National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Ambulatory Care and Surgery (1)
- Behavioral Health (1)
- Blood Pressure (1)
- Cancer: Breast Cancer (1)
- Cardiovascular Conditions (1)
- Chronic Conditions (3)
- Clinical Decision Support (CDS) (1)
- Clinician-Patient Communication (1)
- Communication (1)
- Depression (1)
- Diabetes (3)
- Diagnostic Safety and Quality (1)
- Education: Patient and Caregiver (1)
- Elderly (2)
- Electronic Prescribing (E-Prescribing) (2)
- Evidence-Based Practice (1)
- Healthcare Costs (1)
- Health Information Technology (HIT) (5)
- Health Insurance (2)
- Health Literacy (1)
- Heart Disease and Health (2)
- Hepatitis (1)
- Home Healthcare (1)
- Hospital Discharge (2)
- Hospital Readmissions (1)
- Human Immunodeficiency Virus (HIV) (6)
- Lifestyle Changes (2)
- Medicare (3)
- Medication (15)
- Medication: Safety (1)
- Nutrition (1)
- Patient-Centered Healthcare (1)
- (-) Patient Adherence/Compliance (27)
- Patient Safety (1)
- Patient Self-Management (4)
- Quality Measures (1)
- Racial and Ethnic Minorities (3)
- Screening (1)
- Sex Factors (1)
- Shared Decision Making (1)
- Surgery (1)
- Telehealth (1)
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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 27 Research Studies DisplayedDakwar 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
Pevnick JM, Li N, Asch SM
Effect of electronic prescribing with formulary decision support on medication tier, copayments, and adherence.
The researchers evaluated whether formulary decision support (FDS) could reduce patient medication costs, and thereby improve adherence. In the studied population, interruptive FDS shifted prescribing toward preferred tier medications, but these medications were only minimally less expensive for patients. Thus, FDS did not significantly increase adherence.
AHRQ-funded; HS016391.
Citation: Pevnick JM, Li N, Asch SM .
Effect of electronic prescribing with formulary decision support on medication tier, copayments, and adherence.
BMC Med Inform Decis Mak 2014;14:79. doi: 10.1186/1472-6947-14-79..
Keywords: Electronic Prescribing (E-Prescribing), Medication, Patient Adherence/Compliance, Clinical Decision Support (CDS), Health Information Technology (HIT)
Pan IW, Smith BD, Shih YC
Factors contributing to underuse of radiation among younger women with breast cancer.
This study explores factors associated with noncompliance of RT among insured young patients. It found that competing demands from child care, especially the presence of a young child in the home, can constitute a barrier to complete guideline-concordant breast cancer therapy.
AHRQ-funded; HS018535.
Citation: Pan IW, Smith BD, Shih YC .
Factors contributing to underuse of radiation among younger women with breast cancer.
J Natl Cancer Inst 2014 Jan;106(1):djt340. doi: 10.1093/jnci/djt340..
Keywords: Cancer: Breast Cancer, Health Insurance, Patient Adherence/Compliance, Surgery, Treatments
Schoenthaler A, Montague E, Baier Manwell L
Patient-physician racial/ethnic concordance and blood pressure control: the role of trust and medication adherence.
The researchers examined the associations between racial/ethnic concordance and blood pressure (BP) control to determine whether patient trust and medication adherence mediate these associations. They found that higher levels of trust were associated with better medication adherence and a tendency toward better BP control, irrespective of patient–physician racial/ethnic concordance.
AHRQ-funded; HS011955.
Citation: Schoenthaler A, Montague E, Baier Manwell L .
Patient-physician racial/ethnic concordance and blood pressure control: the role of trust and medication adherence.
Ethn Health 2014;19(5):565-78. doi: 10.1080/13557858.2013.857764..
Keywords: Blood Pressure, Racial and Ethnic Minorities, Medication, Patient Adherence/Compliance
Southern WN, Drainoni ML, Smith BD
Physician nonadherence with a hepatitis C screening program.
The researchers sought to measure adherence to an hepatitis C virus (HCV) screening protocol during a multifaceted continuous intervention. They found that overall adherence to the guideline was low, suggesting that attitudinal and external barriers remained. They concluded that when implementing complex clinical practice guidelines, planners must address attitudinal and external barriers to maximize adherence.
AHRQ-funded; 2902006000012.
Citation: Southern WN, Drainoni ML, Smith BD .
Physician nonadherence with a hepatitis C screening program.
Qual Manag Health Care 2014 Jan-Mar;23(1):1-9. doi: 10.1097/qmh.0000000000000007..
Keywords: Hepatitis, Screening, Patient Adherence/Compliance
Bao Y, Ryan AM, Shao H
Generic initiation and antidepressant therapy adherence under Medicare Part D.
This study assessed the effects of initiating antidepressant treatment with a generic versus a branded prescription (generic initiation) on adherence to antidepressant therapy for the treatment of depression. It found that starting patients with generics had benefits for antidepressant adherence by lowering out-of-pocket costs for all patients and by mitigating the effect of the Part D coverage gap faced by patients not receiving low-income subsidies.
AHRQ-funded; HS018546.
Citation: Bao Y, Ryan AM, Shao H .
Generic initiation and antidepressant therapy adherence under Medicare Part D.
Am J Manag Care 2013 Dec;19(12):989-98..
Keywords: Medication, Depression, Medicare, Patient Adherence/Compliance
Stuart B, Davidoff A, Erten M
AHRQ Author: Davidoff A
How Medicare Part D benefit phases affect adherence with evidence-based medications following acute myocardial infarction.
The authors assessed the impact of Medicare Part D benefit phases on adherence with evidence-based medications after hospitalization for an acute myocardial infarction (AMI). They found that as the Part D doughnut hole is gradually filled in by 2020, Medicare Part D enrollees with critical diseases such as AMI who rely heavily on brand name drugs are likely to exhibit modest increases in adherence, while those reliant on generic drugs are less likely to be affected.
AHRQ-authored.
Citation: Stuart B, Davidoff A, Erten M .
How Medicare Part D benefit phases affect adherence with evidence-based medications following acute myocardial infarction.
Health Serv Res 2013 Dec;48(6 Pt 1):1960-77. doi: 10.1111/1475-6773.12073.
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Keywords: Evidence-Based Practice, Medicare, Medication, Heart Disease and Health, Patient Adherence/Compliance
Bergeron AR, Webb JR, Serper M
Impact of electronic prescribing on medication use in ambulatory care.
This study investigated differences before and after rollout of electronic prescribing (e-prescribing) in (1) patients’ primary adherence to newly prescribed medications, (2) patients' understanding of how to use their medications, and (3) multiple pharmacy use. It found an increase in abandoned prescriptions immediately following the implementation of e-prescribing. However, with time, these issues were resolved and even improved to rates lower than baseline.
AHRQ-funded; HS017220.
Citation: Bergeron AR, Webb JR, Serper M .
Impact of electronic prescribing on medication use in ambulatory care.
Am J Manag Care 2013 Dec;19(12):1012-7..
Keywords: Electronic Prescribing (E-Prescribing), Ambulatory Care and Surgery, Patient Adherence/Compliance, Medication
Soeters HM, Napravnik S, Zakharova OM
Opportunities for sexual transmission of antiretroviral drug resistance among HIV-infected patients in care.
The researchers had two aims: to examine patterns of nonadherence, high-risk sexual behavior, detectable HIV viraemia and antiretroviral drug resistance, and to identify factors associated with potential transmission of drug-resistant HIV among patients engaged in HIV care. They found that a small but significant proportion of clinic patients with viraemia and documented resistant HIV continue to engage in sexual behaviors that place others at risk for transmitted drug resistance.
AHRQ-funded; HS018731.
Citation: Soeters HM, Napravnik S, Zakharova OM .
Opportunities for sexual transmission of antiretroviral drug resistance among HIV-infected patients in care.
AIDS 2013 Nov 28;27(18):2873-81. doi: 10.1097/01.aids.0000433240.78739.30..
Keywords: Human Immunodeficiency Virus (HIV), Lifestyle Changes, Patient Adherence/Compliance