National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Access to Care (2)
- Ambulatory Care and Surgery (1)
- Asthma (1)
- Behavioral Health (1)
- Cancer (1)
- Cancer: Breast Cancer (1)
- Cardiovascular Conditions (1)
- Caregiving (1)
- Children/Adolescents (3)
- Chronic Conditions (2)
- Clinical Decision Support (CDS) (1)
- (-) Clinician-Patient Communication (27)
- Communication (7)
- Community-Based Practice (1)
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) (2)
- Diagnostic Safety and Quality (1)
- Digestive Disease and Health (1)
- Disparities (2)
- Education: Continuing Medical Education (1)
- Education: Patient and Caregiver (1)
- Elderly (1)
- Electronic Health Records (EHRs) (2)
- Healthcare Delivery (1)
- Health Information Technology (HIT) (6)
- Health Services Research (HSR) (1)
- Human Immunodeficiency Virus (HIV) (1)
- Imaging (1)
- Inpatient Care (1)
- Maternal Care (1)
- Medical Errors (1)
- Medicare (1)
- Medication (2)
- Obesity (2)
- Opioids (1)
- Pain (1)
- Patient-Centered Healthcare (3)
- Patient-Centered Outcomes Research (4)
- Patient Adherence/Compliance (1)
- Patient and Family Engagement (4)
- Patient Experience (3)
- Patient Safety (2)
- Patient Self-Management (1)
- Prevention (1)
- Primary Care (2)
- Provider (1)
- Provider: Health Personnel (1)
- Quality of Care (2)
- Racial and Ethnic Minorities (3)
- Risk (1)
- Shared Decision Making (4)
- Telehealth (1)
- Tobacco Use (1)
- Vaccination (1)
- Web-Based (1)
- Women (1)
- Workforce (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 27 Research Studies DisplayedCalo WA, Cubillos L, Breen J
Experiences of Latinos with limited English proficiency with patient registration systems and their interactions with clinic front office staff: an exploratory study to inform community-based translational research in North Carolina.
This study explored Latino patients with limited English proficiency (LEP) experiences with, and expectations for, interactions with patient registration systems and front office staff. It found that Latino patients in North Carolina experienced health services barriers unique to their LEP background. Participants identified ways in which the lack of cultural and linguistic competence of front office staff negatively affect their experiences seeking health services.
AHRQ-funded; HS000032.
Citation: Calo WA, Cubillos L, Breen J .
Experiences of Latinos with limited English proficiency with patient registration systems and their interactions with clinic front office staff: an exploratory study to inform community-based translational research in North Carolina.
BMC Health Serv Res 2015 Dec 23;15:570. doi: 10.1186/s12913-015-1235-z.
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Keywords: Access to Care, Communication, Health Services Research (HSR), Clinician-Patient Communication, Racial and Ethnic Minorities
Hall JA, Ship AN, Ruben MA
Clinically relevant correlates of accurate perception of patients' thoughts and feelings.
The goal of the study was to explore the clinical relevance of accurate understanding of patients' thoughts and feelings. It found that accuracy in understanding patients' thoughts and feelings was significantly correlated with nursing students' clinical course experience, clinicians' favorable attitudes to psychosocial discussion, standardized patients' evaluations of medical students' interpersonal skill, and independent coding of medical students' patient-centered behavior while taking a social history.
AHRQ-funded; HS018942.
Citation: Hall JA, Ship AN, Ruben MA .
Clinically relevant correlates of accurate perception of patients' thoughts and feelings.
Health Commun 2015;30(5):423-9. doi: 10.1080/10410236.2013.865507.
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Keywords: Provider: Health Personnel, Clinician-Patient Communication
Hajizadeh N, Uhler LM, Perez Figueroa RE
Understanding patients' and doctors' attitudes about shared decision making for advance care planning.
The authors sought to gain general insights into the current practice of shared decision making (SDM) and attitudes about patient involvement, and also to gain specific insights into experience with, and attitudes about, SDM for advance care planning. They found that patients were generally open to having end-of-life discussions with their doctors, although their openness sometimes depended on the circumstance. Doctors reported engaging in end-of-life treatment decisions with their patients, although they expressed the need for conversations to take place earlier, in advance of acute illness.
AHRQ-funded; HS022061; HS019473.
Citation: Hajizadeh N, Uhler LM, Perez Figueroa RE .
Understanding patients' and doctors' attitudes about shared decision making for advance care planning.
Health Expect 2015 Dec;18(6):2054-65. doi: 10.1111/hex.12285.
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Keywords: Clinician-Patient Communication, Shared Decision Making, Patient and Family Engagement, Patient-Centered Healthcare
Yi H, Xiao T, Thomas PS
Barriers and facilitators to patient-provider communication when discussing breast cancer risk to aid in the development of decision support tools.
The investigators identified barriers and facilitators to patient-provider communication when discussing breast cancer risk to aid in the development of decision support tools. They found that barriers barriers are time constraints, lack of knowledge, low health literacy, and language barriers, and that facilitators are information needs, desire for personalization, and autonomy when communicating risk in patient-provider encounters. These results will inform the development of a patient-centered decision aid (RealRisks) and a provider-facing breast cancer risk navigation (BNAV) tool.
AHRQ-funded; HS019313.
Citation: Yi H, Xiao T, Thomas PS .
Barriers and facilitators to patient-provider communication when discussing breast cancer risk to aid in the development of decision support tools.
AMIA Annu Symp Proc 2015 Nov 5;2015:1352-60.
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Keywords: Cancer: Breast Cancer, Shared Decision Making, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Clinician-Patient Communication
Eschler J, Liu LS, Vizer LM
Designing asynchronous communication tools for optimization of patient-clinician coordination.
The authors elicited narratives about patients' experiences and expectations for using asynchronous communication to address medical issues with their clinicians. They then presented opportunities for designing asynchronous communication tools to better facilitate understanding of and coordination around care activities between patients and clinicians.
AHRQ-funded; HS021590.
Citation: Eschler J, Liu LS, Vizer LM .
Designing asynchronous communication tools for optimization of patient-clinician coordination.
AMIA Annu Symp Proc 2015 Nov 5;2015:543-52.
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Keywords: Chronic Conditions, Health Information Technology (HIT), Patient Experience, Clinician-Patient Communication, Web-Based
O'Leary K, Vizer L, Eschler J
Understanding patients' health and technology attitudes for tailoring self-management interventions.
The researchers elicited attitudes toward technology use and participation in care of 40 participants in a maximum variation sample. They found three participant clusters-"Proactive Techies," "Indie Self-Managers," and "Remind Me! Non-Techies"-that represent varying attitudes toward health behaviors and technologies that were independent of race, education level, and age. Their approach provides insight into how people prioritize important values related to health participation and technology.
AHRQ-funded; HS021590.
Citation: O'Leary K, Vizer L, Eschler J .
Understanding patients' health and technology attitudes for tailoring self-management interventions.
AMIA Annu Symp Proc 2015 Nov 5;2015:991-1000.
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Keywords: Chronic Conditions, Health Information Technology (HIT), Patient and Family Engagement, Clinician-Patient Communication
Melnick ER
How to make less more: empathy can fill the gap left by reducing unnecessary care.
The author argues that regardless of how overuse of medical services is curtailed, it must be replaced with empathic care. Empathy in patient care is the “cognitive attribute that involves an understanding of patients’ experiences, concerns, and perspectives combined with a capacity to communicate this understanding. Empathic engagement with patients has many benefits. Patients who are engaged by their clinician feel more informed, and more accurately understand the potential benefits and harms of appropriate clinical options.
AHRQ-funded; HS021271.
Citation: Melnick ER .
How to make less more: empathy can fill the gap left by reducing unnecessary care.
BMJ 2015 Nov 4;351:h5831. doi: 10.1136/bmj.h5831..
Keywords: Clinician-Patient Communication, Patient Safety, Patient Experience
Schussler-Fiorenza Rose SM, Gangnon RE, Chewning B
Increasing discussion rates of incontinence in primary care: a randomized controlled trial.
The study’s aim was to evaluate whether the use of an electronic pelvic floor assessment questionnaire (ePAQ-PF) improves communication about incontinence in primary care. It found that use of the ePAQ-PF prior to clinic visits increases discussion of urinary and fecal incontinence, particularly clinician-initiated discussion.
AHRQ-funded; HS017028.
Citation: Schussler-Fiorenza Rose SM, Gangnon RE, Chewning B .
Increasing discussion rates of incontinence in primary care: a randomized controlled trial.
J Womens Health 2015 Nov;24(11):940-9. doi: 10.1089/jwh.2015.5230..
Keywords: Clinician-Patient Communication, Communication, Primary Care, Women
Persell SD, Brown T, Lee JY
Individualized risk communication and outreach for primary cardiovascular disease prevention in community health centers: randomized trial.
The researchers conducted a randomized trial to determine if mailed outreach containing patients’ individualized CVD risk and uncontrolled risk factors followed by telephone discussion with trained lay health workers would improve statin use for primary prevention among community health center patients with moderately high cardiovascular risk. They found that the intervention, led to more cholesterol treatment discussions with primary care clinicians but had little impact on statin prescribing.
AHRQ-funded; HS021141.
Citation: Persell SD, Brown T, Lee JY .
Individualized risk communication and outreach for primary cardiovascular disease prevention in community health centers: randomized trial.
Circ Cardiovasc Qual Outcomes 2015 Nov;8(6):560-6. doi: 10.1161/circoutcomes.115.001723..
Keywords: Cardiovascular Conditions, Prevention, Community-Based Practice, Clinician-Patient Communication, Risk
Khan A, Rogers JE, Melvin P
Physician and nurse nighttime communication and parents' hospital experience.
The researchers examined relationships between nighttime communication and parents’ inpatient experience. They found that parents provided the highest percentage of top ratings for the individual item pertaining to whether nurses listened to their concerns (70.5 percent strongly agreed) and the lowest such ratings for regular communication with nighttime doctors (31.4 percent excellent).
AHRQ-funded; HS022986; HS000063.
Citation: Khan A, Rogers JE, Melvin P .
Physician and nurse nighttime communication and parents' hospital experience.
Pediatrics 2015 Nov;136(5):e1249-58. doi: 10.1542/peds.2015-2391..
Keywords: Children/Adolescents, Clinician-Patient Communication, Patient-Centered Outcomes Research
Shortell SM, Sehgal NJ, Bibi S
An early assessment of accountable care organizations' efforts to engage patients and their families.
The authors sought to examine the extent to which ACOs actively engage patients and their families, explore challenges involved, and consider approaches for dealing with those challenges. They identified important practices associated with greater patient activation and engagement, including high-level leadership commitment, goal-setting supported by adequate resources, extensive provider training, use of interdisciplinary care teams, and frequent monitoring and reporting on progress.
AHRQ-funded; HS022241.
Citation: Shortell SM, Sehgal NJ, Bibi S .
An early assessment of accountable care organizations' efforts to engage patients and their families.
Med Care Res Rev 2015 Oct;72(5):580-604. doi: 10.1177/1077558715588874.
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Keywords: Shared Decision Making, Quality of Care, Patient and Family Engagement, Clinician-Patient Communication
Sulzer SH
Does "difficult patient" status contribute to de facto demedicalization? The case of borderline personality disorder.
This study relies on 22 in-depth interviews with mental health clinicians in the United States to evaluate how they describe patients with borderline personality disorder (BPD), how the diagnosis of BPD affects the treatment clinicians are willing to provide, and the implications for patients. Its findings suggest patients with BPD are routinely labeled “difficult,” and subsequently routed out of care through a variety of direct and indirect means.
AHRQ-funded; HS000032.
Citation: Sulzer SH .
Does "difficult patient" status contribute to de facto demedicalization? The case of borderline personality disorder.
Soc Sci Med 2015 Oct;142:82-9. doi: 10.1016/j.socscimed.2015.08.008..
Keywords: Behavioral Health, Clinician-Patient Communication, Access to Care
Attanasio L, Kozhimannil KB
Patient-reported communication quality and perceived discrimination in maternity care.
The researchers assessed racial/ethnic disparities in patient-reported communication problems and perceived discrimination in maternity care among women nationally and measured racial/ethnic variation in the correlates of these outcomes. They found that over 40 percent of women reported communication problems in prenatal care, and 24 percent perceived discrimination during their hospitalization for birth.
AHRQ-funded; HS000036.
Citation: Attanasio L, Kozhimannil KB .
Patient-reported communication quality and perceived discrimination in maternity care.
Med Care 2015 Oct;53(10):863-71. doi: 10.1097/mlr.0000000000000411..
Keywords: Communication, Disparities, Maternal Care, Clinician-Patient Communication, Racial and Ethnic Minorities
Rangachari P, Mehta R, Rethemeyer RK
Short or long end of the lever? Associations between provider communication of the "asthma-action plan" and outpatient revisits for pediatric asthma.
This study addresses the gap in understanding the extent of leverage that healthcare providers may have in preventing hospital revisits for asthma through effective communication of the Asthma-Action Plan (AAP) in the outpatient setting. The Children's Hospital of Georgia survey results suggest limited potential of effective provider communication of AAP in reducing outpatient revisits for pediatric asthma and indicate a need for broader community-based interventions to address patient life variables impacting self-management and hospital revisits for pediatric asthma.
AHRQ-funded; HS019785.
Citation: Rangachari P, Mehta R, Rethemeyer RK .
Short or long end of the lever? Associations between provider communication of the "asthma-action plan" and outpatient revisits for pediatric asthma.
J Hosp Adm 2015 Oct;4(5):26-39. doi: 10.5430/jha.v4n5p26.
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Keywords: Asthma, Children/Adolescents, Ambulatory Care and Surgery, Clinician-Patient Communication, Patient Self-Management
Beach MC, Roter DL, Saha S
Impact of a brief patient and provider intervention to improve the quality of communication about medication adherence among HIV patients.
The authors designed this study to improve patient-provider communication about HIV medication adherence. They found that brief provider training, combined with patient coaching sessions, improved provider communication behaviors and increased dialogue regarding medication adherence.
AHRQ-funded; HS013903; 290010012.
Citation: Beach MC, Roter DL, Saha S .
Impact of a brief patient and provider intervention to improve the quality of communication about medication adherence among HIV patients.
Patient Educ Couns 2015 Sep;98(9):1078-83. doi: 10.1016/j.pec.2015.05.011.
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Keywords: Human Immunodeficiency Virus (HIV), Medication, Patient Adherence/Compliance, Patient and Family Engagement, Clinician-Patient Communication
Crotty BH, Walker J, Dierks M
Information sharing preferences of older patients and their families.
This study identified how patients older than 75 years (hereinafter, elders) and family caregivers of such patients approach sharing of health information, with the hope of applying the results to collaborative patient portals. It found that information sharing and control are complex issues even under the most well-meaning circumstances. While elders may delegate control and share information with family, they want to retain granular control of their information.
AHRQ-funded; HS021495.
Citation: Crotty BH, Walker J, Dierks M .
Information sharing preferences of older patients and their families.
JAMA Intern Med 2015 Sep;175(9):1492-7. doi: 10.1001/jamainternmed.2015.2903..
Keywords: Caregiving, Clinician-Patient Communication, Communication, Elderly, Electronic Health Records (EHRs), Health Information Technology (HIT)
Rand CM, Blumkin A, Vincelli P
Parent preferences for communicating with their adolescent's provider using new technologies.
The researchers assessed the views of parents of adolescents on various means to communicate with their adolescents’ physicians about vaccine reminders and appointments, medication refills and test results including phone, mail, e-mail, text messages, and personal health records (PHR). They found that young parents of adolescents are most likely to accept text message vaccine reminders; suburban parents prefer e-mail reminders. Personal health records are accepted generally by those parents who are younger and suburban.
AHRQ-funded; HS017951.
Citation: Rand CM, Blumkin A, Vincelli P .
Parent preferences for communicating with their adolescent's provider using new technologies.
J Adolesc Health 2015 Sep;57(3):299-304. doi: 10.1016/j.jadohealth.2015.06.006..
Keywords: Health Information Technology (HIT), Clinician-Patient Communication, Children/Adolescents, Vaccination
Arora VM, Prochaska MT, Farnan JM
Patient perceptions of whom is most involved in their care with successive duty hour limits.
The researchers aimed to assess if patients’ perceptions of who is most involved in their care changed with residency duty hours. They found that after successive residency duty hours limits, hospitalized patients were more likely to report the attending physician and less likely to report the resident or intern as most involved in their hospital care.
AHRQ-funded; HS010597; HS016967.
Citation: Arora VM, Prochaska MT, Farnan JM .
Patient perceptions of whom is most involved in their care with successive duty hour limits.
J Gen Intern Med 2015 Sep;30(9):1275-8. doi: 10.1007/s11606-015-3239-0..
Keywords: Education: Continuing Medical Education, Inpatient Care, Provider, Clinician-Patient Communication, Workforce
Chung CF, Cook K, Bales E
More than telemonitoring: Health provider use and nonuse of life-log data in irritable bowel syndrome and weight management.
The researchers sought to develop an in-depth understanding of providers’ facilitators and barriers to successfully integrating life-log data into their practices and creating better experiences. Providers reported using self-monitoring data to enhance provider-patient communication, develop personalized treatment plans, and to motivate and educate patients, in addition to using them as diagnostic and adherence tools. Barriers included a lack of time to review detailed records and questions about providers' expertise to review it.
AHRQ-funded; HS023654.
Citation: Chung CF, Cook K, Bales E .
More than telemonitoring: Health provider use and nonuse of life-log data in irritable bowel syndrome and weight management.
J Med Internet Res 2015 Aug 21;17(8):e203. doi: 10.2196/jmir.4364..
Keywords: Digestive Disease and Health, Health Information Technology (HIT), Telehealth, Obesity, Clinician-Patient Communication
El-Jawahri A, Mitchell SL, Paasche-Orlow MK
A randomized controlled trial of a CPR and intubation video decision support tool for hospitalized patients.
The researchers examined the impact of a video decision tool for CPR and intubation on patients’ choices, knowledge, medical orders, and discussions with providers. They found that seriously ill patients who viewed a video about CPR and intubation were more likely not to want these treatments, be better informed about their options, have orders to forgo CPR/ intubation, and discuss preferences with providers.
AHRQ-funded; HS018780.
Citation: El-Jawahri A, Mitchell SL, Paasche-Orlow MK .
A randomized controlled trial of a CPR and intubation video decision support tool for hospitalized patients.
J Gen Intern Med 2015 Aug;30(8):1071-80. doi: 10.1007/s11606-015-3200-2..
Keywords: Patient-Centered Outcomes Research, Clinical Decision Support (CDS), Shared Decision Making, Clinician-Patient Communication
Morgans AK, Schapira L
Confronting therapeutic failure: a conversation guide.
The authors review the classic six-step SPIKES (setting, perception, invitation for information, knowledge, empathy, summarize and strategize) protocol for giving bad news that has been widely adopted since it was first published in this journal in 2005. They also offer practical tips derived from a thorough review of the evidence and our clinical experience.
AHRQ-funded; HS022990.
Citation: Morgans AK, Schapira L .
Confronting therapeutic failure: a conversation guide.
Oncologist 2015 Aug;20(8):946-51. doi: 10.1634/theoncologist.2015-0050..
Keywords: Cancer, Clinician-Patient Communication, Communication, Patient-Centered Healthcare, Patient-Centered Outcomes Research
Baer HJ, Wee CC, DeVito K
Design of a cluster-randomized trial of electronic health record-based tools to address overweight and obesity in primary care.
The researchers described the design of a trial to examine the effectiveness of electronic health record-based tools for the assessment and management of overweight and obesity among adult primary care patients, as well as the challenges encountered. New features included reminders to measure height and weight, and an alert asking providers to add overweight or obesity to the problem list.
AHRQ-funded; HS019789.
Citation: Baer HJ, Wee CC, DeVito K .
Design of a cluster-randomized trial of electronic health record-based tools to address overweight and obesity in primary care.
Clin Trials 2015 Aug;12(4):374-83. doi: 10.1177/1740774515578132..
Keywords: Health Information Technology (HIT), Primary Care, Obesity, Electronic Health Records (EHRs), Clinician-Patient Communication
Gallagher TH, Mazor KM
Taking complaints seriously: using the patient safety lens.
This editorial defined a patient safety lens that favors learning over protection. It listed five critical components of the patient safety lens and concluded that the first and most important step entails expanding our perspective beyond the technical execution of care to encompass and appreciate patients’ reports of their care experiences.
AHRQ-funded; HS022757.
Citation: Gallagher TH, Mazor KM .
Taking complaints seriously: using the patient safety lens.
BMJ Qual Saf 2015 Jun;24(6):352-5. doi: 10.1136/bmjqs-2015-004337.
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Keywords: Healthcare Delivery, Medical Errors, Patient Safety, Patient Experience, Clinician-Patient Communication
Zhu J, Weingart SN, Ritter GA
Racial/Ethnic disparities in patient experience with communication in hospitals: real differences or measurement errors?
This study examined assumptions about the degree of commonality across racial/ethnic groups in their perceptions and investigated the validity of racial/ethnic differences in communication quality. Its results provide strongest support for racial/ethnic comparisons on communication with nurses and doctors, and reason to caution against comparisons on communication about medicines due to significant differences in model parameters across groups.
AHRQ-funded; 290010003.
Citation: Zhu J, Weingart SN, Ritter GA .
Racial/Ethnic disparities in patient experience with communication in hospitals: real differences or measurement errors?
Med Care 2015 May;53(5):446-54. doi: 10.1097/mlr.0000000000000350..
Keywords: Disparities, Clinician-Patient Communication, Consumer Assessment of Healthcare Providers and Systems (CAHPS), Racial and Ethnic Minorities, Quality of Care
Hughes HK, Korthuis PT, Saha S
A mixed methods study of patient-provider communication about opioid analgesics.
The researchers sought to describe patient-provider communication about opioid pain medicine and explore how these discussions affect provider attitudes toward patients. They found that pain management discussions are common in routine outpatient HIV encounters and providers may regard patients less favorably if opioids are discussed during visits. The sometimes-adversarial nature of these discussions may negatively affect provider attitudes toward patients.
AHRQ-funded; 290010012; HS013903.
Citation: Hughes HK, Korthuis PT, Saha S .
A mixed methods study of patient-provider communication about opioid analgesics.
Patient Educ Couns 2015 Apr;98(4):453-61. doi: 10.1016/j.pec.2014.12.003..
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Keywords: Communication, Medication, Opioids, Pain, Clinician-Patient Communication