National Healthcare Quality and Disparities Report
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- Access to Care (3)
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- Pain (1)
- Palliative Care (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
26 to 50 of 58 Research Studies DisplayedYucel A, Essien EJ, Sanyal S
Racial/ethnic differences in the treatment of adolescent major depressive disorders (MDD) across healthcare providers participating in the Medicaid program.
The purpose of this study was to examine whether racial/ethnic differences in receipt of major depressive disorder (MDD) treatment could be explained by the specialty of provider diagnosing the adolescent. The investigators found that for adolescents with MDD, being first diagnosed by a psychiatrist was associated with higher treatment rate and reduced racial/ethnic variation in the utilization of pharmacotherapy.
AHRQ-funded; HS025251.
Citation: Yucel A, Essien EJ, Sanyal S .
Racial/ethnic differences in the treatment of adolescent major depressive disorders (MDD) across healthcare providers participating in the Medicaid program.
J Affect Disord 2018 Aug 1;235:155-61. doi: 10.1016/j.jad.2018.04.045..
Keywords: Access to Care, Depression, Disparities, Medicaid, Behavioral Health, Racial and Ethnic Minorities
Brunwasser SM, Freres DR, Gillham JE
Youth cognitive-behavioral depression prevention: testing theory in a randomized controlled trial.
This study tested the plausibility of a theoretical model of change for the Penn Resiliency Program (PRP), a cognitive-behavioral (CB) depression prevention program for adolescents. The authors assert that when effective, PRP's CB training provides incremental value over non-specific components and there are indirect effects on depressive symptoms through improvements in explanatory style.
AHRQ-funded; HS022990.
Citation: Brunwasser SM, Freres DR, Gillham JE .
Youth cognitive-behavioral depression prevention: testing theory in a randomized controlled trial.
Cognit Ther Res 2018 Aug;42(4):468-82..
Keywords: Children/Adolescents, Behavioral Health, Depression, Patient-Centered Healthcare, Prevention
Rhoten BA, Murphy BA, Dietrich MS
Depressive symptoms, social anxiety, and perceived neck function in patients with head and neck cancer.
This study examined the relationships of depressive symptoms and social anxiety with perceived neck function in patients treated for head and neck cancer. Significant associations were found between membership in the neck disability index trajectories and membership in the longitudinal patterns of depressive symptoms and social anxiety. The investigators concluded that impaired physical function and psychological distress are intertwined for patients with head and neck cancer long after completing treatment.
AHRQ-funded; HS022990.
Citation: Rhoten BA, Murphy BA, Dietrich MS .
Depressive symptoms, social anxiety, and perceived neck function in patients with head and neck cancer.
Head Neck 2018 Jul;40(7):1443-52. doi: 10.1002/hed.25129..
Keywords: Anxiety, Cancer, Depression, Behavioral Health
Weber NS, Gressitt KL, Cowan DN
AHRQ Author: Niebuhr DW
Monocyte activation detected prior to a diagnosis of schizophrenia in the US Military New Onset Psychosis Project (MNOPP).
Low-grade inflammation is present in some cases of schizophrenia, particularly in the early stages of this disorder. The inflammation source is not known but may be the result of dysbiotic processes occurring in the gut. In this study, the investigators examined peripheral biomarkers of bacterial translocation, soluble CD14 (sCD14) and lipopolysaccharide binding protein (LBP), and of general inflammation, C-reactive protein (CRP), in a unique, pre-onset study of schizophrenia.
AHRQ-authored.
Citation: Weber NS, Gressitt KL, Cowan DN .
Monocyte activation detected prior to a diagnosis of schizophrenia in the US Military New Onset Psychosis Project (MNOPP).
Schizophr Res 2018 Jul;197:465-69. doi: 10.1016/j.schres.2017.12.016..
Keywords: Behavioral Health, Diagnostic Safety and Quality
Sobotka SA, Peters S, Pinto NP
Neurodevelopmental disorders in the PICU population.
Attention deficit hyperactivity disorder (ADHD), affecting 11% of children and adolescents, increases risk for injury and may predispose children to illness. However, the prevalence of ADHD and other developmental disorders in the pediatric intensive care unit (PICU) has not been previously studied. In this study, the investigators performed a single-center, prospective cohort study of children aged 6 to 12 years who were hospitalized in the PICU from May through August 2016.
AHRQ-funded; HS023007.
Citation: Sobotka SA, Peters S, Pinto NP .
Neurodevelopmental disorders in the PICU population.
Clin Pediatr 2018 Jul;57(8):913-19. doi: 10.1177/0009922817737080..
Keywords: Children/Adolescents, Intensive Care Unit (ICU), Critical Care, Behavioral Health
Yin S, Connolly Gibbons MB, Diehl C
A self-report version of the ways of responding: reliability and validity in a clinical sample.
This study evaluated the reliability and validity of a modified, self-report version of the Ways of Responding instrument measures (WOR-SR) in a community mental health sample with depressive symptoms. Subjects completed the WOR-SR and other measures of depressive symptoms, dysfunctional cognitions, functioning, quality of life, and interpersonal problems at multiple time points. The authors conclude from their results that the WOR-SR is a reliable and valid measure of compensatory skills in patients receiving treatment for depression at community mental health centers.
AHRQ-funded; HS022124; HS018440.
Citation: Yin S, Connolly Gibbons MB, Diehl C .
A self-report version of the ways of responding: reliability and validity in a clinical sample.
Psychother Res 2018 Jul;28(4):581-92. doi: 10.1080/10503307.2016.1233367..
Keywords: Depression, Diagnostic Safety and Quality, Behavioral Health, Outcomes
Parker WF, Georges RJ, Gao YN
Association between groundwater lithium and the diagnosis of bipolar disorder and dementia in the United States.
This study examined the association between groundwater lithium and the diagnoses of bipolar disorder and dementia in the United States, with adjustment for local health care resources and demographics. Data on groundwater lithium concentrations was collected by the US Geological Survey, and diagnoses were identified from inpatient hospital, long-term care, and other therapy claims files from several sources. The results of the study indicate that, in spite of the substantial variations in groundwater lithium exposure, no significant association between exposure and the risk of bipolar disorder or dementia after adjustment for county-level demographics and health care resource was found. The authors note that therapeutic lithium doses are orders of magnitude larger than groundwater lithium concentrations, which makes a true causal relationship between groundwater lithium and mental health dubious.
AHRQ-funded; HS000084.
Citation: Parker WF, Georges RJ, Gao YN .
Association between groundwater lithium and the diagnosis of bipolar disorder and dementia in the United States.
JAMA Psychiatry 2018 Jul;75(7):751-54. doi: 10.1001/jamapsychiatry.2018.1020..
Keywords: Dementia, Behavioral Health, Neurological Disorders, Risk
Andreae SJ, Andreae LJ, Cherrington AL
Development of a community health worker-delivered cognitive behavioral training intervention for individuals with diabetes and chronic pain.
The investigators presented an iterative developmental approach to cognitive behavioral therapy (CBT) that combined program adaptation, pretesting, and community health workers (CHW) training processes for a CBT-based diabetes self-care program for individuals living with diabetes and chronic pain.
AHRQ-funded; HS019239.
Citation: Andreae SJ, Andreae LJ, Cherrington AL .
Development of a community health worker-delivered cognitive behavioral training intervention for individuals with diabetes and chronic pain.
Fam Community Health 2018 Jul/Sep;41(3):178-84. doi: 10.1097/fch.0000000000000197.
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Keywords: Behavioral Health, Chronic Conditions, Community-Based Practice, Diabetes, Rural Health
Ivey SL, Shortell SM, Rodriguez HP
Patient engagement in ACO practices and patient-reported outcomes among adults with co-occurring chronic disease and mental health conditions.
The purpose of this study was to assess the extent to which practices with patient-centered cultures, greater shared decision-making strategies, and better coordination among team members have better patient-reported outcomes for patients with diabetes and/or cardiovascular and comorbid mental health diagnoses. The study concluded that Accountable Care Organization patients with comorbid physical and mental health diagnoses report better physical functioning when practices have patient-centered cultures.
AHRQ-funded; HS024075.
Citation: Ivey SL, Shortell SM, Rodriguez HP .
Patient engagement in ACO practices and patient-reported outcomes among adults with co-occurring chronic disease and mental health conditions.
Med Care 2018 Jul;56(7):551-56. doi: 10.1097/mlr.0000000000000927..
Keywords: Chronic Conditions, Behavioral Health, Patient and Family Engagement, Patient-Centered Healthcare, Patient-Centered Outcomes Research
Beebe L, Smith KD, Oppizzi LM
Telephone Intervention-Problem Solving (TIPS) for schizophrenia spectrum disorders: responses of stable outpatients over nine months.
In this study, the investigators conducted a descriptive analysis of data gathered during calls to 87 stable outpatients with schizophrenia spectrum disorders, receiving weekly telephone intervention-problem solving (TIPS) for nine months. The investigators suggest that their findings regarding racial differences in antipsychotic delivery method warrant further investigation.
AHRQ-funded; HS022166.
Citation: Beebe L, Smith KD, Oppizzi LM .
Telephone Intervention-Problem Solving (TIPS) for schizophrenia spectrum disorders: responses of stable outpatients over nine months.
Issues Ment Health Nurs 2018 Jul;39(7):561-67. doi: 10.1080/01612840.2018.1431824..
Keywords: Ambulatory Care and Surgery, Medication, Behavioral Health, Patient Adherence/Compliance
Hudson KE, Wolf SP, Samsa GP
The surprise question and identification of palliative care needs among hospitalized patients with advanced hematologic or solid malignancies.
Little is known about quality of life (QOL), depression, and end-of-life (EOL) outcomes among hospitalized patients with advanced cancer. The objective of this study was to assess whether a surprise question identified inpatients with advanced cancer likely to have unmet palliative care needs. The investigators indicated that hospitalized patients with advanced cancer may benefit from palliative care interventions to improve mood, QOL, and EOL care, and the surprise question is a practical method to identify those with unmet needs.
AHRQ-funded; HS023681.
Citation: Hudson KE, Wolf SP, Samsa GP .
The surprise question and identification of palliative care needs among hospitalized patients with advanced hematologic or solid malignancies.
J Palliat Med 2018 Jun;21(6):789-95. doi: 10.1089/jpm.2017.0509..
Keywords: Palliative Care, Cancer, Inpatient Care, Quality of Life, Depression, Behavioral Health
Axeen S, Seabury SA, Menchine M
Emergency department contribution to the prescription opioid epidemic.
The investigators used MEPS data to characterize the relative contribution of emergency departments (EDs) to national opioid prescribing, to estimate trends in opioid prescribing by site of care, and to examine whether higher-risk opioid users receive a disproportionate quantity of their opioids from ED settings. During the study period, they found that the relative contribution of EDs to the prescription opioid problem was modest and declining. They therefore recommended that further efforts to reduce the quantity of opioids prescribed focus on office-based settings.
AHRQ-funded; HS024251.
Citation: Axeen S, Seabury SA, Menchine M .
Emergency department contribution to the prescription opioid epidemic.
Ann Emerg Med 2018 Jun;71(6):659-67.e3. doi: 10.1016/j.annemergmed.2017.12.007..
Keywords: Behavioral Health, Emergency Department, Medical Expenditure Panel Survey (MEPS), Medication, Opioids, Practice Patterns, Substance Abuse
Goode AP, Coeytaux RR, Maslow GR
Nonpharmacologic treatments for attention-deficit/hyperactivity disorder: a systematic review.
The authors assessed the comparative effectiveness of non-pharmacologic treatments for attention-deficit/hyperactivity disorder (ADHD) among individuals 17 years of age and younger. Non-pharmacologic treatments they identified included neurofeedback, cognitive training, cognitive behavioral therapy, child or parent training, dietary omega fatty acid supplementation, and herbal and/or dietary approaches. They identified no new guidance regarding the comparative effectiveness of non-pharmacologic treatments, concluding that, despite wide use, there are significant gaps in knowledge regarding the effectiveness of ADHD non-pharmacologic treatments.
AHRQ-funded; 290201500004I.
Citation: Goode AP, Coeytaux RR, Maslow GR .
Nonpharmacologic treatments for attention-deficit/hyperactivity disorder: a systematic review.
Pediatrics 2018 Jun;141(6). doi: 10.1542/peds.2018-0094.
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Keywords: Children/Adolescents, Behavioral Health, Comparative Effectiveness, Treatments, Evidence-Based Practice
Levis B, Benedetti A, Riehm KE
Probability of major depression diagnostic classification using semi-structured versus fully structured diagnostic interviews.
This study compared two interview methods that are used to diagnose depression in patients. It was found that the odds of diagnosing for depression were high for the Mini International Neuropsychiatric Interview (MINI) than the Composite International Diagnostic Interview (CIDI).
AHRQ-funded; HS018246.
Citation: Levis B, Benedetti A, Riehm KE .
Probability of major depression diagnostic classification using semi-structured versus fully structured diagnostic interviews.
Br J Psychiatry 2018 Jun;212(6):377-85. doi: 10.1192/bjp.2018.54..
Keywords: Depression, Diagnostic Safety and Quality, Behavioral Health
Jones AL, Cochran SD, Leibowitz A
Racial, ethnic, and nativity differences in mental health visits to primary care and specialty mental health providers: analysis of the Medical Expenditures Panel Survey, 2010-2015.
The researchers sought to guide post-ACA efforts to address mental health service disparities, by using a nationally representative sample to characterize baseline race-, ethnicity-, and nativity-associated differences in mental health services in the context of primary care. They found that all racial/ethnic groups were less likely than non-Latino Whites to have any primary care (PC) visit. Their conclusion was that racial-, ethnic-, and nativity-associated disparities persist in PC provided mental health services.
AHRQ-funded; HS021721.
Citation: Jones AL, Cochran SD, Leibowitz A .
Racial, ethnic, and nativity differences in mental health visits to primary care and specialty mental health providers: analysis of the Medical Expenditures Panel Survey, 2010-2015.
Healthcare 2018 Mar 22;6(2). doi: 10.3390/healthcare6020029.
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Keywords: Disparities, Medical Expenditure Panel Survey (MEPS), Behavioral Health, Primary Care, Racial and Ethnic Minorities
Yellowlees P, Burke Parish M, Gonzalez A
Asynchronous telepsychiatry: a component of stepped integrated care.
The article reports findings from a clinical trial comparing asynchronous telepsychiatry (ATP) with synchronous telepsychiatry (STP) consultations. Patients were randomly assigned to either an ATP or STP treatment group, and data on clinical outcomes, economic information, and patient satisfaction collected at intervals. The authors conclude that ATP implementation in existing integrated behavioral healthcare models might increase efficiency in mental healthcare.
AHRQ-funded; HS021477.
Citation: Yellowlees P, Burke Parish M, Gonzalez A .
Asynchronous telepsychiatry: a component of stepped integrated care.
Telemed J E Health 2018 May;24(5):375-78. doi: 10.1089/tmj.2017.0103..
Keywords: Behavioral Health, Health Information Technology (HIT), Patient-Centered Healthcare, Telehealth
Stringer KL, Azuero A, Ott C
Feasibility and acceptability of real-time antiretroviral adherence monitoring among depressed women living with HIV in the deep south of the US.
The purpose of this study was to present feasibility and acceptability data on the use of an electronic adherence monitor (EAM) among African American women in remote areas of the Southeastern United States with HIV and co-occurring depression. EAM and self-reported antiretroviral therapy (ART) adherence was monitored among 25 participants recruited at four HIV clinics in Alabama. Intra-class correlation showed a low degree of concordance between EAM and self-reported adherence. 83% of data collected via EAM was transmitted in real-time; the remainder was delayed though technological failures or was lost entirely. The authors conclude that EAM monitoring is feasible in a rural US setting but that technological difficulties may impede the device's usefulness for just-in-time adherence interventions.
AHRQ-funded; HS013852.
Citation: Stringer KL, Azuero A, Ott C .
Feasibility and acceptability of real-time antiretroviral adherence monitoring among depressed women living with HIV in the deep south of the US.
AIDS Behav 2018 May;23(5):1306-14. doi: 10.1007/s10461-018-2322-z..
Keywords: Depression, Health Information Technology (HIT), Human Immunodeficiency Virus (HIV), Medication, Behavioral Health, Patient Adherence/Compliance, Rural Health, Telehealth, Women
McCreedy EM, Weinstein BE, Chodosh J
Hearing loss: why does it matter for nursing homes?
This paper examines the impact of hearing loss on residents in nursing home settings and provides an estimate of prevalence using the Minimum Data Set (MDS v.3.0). They outline steps to mitigate hearing loss and discuss solutions that may be inexpensive and low-tech.
AHRQ-funded; HS000011.
Citation: McCreedy EM, Weinstein BE, Chodosh J .
Hearing loss: why does it matter for nursing homes?
J Am Med Dir Assoc 2018 Apr;19(4):323-27. doi: 10.1016/j.jamda.2017.12.007..
Keywords: Nursing Homes, Elderly, Quality of Life, Depression, Behavioral Health
Callahan CM, Bateman DR, Wang S
State of science: bridging the science-practice gap in aging, dementia and mental health.
This article describes why new models of care in aging, dementia, and mental health diffuse inadequately into the healthcare systems and communities where they might benefit older adults. The investigators review a general framework for the diffusion of innovations and highlight the importance of other features of innovations that deter or facilitate diffusion.
AHRQ-funded; HS024384.
Citation: Callahan CM, Bateman DR, Wang S .
State of science: bridging the science-practice gap in aging, dementia and mental health.
J Am Geriatr Soc 2018 Apr;66(Suppl 1):S28-s35. doi: 10.1111/jgs.15320..
Keywords: Elderly, Dementia, Behavioral Health, Healthcare Delivery, Neurological Disorders, Implementation, Evidence-Based Practice
Parast L, Bardach NS, Burkhart Q
Development of new quality measures for hospital-based care of suicidal youth.
This study researched the value of 4 new quality measures developed to assess hospital-based care for suicidal youth. The four quality measures focused on counseling caregivers about restricting access to lethal means of self-harm, and the benefits and risks of antidepressant medications. They were divided into measures for the emergency department (ED) and inpatient measures. Survey field tests were conducted with caregivers of youth who were admitted to the ED or inpatient care for suicidality at 1 of 2 children’s hospitals between July 2013 and June 2014. Most caregivers did receive counseling about restricting their child’s access to lethal means of self-harm and also reported higher rates of counseling of benefits on antidepressants both in the ED and in the inpatient setting than the risks.
AHRQ-funded; HS020506.
Citation: Parast L, Bardach NS, Burkhart Q .
Development of new quality measures for hospital-based care of suicidal youth.
Acad Pediatr 2018 Apr;18(3):248-55. doi: 10.1016/j.acap.2017.09.017..
Keywords: Caregiving, Children/Adolescents, Consumer Assessment of Healthcare Providers and Systems (CAHPS), Education: Patient and Caregiver, Emergency Department, Hospitalization, Hospitals, Inpatient Care, Behavioral Health, Prevention, Quality of Care, Quality Measures
Lau KSL, Rosenman MB, Wiehe SE
Race/ethnicity, and behavioral health status: first arrest and outcomes in a large sample of juvenile offenders.
The objective of this study was to assess the simultaneous effects of gender, race/ethnicity, and pre-arrest behavioral health (BH) service-use on age at first arrest, and first arrest outcomes. It found that black youth were arrested at younger ages than white or Hispanic youth. Youth with psychiatric problems were arrested at younger ages than youth with substance-use, dual-diagnoses, or no BH problems.
AHRQ-funded; HS024296; HS023318.
Citation: Lau KSL, Rosenman MB, Wiehe SE .
Race/ethnicity, and behavioral health status: first arrest and outcomes in a large sample of juvenile offenders.
J Behav Health Serv Res 2018 Apr;45(2):237-51. doi: 10.1007/s11414-017-9578-3.
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Keywords: Behavioral Health, Outcomes, Racial and Ethnic Minorities, Sex Factors
Olfson M, Wall M, Wang S
Suicide after deliberate self-harm in adolescents and young adults.
This study’s objective was to identify risk factors for repeated nonfatal self-harm and suicide death among adolescents and young adults, using a national cohort of patients in the Medicaid program who were followed for up to 1 year after initial self-harm. Data on cause of death was obtained from the National Death Index. The results of the study indicated that adolescents and young adults showed a markedly elevated risk of suicide after nonfatal self-harm. The 12-month suicide standardized mortality rate ratio after self-harm was significantly higher for adolescents than young adults. Hazards of suicide after self-harm were also higher for American Indians and Alaskan natives than for non-Hispanic white patients and for those self-harm patients who initially used violent methods, particularly firearms. The authors conclude that these results underscore the importance of follow-up care to help ensure the safety of self-harm patients.
AHRQ-funded; HS021112.
Citation: Olfson M, Wall M, Wang S .
Suicide after deliberate self-harm in adolescents and young adults.
Pediatrics 2018 Apr;141(4). doi: 10.1542/peds.2017-3517..
Keywords: Children/Adolescents, Medicaid, Behavioral Health, Risk, Young Adults
McKernan LC, Walsh CG, Reynolds WS
Psychosocial co-morbidities in Interstitial cystitis/bladder pain syndrome (IC/BPS): a systematic review.
Psychosocial factors amplify symptoms of Interstitial Cystitis (IC/BPS). While psychosocial self-management is efficacious in other pain conditions, its impact on an IC/BPS population has rarely been studied. The objective of this review was to learn the prevalence and impact of psychosocial factors on IC/BPS, assess baseline psychosocial characteristics, and offer recommendations for assessment and treatment.
AHRQ-funded; HS022990.
Citation: McKernan LC, Walsh CG, Reynolds WS .
Psychosocial co-morbidities in Interstitial cystitis/bladder pain syndrome (IC/BPS): a systematic review.
Neurourol Urodyn 2018 Mar;37(3):926-41. doi: 10.1002/nau.23421..
Keywords: Pain, Anxiety, Depression, Behavioral Health, Patient-Centered Outcomes Research, Outcomes, Chronic Conditions
Aysola J, Tahirovic E, Troxel AB
A randomized controlled trial of opt-in versus opt-out enrollment into a diabetes behavioral intervention.
This study compared an opt-out default recruitment strategy with a conventional opt-in strategy for enrollment in behavioral intervention for poorly controlled diabetic patients. The patients were put in a randomized controlled trial at the University of Pennsylvania-associated primary care practices. Enrollment rates were improved for the opt-out default patients.
AHRQ-funded; HS021706.
Citation: Aysola J, Tahirovic E, Troxel AB .
A randomized controlled trial of opt-in versus opt-out enrollment into a diabetes behavioral intervention.
Am J Health Promot 2018 Mar;32(3):745-52. doi: 10.1177/0890117116671673..
Keywords: Behavioral Health, Diabetes, Lifestyle Changes, Patient Adherence/Compliance
Hansen RA, Hohmann N, Maciejewski ML
Continuity of medication management among adults with schizophrenia and comorbid cardiometabolic conditions.
This study examined whether medication adherence, inpatient admissions, and emergency department (ED) visits vary by the number and types of prescribers seen by adults with schizophrenia and cardiometabolic conditions. Greater antipsychotic adherence for adults receiving prescriptions from multiple psychiatric specialists was counteracted by lower statin adherence and greater risk of ED and inpatient utilization.
AHRQ-funded; HS023099.
Citation: Hansen RA, Hohmann N, Maciejewski ML .
Continuity of medication management among adults with schizophrenia and comorbid cardiometabolic conditions.
J Pharm Health Serv Res 2018 Mar;9(1):13-20. doi: 10.1111/jphs.12201.
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Keywords: Chronic Conditions, Medication, Behavioral Health, Patient Adherence/Compliance, Patient-Centered Healthcare