National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
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Search All Research Studies
Topics
- Alcohol Use (1)
- Asthma (1)
- Behavioral Health (2)
- Blood Pressure (1)
- Cardiovascular Conditions (3)
- Case Study (1)
- Children/Adolescents (2)
- Clinical Decision Support (CDS) (1)
- Comparative Effectiveness (1)
- Depression (1)
- Electronic Health Records (EHRs) (1)
- Evidence-Based Practice (4)
- Guidelines (1)
- Healthcare Delivery (1)
- Health Information Technology (HIT) (2)
- Heart Disease and Health (1)
- Lifestyle Changes (2)
- Obesity (2)
- Outcomes (3)
- Patient-Centered Outcomes Research (2)
- Prevention (5)
- (-) Primary Care (11)
- Quality Improvement (1)
- Quality of Care (1)
- Screening (2)
- Substance Abuse (3)
- (-) Tobacco Use (11)
- Tobacco Use: Smoking Cessation (5)
- U.S. Preventive Services Task Force (USPSTF) (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 11 of 11 Research Studies DisplayedRoberts MM, Marino M, Wells R
Differences in use of clinical decision support tools and implementation of aspirin, blood pressure control, cholesterol management, and smoking cessation quality metrics in small practices by race and sex.
The objective of this cross-sectional study was to evaluate the association between population-based clinical decision support (CDS) tools and racial and sex disparities in the aspirin use, blood pressure control, cholesterol management, and smoking cessation (ABCS) care quality metrics among smaller primary care practices. Researchers used practice-level data from the EvidenceNOW initiative, from practices that submitted both survey data and electronic health record (EHR)-derived ABCS data stratified by race and sex. Their findings suggested that practices using CDS tools had small disparities but were not statistically significant; however, CDS tools were not associated with reductions in disparities. They concluded that more research was needed on effective practice-level interventions to mitigate disparities.
AHRQ-funded; HS023940.
Citation: Roberts MM, Marino M, Wells R .
Differences in use of clinical decision support tools and implementation of aspirin, blood pressure control, cholesterol management, and smoking cessation quality metrics in small practices by race and sex.
JAMA Netw Open 2023 Aug; 6(8):e2326905. doi: 10.1001/jamanetworkopen.2023.26905..
Keywords: Clinical Decision Support (CDS), Health Information Technology (HIT), Cardiovascular Conditions, Tobacco Use, Tobacco Use: Smoking Cessation, Primary Care, Evidence-Based Practice, Prevention
Kowitt SD, Goldstein AO, Cykert S
A heart healthy intervention improved tobacco screening rates and cessation support in primary care practices.
This study investigated the outcomes of an evidence-based cardiovascular disease risk reduction tool called Heart Health Now to improve rates for tobacco cessation screening and counseling in small primary care practices in North Carolina. This tool was developed as part of AHRQ’s EvidenceNow initiative. This stepped wedge, stratified, cluster randomized trial looked at 28 practices that were staffed by 10 or fewer clinicians and had an electronic health record. Heart Health Now consisted of education tools, onsite practice facilitation for a year, and a practice-specific cardiovascular population management dashboard that included monthly, measure-specific run charts to help guide quality improvement. The practices included in their analyses consisted of 78,120 patients, and 17,687 smokers. From pre- to post-intervention, screening rates significantly increased from 82.7 to 96.2%. Cessation support rates also significantly increased from 44.3% to 50.1%. Some of the practices associated with improvement included being in an academic health center or faculty, having more clinicians, and having a lower percentage of White patients.
AHRQ-funded; HS023912.
Citation: Kowitt SD, Goldstein AO, Cykert S .
A heart healthy intervention improved tobacco screening rates and cessation support in primary care practices.
J Prev 2022 Jun;43(3):375-86. doi: 10.1007/s10935-022-00672-5..
Keywords: Tobacco Use, Tobacco Use: Smoking Cessation, Screening, Primary Care, Evidence-Based Practice, Heart Disease and Health, Cardiovascular Conditions
McClure JB, Lapham G
Tobacco quitline engagement and outcomes among primary care patients reporting use of tobacco or dual tobacco and cannabis: an observational study.
Researchers examined dual users of tobacco and cannabis and how this use impacts individuals' interest in or ability to stop smoking. They found that, although dual use of tobacco and cannabis is common among smokers seen in primary care and those enrolling in quitline care, it may not undermine tobacco quitline engagement or smoking cessation. They concluded that tobacco quitline care was equally engaging and effective among tobacco users and dual users of tobacco and cannabis.
AHRQ-funded; HS026369.
Citation: McClure JB, Lapham G .
Tobacco quitline engagement and outcomes among primary care patients reporting use of tobacco or dual tobacco and cannabis: an observational study.
Subst Abus 2021;42(4):417-22. doi: 10.1080/08897077.2020.1846665..
Keywords: Tobacco Use, Tobacco Use: Smoking Cessation, Primary Care
Cohen DJ, Sweeney SM, Miller WL
Improving smoking and blood pressure outcomes: the interplay between operational changes and local context.
This study identified conditions and operational changes linked to improvements in smoking and blood pressure (BP) outcomes in primary care using samples and interviews from a subset of 104 practices participating in EvidenceNOW, a multisite cardiovascular disease prevention initiative. The authors calculated Clinical Quality Measure improvements, with targets of 10-point or greater absolute improvements in the proportion of patients with smoking screening, and if relevant, counseling and the proportion of hypertensive patients with adequately controlled BP. Primary care staff were surveyed and interviewed. In clinician-owned practices, implementing a workflow to routinely screen and counsel patients on smoking cessation resources, or implementing a documentation change or a referral to a resource alone led to an improvement of at least 10 points in the smoking outcome. These improvements did not occur though in health- or hospital system-owned practices or in Federally Qualified Health Centers. BP outcome improved by at least 10 points among solo practices after medical assistants learned how to take an accurate BP. Among larger, clinician-owned practices, BP outcomes improvement took place when staff took a second BP measurement after the first measurement was elevated and when staff learned where to document this information in the electronic health record. For larger and health- and hospital system-owned practices, 50 or more hours of facilitation was needed to improve BP outcomes.
AHRQ-funded; HS023940.
Citation: Cohen DJ, Sweeney SM, Miller WL .
Improving smoking and blood pressure outcomes: the interplay between operational changes and local context.
Ann Fam Med 2021 May-Jun;19(3):240-48. doi: 10.1370/afm.2668..
Keywords: Blood Pressure, Tobacco Use, Primary Care, Quality Improvement, Cardiovascular Conditions, Quality of Care, Evidence-Based Practice, Patient-Centered Outcomes Research, Prevention, Outcomes
Fan T, Smith HJ
AHRQ Author: Fan T
Primary care interventions for prevention and cessation of tobacco use in children and adolescents.
In this case study, three questions are posed concerning a 13-year-old girl presenting for a routine well-child visit who reports that she has never used tobacco products in any form.
AHRQ-authored.
Citation: Fan T, Smith HJ .
Primary care interventions for prevention and cessation of tobacco use in children and adolescents.
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Keywords: U.S. Preventive Services Task Force (USPSTF), Case Study, Children/Adolescents, Tobacco Use: Smoking Cessation, Tobacco Use, Primary Care, Prevention, Substance Abuse
Selph S, Patnode C, Bailey SR
Primary care-relevant interventions for tobacco and nicotine use prevention and cessation in children and adolescents: updated evidence report and systematic review for the US Preventive Services Task Force.
Interventions to discourage the use of tobacco products (including electronic nicotine delivery systems or e-cigarettes) among children and adolescents may help decrease tobacco-related illness and injury. The objective of this study was to update the 2013 review on primary care-relevant interventions for tobacco use prevention and cessation in children and adolescents to inform the US Preventive Services Task Force.
AHRQ-funded; 290201500009I.
Citation: Selph S, Patnode C, Bailey SR .
Primary care-relevant interventions for tobacco and nicotine use prevention and cessation in children and adolescents: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2020 Apr 28;323(16):1599-608. doi: 10.1001/jama.2020.3332..
Keywords: U.S. Preventive Services Task Force (USPSTF), Children/Adolescents, Tobacco Use, Tobacco Use: Smoking Cessation, Prevention, Primary Care, Evidence-Based Practice, Guidelines
Shafer PR, Borsky A, Ngo-Metzger Q
AHRQ Author: Shafer PR, Borsky A, Ngo-Metzger Q, Miller T, Meyers D
The practice gap: national estimates of screening and counseling for alcohol, tobacco, and obesity.
The authors of this study estimated screening and counseling rates for tobacco and alcohol use, and obesity by using a nationally representative sample of adults aged 35 years and older. Receipt of the recommended level of services ranged from nearly two-thirds for obesity and tobacco use to less than half for alcohol misuse. The authors conclude that care delivery shows significant room for improvement, but primary care practices may need additional resources to raise their screening and counseling rates.
AHRQ-authored.
Citation: Shafer PR, Borsky A, Ngo-Metzger Q .
The practice gap: national estimates of screening and counseling for alcohol, tobacco, and obesity.
Ann Fam Med 2019 Mar;17(2):161-63. doi: 10.1370/afm.2363..
Keywords: Alcohol Use, Lifestyle Changes, Obesity, Prevention, Primary Care, Screening, Substance Abuse, Tobacco Use
Lapham GT, Lee AK, Caldeiro RM
Prevalence of behavioral health conditions across frequency of cannabis use among adult primary care patients in Washington state.
This population-based study of primary care patients reports on the prevalence of common behavioral health conditions across cannabis use frequency. The investigators concluded that their study found a strong association between the frequency of cannabis use and tobacco use, depression symptoms, and other drug use, and as well as diagnosed mental health and substance use disorders.
AHRQ-funded; HS023173.
Citation: Lapham GT, Lee AK, Caldeiro RM .
Prevalence of behavioral health conditions across frequency of cannabis use among adult primary care patients in Washington state.
J Gen Intern Med 2018 Nov;33(11):1833-35. doi: 10.1007/s11606-018-4558-8..
Keywords: Behavioral Health, Depression, Primary Care, Substance Abuse, Tobacco Use
Bailey SR, Stevens VJ, Fortmann SP
Long-term outcomes from repeated smoking cessation assistance in routine primary care.
This study assessed the importance of primary care support for smokers trying to quit. This retrospective, observational cohort study followed over 33,000 patients at six diverse health systems over 4 years. Long-term quit (LTQ) status (longer than 365 days) was measured, and it was determined that frequent visits (more than 75% of visits) had almost 3 times the success than patients who visited less than 25%.
AHRQ-funded; HS019828.
Citation: Bailey SR, Stevens VJ, Fortmann SP .
Long-term outcomes from repeated smoking cessation assistance in routine primary care.
Am J Health Promot 2018 Sep;32(7):1582-90. doi: 10.1177/0890117118761886..
Keywords: Comparative Effectiveness, Lifestyle Changes, Outcomes, Patient-Centered Outcomes Research, Primary Care, Tobacco Use
Bailey SR, Heintzman JD, Marino M
Smoking-cessation assistance: before and after stage 1 meaningful use implementation.
This study examined whether smoking status assessment, cessation assistance, and odds of being a current smoker changed after Stage 1 Meaningful Use (MU) implementation. Its findings suggest that incentives for MU of electronic health records increase the odds of smoking assessment and cessation assistance, which could lead to decreased smoking rates among vulnerable populations.
AHRQ-funded; HS021522.
Citation: Bailey SR, Heintzman JD, Marino M .
Smoking-cessation assistance: before and after stage 1 meaningful use implementation.
Am J Prev Med 2017 Aug;53(2):192-200. doi: 10.1016/j.amepre.2017.02.006.
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Keywords: Behavioral Health, Electronic Health Records (EHRs), Health Information Technology (HIT), Healthcare Delivery, Primary Care, Tobacco Use
Yawn BP, Rank MA, Bertram SL
Obesity, low levels of physical activity and smoking present opportunities for primary care asthma interventions: an analysis of baseline data from the asthma tools study.
The researchers calculated cross-sectional frequencies of activity levels, smoking, secondhand smoke exposure and the presence of obesity, as well as rates of out-of-control asthma and asthma exacerbations. They found that tobacco smoke exposure, obesity, low activity levels, poverty, inadequately controlled asthma and high asthma-related health-care utilization were common. Across all age groups, obesity was associated with poorer asthma outcomes.
AHRQ-funded; HS018431.
Citation: Yawn BP, Rank MA, Bertram SL .
Obesity, low levels of physical activity and smoking present opportunities for primary care asthma interventions: an analysis of baseline data from the asthma tools study.
NPJ Prim Care Respir Med 2015 Oct 1;25:15058. doi: 10.1038/npjpcrm.2015.58..
Keywords: Asthma, Obesity, Tobacco Use, Primary Care, Outcomes