Exp Biol Med. 2014 Nov;239(11):1531-40. doi: 10.1177/1535370214525302..
Keywords: Obesity, Asthma, Diagnostic Safety and Quality, Primary Care, Chronic Conditions
Davis AM, Brown RF, Taylor JL
Transition care for children with special health care needs.
This article examined 25 studies evaluating transition care programs for children with special health care needs moving from pediatric to adult care. The majority of studies concerned patients with diabetes or transplant patients.The authors also interviewed key informants representing clinicians who provide transition care. They found that there is no accepted way to measure transition success.
AHRQ-funded; 290201200009I
Citation: Davis AM, Brown RF, Taylor JL .
Transition care for children with special health care needs.
Pediatrics. 2014 Nov;134(5):900-8. doi: 10.1542/peds.2014-1909..
Keywords: Children/Adolescents, Transitions of Care, Chronic Conditions
Voils CI, Sleath B, Maciejewski ML
Patient perspectives on having multiple versus single prescribers of chronic disease medications: results of a qualitative study in a veteran population.
The researchers sought to understand the reasons why patients have increasing numbers of prescribers of medications and to understand patient perspectives on advantages and disadvantages of having multiple prescribers, including effects on medication supply. They found that, with patients from a Veterans Affairs (VA) Medical Center, multiple prescribers arose through referrals and patients actively seeking non-VA prescribers to maximize timeliness and access to medications, to provide access to medications not on the VA formulary, and to minimize out-of-pocket costs.
AHRQ-funded; HS019445.
Citation: Voils CI, Sleath B, Maciejewski ML .
Patient perspectives on having multiple versus single prescribers of chronic disease medications: results of a qualitative study in a veteran population.
BMC Health Serv Res 2014 Oct 25;14:490. doi: 10.1186/s12913-014-0490-8.
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Keywords: Chronic Conditions, Medication, Diabetes, Blood Pressure, Heart Disease and Health
Chung S, Azar KM, Baek M
Reconsidering the age thresholds for type II diabetes screening in the U.S.
In order to examine the optimal age cut-point for opportunistic universal screening (as opposed to targeted screening), the researchers used a nationally representative sample from the National Health and Nutrition Examination Survey (2007-2010) and other resources. They found that opportunistic screening among individuals 35 years of age and older could greatly reduce the prevalence of undiagnosed diabetes or pre-diabetes.
AHRQ-funded; HS019815; HS019815.
Citation: Chung S, Azar KM, Baek M .
Reconsidering the age thresholds for type II diabetes screening in the U.S.
Am J Prev Med. 2014 Oct;47(4):375-81. doi: 10.1016/j.amepre.2014.05.012..
Keywords: Diabetes, Screening, Prevention, Chronic Conditions
Parekh AK, Kronick R, Tavenner M
AHRQ Author: Kronick R
Optimizing health for persons with multiple chronic conditions.
The paper discussed four overarching goals resulting from the 2010 HHS report, "Strategic Framework on Multiple Chronic Conditions." These goals are foster health systems change, empower individuals, equip clinicians, and enhance research.
AHRQ-authored.
Citation: Parekh AK, Kronick R, Tavenner M .
Optimizing health for persons with multiple chronic conditions.
JAMA 2014 Sep 24;312(12):1199-200. doi: 10.1001/jama.2014.10181.
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Keywords: Chronic Conditions, Healthcare Delivery
Ayers DC, Franklin PD
Joint replacement registries in the United States: a new paradigm.
This commentary serves as an introduction to an upcoming series of articles about orthopaedic registries, in general, with an emphasis on lessons learned from the evolving U.S. and international total joint replacement registries. Specifically, this paper provides an overview of total joint replacement registries and the current expansion of data collection beyond implant attributes and survival to include postoperative complications and patient-reported outcomes.
AHRQ-funded; HS018910.
Citation: Ayers DC, Franklin PD .
Joint replacement registries in the United States: a new paradigm.
J Bone Joint Surg Am 2014 Sep 17;96(18):1567-9. doi: 10.2106/jbjs.n.00641..
Keywords: Arthritis, Chronic Conditions, Patient-Centered Outcomes Research, Registries, Surgery
Ayers DC, Franklin PD
Joint replacement registries in the United States: a new paradigm.
This commentary serves as an introduction to an upcoming series of articles about orthopaedic registries, in general, with an emphasis on lessons learned from the evolving U.S. and international total joint replacement registries. Specifically, this paper provides an overview of total joint replacement registries and the current expansion of data collection beyond implant attributes and survival to include postoperative complications and patient-reported outcomes.
AHRQ-funded; HS018910.
Citation: Ayers DC, Franklin PD .
Joint replacement registries in the United States: a new paradigm.
J Bone Joint Surg Am 2014 Sep 17;96(18):1567-9. doi: 10.2106/jbjs.n.00641.
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Keywords: Arthritis, Chronic Conditions, Patient-Centered Outcomes Research, Registries, Surgery
Makris UE, Abrams RC, Gurland B
Management of persistent pain in the older patient: a clinical review.
The purpose of this study was to 1.) Describe barriers to the management of persistent pain among older adults; 2.) Summarize current management approaches, including pharmacologic and nonpharmacologic modalities; 3.) Present rehabilitative approaches; and 4.) Highlight aspects of the patient-physician relationship that can help to improve treatment outcomes.
AHRQ-funded; HS020648.
Citation: Makris UE, Abrams RC, Gurland B .
Management of persistent pain in the older patient: a clinical review.
JAMA 2014 Aug 27;312(8):825-36. doi: 10.1001/jama.2014.9405..
Keywords: Care Management, Chronic Conditions, Elderly, Medication, Treatments
Benkert R, Dennehy P, White J
Diabetes and hypertension quality measurement in four safety-net sites: lessons learned after implementation of the same commercial electronic health record.
The authors described what implementation of a commercially available EHR with built-in quality query algorithms showed us about our care for diabetes and hypertension populations in four safety net clinics. They found that utilizing a shared EHR, a Regional Extension Center-like partnership model, and similar quality query algorithms allowed safety-net clinics to benchmark and improve the quality of care across differing patient populations and health care delivery models.
AHRQ-funded; HS017191.
Citation: Benkert R, Dennehy P, White J .
Diabetes and hypertension quality measurement in four safety-net sites: lessons learned after implementation of the same commercial electronic health record.
Appl Clin Inform 2014 Aug 20;5(3):757-72. doi: 10.4338/aci-2014-03-ra-0019.
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Keywords: Diabetes, Blood Pressure, Electronic Health Records (EHRs), Health Information Technology (HIT), Quality of Care, Chronic Conditions
Feudtner C, Feinstein JA, Zhong W
Pediatric complex chronic conditions classification system version 2: updated for ICD-10 and complex medical technology dependence and transplantation.
In order to update the pediatric complex chronic conditions (CCC) classification system, the authors incorporated ICD-9 diagnostic codes that had been either omitted or incorrectly specified in the original system, and then translated between ICD-9 and ICD-10 using General Equivalence Mappings (GEMs). They concluded that the updated CCC version 2 system is comprehensive and multidimensional, providing a necessary update to accommodate widespread implementation of ICD-10.
AHRQ-funded; HS018425.
Citation: Feudtner C, Feinstein JA, Zhong W .
Pediatric complex chronic conditions classification system version 2: updated for ICD-10 and complex medical technology dependence and transplantation.
BMC Pediatr 2014 Aug 8;14:199. doi: 10.1186/1471-2431-14-199.
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Keywords: Children/Adolescents, Chronic Conditions, Transplantation
Davis AE, Mehrotra S, Kilambi V
The effect of the Statewide Sharing variance on geographic disparity in kidney transplantation in the United States.
This study examined the effect of Statewide Sharing on geographic allocation disparity over time between donor service areas (DSAs) within Tennessee and Florida and compared them with geographic disparity between the DSAs within a state for all states with more than one DSA (California, New York, North Carolina, Ohio, Pennsylvania, Texas, and Wisconsin). Findings suggested that changes which are untested run the risk of unintended consequences, and Statewide Sharing should be further studied and considered.
AHRQ-funded; HS021078.
Citation: Davis AE, Mehrotra S, Kilambi V .
The effect of the Statewide Sharing variance on geographic disparity in kidney transplantation in the United States.
Clin J Am Soc Nephrol 2014 Aug 7;9(8):1449-60. doi: 10.2215/cjn.05350513.
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Keywords: Chronic Conditions, Disparities, Kidney Disease and Health, Policy, Transplantation
Gawron AJ, French DD, Pandolfino JE
Economic evaluations of gastroesophageal reflux disease medical management.
This article systematically evaluated the existing literature to identify economic evaluations of GERD medical management strategies and assess the scientific quality of these reports using the CHEERS guidelines. It concluded that initial empiric PPI therapy is likely the most cost-effective initial strategy for patients with typical GERD symptoms. Surgery may be cost effective in patients with chronic GERD symptoms at time horizons of 3–10 years.
AHRQ-funded; HS000078.
Citation: Gawron AJ, French DD, Pandolfino JE .
Economic evaluations of gastroesophageal reflux disease medical management.
Pharmacoeconomics 2014 Aug;32(8):745-58. doi: 10.1007/s40273-014-0164-8..
Keywords: Care Management, Chronic Conditions, Healthcare Costs
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
Friedly JL, Comstock BA, Turner JA
A randomized trial of epidural glucocorticoid injections for spinal stenosis.
The researchers designed the Lumbar Epidural Steroid Injections for Spinal Stenosis trial to compare the effectiveness of epidural injections of glucocorticoids plus anesthetic with injections of anesthetic alone in patients with lumbar spinal stenosis. They found that epidural injection of glucocorticoids plus lidocaine offered minimal or no short-term benefit as compared with lidocaine alone.
AHRQ-funded; HS019222
Citation: Friedly JL, Comstock BA, Turner JA .
A randomized trial of epidural glucocorticoid injections for spinal stenosis.
N Engl J Med. 2014 Jul 3;371(1):11-21. doi: 10.1056/NEJMoa1313265..
Keywords: Comparative Effectiveness, Chronic Conditions, Elderly, Outcomes
Chambers C, Chiu S, Scott AN
Factors associated with poor mental health status among homeless women with and without dependent children.
The researchers estimated the prevalence of mental health problems among homeless women as well as the effects of risk factors on those problems. They found that, in a group of 522 homeless women in Toronto, Canada, poor mental health was associated with low perceived access to social support, physical/sexual assault in the past 12 months, presence of a chronic health condition, and presence of a drug use problem.
AHRQ-funded; HS014129
Citation: Chambers C, Chiu S, Scott AN .
Factors associated with poor mental health status among homeless women with and without dependent children.
Community Ment Health J. 2014 Jul;50(5):553-9. doi: 10.1007/s10597-013-9605-7..
Keywords: Behavioral Health, Chronic Conditions, Social Determinants of Health, Risk
Forrest CB, Margolis PA, Bailey LC
PEDSnet: a National Pediatric Learning Health System.
The authors describe a National Pediatric Learning Health System (NPLHS) that is being implemented by PEDSnet, a clinical data research network. The NPLHS will consist of a flexible dual data architecture that incorporates two widely used data models and national terminology standards to support multi-institutional data integration, cohort discovery, and advanced analytics that enable rapid learning.
AHRQ-funded; HS022974; HS019912
Citation: Forrest CB, Margolis PA, Bailey LC .
PEDSnet: a National Pediatric Learning Health System.
J Am Med Inform Assoc. 2014 Jul-Aug;21(4):602-6. doi: 10.1136/amiajnl-2014-002743..
Keywords: Children/Adolescents, Health Information Technology (HIT), Chronic Conditions
Forrest CB, Margolis P, Seid M
PEDSnet: how a prototype pediatric learning health system is being expanded into a national network.
The authors describe a National Pediatric Learning Health System (NPLHS) that is being implemented by PEDSnet, a clinical data research network. The NPLHS will consist of a flexible dual data architecture that incorporates two widely used data models and national terminology standards to support multi-institutional data integration, cohort discovery, and advanced analytics that enable rapid learning.
AHRQ-funded; HS020024
Citation: Forrest CB, Margolis P, Seid M .
PEDSnet: how a prototype pediatric learning health system is being expanded into a national network.
Health Aff. 2014 Jul;33(7):1171-7. doi: 10.1377/hlthaff.2014.0127..
Keywords: Children/Adolescents, Health Information Technology (HIT), Chronic Conditions
Suri P, Boyko EJ, Goldberg J
Longitudinal associations between incident lumbar spine MRI findings and chronic low back pain or radicular symptoms: retrospective analysis of data from the longitudinal assessment of imaging and disability of the back (LAIDBACK).
The researchers examined the association of incident lumbar MRI findings with two specific spine-related symptom outcomes: 1) incident chronic bothersome lower back pain, and 2) incident radicular symptoms such as pain, weakness, or sensation alterations in the lower extremity. They found that even when applying more specific definitions for spine-related symptom outcomes, few MRI findings show strong associations with symptom outcomes.
AHRQ-funded; HS019222
Citation: Suri P, Boyko EJ, Goldberg J .
Longitudinal associations between incident lumbar spine MRI findings and chronic low back pain or radicular symptoms: retrospective analysis of data from the longitudinal assessment of imaging and disability of the back (LAIDBACK).
BMC Musculoskelet Disord. 2014 May 13;15:152. doi: 10.1186/1471-2474-15-152..
Keywords: Back Health and Pain, Chronic Conditions, Diagnostic Safety and Quality, Imaging, Pain
McGuire TG, Newhouse JP, Normand SL
AHRQ Author: Zuvekas S
Assessing incentives for service-level selection in private health insurance exchanges.
The authors used MEPS data to measure plan incentives by constructing predictive ratios and by measuring incentives based on the predictability and predictiveness of various medical diagnoses. They found that, among the chronic diseases studied, plans have the greatest incentive to skimp on care for cancer, mental health, and substance abuse.
AHRQ-authored.
Citation: McGuire TG, Newhouse JP, Normand SL .
Assessing incentives for service-level selection in private health insurance exchanges.
J Health Econ 2014 May;35:47-63. doi: 10.1016/j.jhealeco.2014.01.009.
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Keywords: Chronic Conditions, Health Insurance, Health Status, Medical Expenditure Panel Survey (MEPS)
Callaghan BC, Kerber KA, Pace RJ
Headaches and neuroimaging: high utilization and costs despite guidelines.
Little is known about recent headache neuroimaging utilization, associated expenditures, and temporal trends. Looking at 51.1 million outpatient headache visits over 4 years, this study found that neuroimaging is ordered during 12% of these visits, costs $1 billion annually, and is increasing over time.
AHRQ-funded; HS017690
Citation: Callaghan BC, Kerber KA, Pace RJ .
Headaches and neuroimaging: high utilization and costs despite guidelines.
JAMA Intern Med. 2014 May;174(5):819-21. doi: 10.1001/jamainternmed.2014.173..
Keywords: Neurological Disorders, Healthcare Utilization, Guidelines, Healthcare Costs, Chronic Conditions
Smucker DR, Regan S, Elder NC
Patient safety incidents in home hospice care: the experiences of hospice interdisciplinary team members.
The study objective was to explore the types and characteristics of patient safety incidents in home hospice care from the experiences of hospice interdisciplinary team members. Based on interviews of 19 experienced hospice leaders, the most commonly described categories of patient harm were injuries from falls and inadequate symptom control.
AHRQ-funded; HS018245
Citation: Smucker DR, Regan S, Elder NC .
Patient safety incidents in home hospice care: the experiences of hospice interdisciplinary team members.
J Palliat Med. 2014 May;17(5):540-4. doi: 10.1089/jpm.2013.0111..
Keywords: Patient Safety, Home Healthcare, Falls, Chronic Conditions