National Healthcare Quality and Disparities Report
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Topics
- (-) Asthma (11)
- Breast Feeding (1)
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- Diagnostic Safety and Quality (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 11 of 11 Research Studies DisplayedBell N, Lòpez-De Fede A, Cai B
Geographic proximity to primary care providers as a risk-assessment criterion for quality performance measures.
This retrospective cohort study examined geographic proximity to primary care providers as a risk-assessment criterion for quality performance measures for pediatric patients with either attention deficit/hyperactivity disorder (ADD, ages 6-12) or asthma (MMA, ages 5-18) defined using Healthcare Effectiveness Data and Information Set (HEDIS) performance measures. The authors investigated differences in avoidable and potentially avoidable ED visits by the beneficiary's primary care medical home (PCMH) attribution type and in relation to differences in proximity to their primary care providers versus hospitals. There was a 2.4 percentage point reduction in risk of avoidable emergency department (ED) visits among children in the ADD cohort who attended a PCMH versus those who did not which increased to 3.9 to 7.2 percentage points as relative proximity to primary care providers versus hospitals improved. Children in the ADD and MMA cohorts who were enrolled in a PCMH but did not attend one for primary care services exhibited a 5.4 and 3.0 percentage point increase in avoidable ED visits compared to children who were unenrolled and did not attend medical homes, but these differences were only observed when geographic proximity to hospitals was more convenient than primary care providers.
AHRQ-funded; HS026263.
Citation: Bell N, Lòpez-De Fede A, Cai B .
Geographic proximity to primary care providers as a risk-assessment criterion for quality performance measures.
PLoS One 2022 Sep 6;17(9):e0273805. doi: 10.1371/journal.pone.0273805..
Keywords: Children/Adolescents, Primary Care, Asthma, Medicaid, Emergency Department
Rudin RA, Perez S, Rodriguez JA
User-centered design of a scalable, electronic health record-integrated remote symptom monitoring intervention for patients with asthma and providers in primary care.
The objective of this study was to determine user and electronic health records (EHR) integration requirements for a scalable remote symptom monitoring intervention for asthma patients and their providers. Using the NASSS framework to guide their user-centered design process, the investigators identified patient and provider requirements for scaling an EHR-integrated remote symptom monitoring intervention in primary care.
AHRQ-funded; HS026432.
Citation: Rudin RA, Perez S, Rodriguez JA .
User-centered design of a scalable, electronic health record-integrated remote symptom monitoring intervention for patients with asthma and providers in primary care.
J Am Med Inform Assoc 2021 Oct 12;28(11):2433-44. doi: 10.1093/jamia/ocab157..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Asthma, Respiratory Conditions, Primary Care
Harder VS, Shaw JS, McCulloch CE
Statewide asthma learning collaborative participation and asthma-related emergency department use.
This study looked at outcomes from participation of pediatric practices in a quality improvement (QI) collaborative to decrease asthma-related emergency department (ED) visits. A statewide network of practices participated in the collaborative from 2015 to 2016. Asthma-related ED visit rates per 100 child-years for children ages 3 to 21 was evaluated using the state’s all-payer claims databases. The authors found that in the postintervention year (2017) participating practices’ ED visit rate decreased by 5.8 per 100 child-years, compared to an increase of 1.8 per 100 child-years in non-participating practices. There were no statistically significant differences in asthma-related ED visit rates during 2016, which indicated that it took some time for QI elements to be successfully implemented in pediatric practices.
AHRQ-funded; HS025297.
Citation: Harder VS, Shaw JS, McCulloch CE .
Statewide asthma learning collaborative participation and asthma-related emergency department use.
Pediatrics 2020 Dec;146(6):e20200213. doi: 10.1542/peds.2020-0213..
Keywords: Children/Adolescents, Asthma, Emergency Department, Quality Improvement, Quality of Care, Primary Care, Guidelines
Heintzman J, Kaufmann J, Ezekiel-Herrera D
Asthma/COPD disparities in diagnosis and basic care utilization among low-income primary care patients.
Obstructive pulmonary disease outcomes in the United States differ between Latinos and non-Hispanic whites. There is little objective data about diagnosis prevalence and primary care visit frequency in these disease processes. In this study, the investigators used electronic health record data to perform a retrospective cohort analysis of 34,849 low-income patients seen at Oregon community health centers between 2009 and 2013 to assess joint racial/ethnic and insurance disparities in diagnosis and visit rates between Latino and non-Hispanic white patients.
AHRQ-funded; HS021522.
Citation: Heintzman J, Kaufmann J, Ezekiel-Herrera D .
Asthma/COPD disparities in diagnosis and basic care utilization among low-income primary care patients.
J Immigr Minor Health 2019 Jun;21(3):659-63. doi: 10.1007/s10903-018-0798-2..
Keywords: Asthma, Respiratory Conditions, Chronic Conditions, Disparities, Healthcare Utilization, Low-Income, Primary Care
Liu TL, Taylor YJ, Mahabaleshwarkar R
Shared decision making and time to exacerbation in children with asthma.
This study examined the use of shared decision making (SDM) to delay exacerbation in children with asthma. A prospective cohort of children at five primary care practices in Charlotte, North Carolina that serve vulnerable population was studied between 2011 and 2013. The cohort included 746 children, with 60.5% male and 54.2% African American with a mean age of 8.6 years. The final analysis included 100 matched pairs of children for use of SDM and normal care. There was a marginally significant difference in the time of exacerbation between the two groups.
AHRQ-funded; HS019946.
Citation: Liu TL, Taylor YJ, Mahabaleshwarkar R .
Shared decision making and time to exacerbation in children with asthma.
J Asthma 2018 Sep;55(9):949-55. doi: 10.1080/02770903.2017.1378357..
Keywords: Children/Adolescents, Shared Decision Making, Asthma, Respiratory Conditions, Chronic Conditions, Primary Care
Yawn BP, Wollan PC, Rank MA
Use of asthma APGAR tools in primary care practices: a cluster-randomized controlled trial.
The purpose of this study was to assess patient and practice outcomes after introducing the Asthma APGAR (Activities, Persistent, triGGers, Asthma medications, Response to therapy) tools into primary care practices. It concluded that introduction of the Asthma APGAR tools improves rates of asthma control; reduces asthma-related ED, urgent care, and hospital visits; and increases practices' adherence to asthma management guidelines.
AHRQ-funded; HS022126.
Citation: Yawn BP, Wollan PC, Rank MA .
Use of asthma APGAR tools in primary care practices: a cluster-randomized controlled trial.
Ann Fam Med 2018 Mar;16(2):100-10. doi: 10.1370/afm.2179.
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Keywords: Asthma, Patient-Centered Outcomes Research, Primary Care, Medical Expenditure Panel Survey (MEPS), Tools & Toolkits
Kato E, Rajupet S
AHRQ Author: Kato E
Primary interventions to support breastfeeding.
This case study involves a 26-year-old woman, who presents for a routine prenatal visit at 28 weeks’ gestation. Her medical history is significant for poorly controlled asthma, and her family history is significant for breast cancer diagnosed in her mother. It poses three multiple choice questions together with the U.S. Preventive Services Task Force recommendations and related background information.
AHRQ-authored.
Citation: Kato E, Rajupet S .
Primary interventions to support breastfeeding.
Am Fam Physician 2017 Apr 15;95(8):517-18.
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Keywords: U.S. Preventive Services Task Force (USPSTF), Breast Feeding, Primary Care, Pregnancy, Asthma
Fiks AG, DuRivage N, Mayne SL
Adoption of a portal for the primary care management of pediatric asthma: a mixed-methods implementation study.
The researchers evaluated the feasibility of using a patient portal for pediatric asthma in primary care. Fewer than three percent of those families invited to enroll used the portal. The authors found that although use of the portal was associated with higher treatment engagement, their results suggested that achieving widespread portal adoption is unlikely in the short term.
AHRQ-funded; HS021645; HS022689.
Citation: Fiks AG, DuRivage N, Mayne SL .
Adoption of a portal for the primary care management of pediatric asthma: a mixed-methods implementation study.
J Med Internet Res 2016 Jun 29;18(6):e172. doi: 10.2196/jmir.5610.
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Keywords: Web-Based, Primary Care, Children/Adolescents, Patient-Centered Healthcare, Asthma
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
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
Gillette C, Blalock SJ, Rao JK
Provider-caregiver-child discussions about risks associated with asthma control medications: content and prevalence.
The objectives of the study were to: (1) describe the extent to which primary care pediatric providers discuss risks associated with asthma control medications with families and (2) examine the relationship between child, caregiver, provider, and clinic visit characteristics and discussions about risks associated with asthma control medications. It found that providers discussed asthma control medication risks during 23% of visits.
AHRQ-funded; HS020534.
Citation: Gillette C, Blalock SJ, Rao JK .
Provider-caregiver-child discussions about risks associated with asthma control medications: content and prevalence.
Pediatr Pulmonol 2014 Aug;49(8):727-33. doi: 10.1002/ppul.22892..
Keywords: Medication, Asthma, Children/Adolescents, Clinician-Patient Communication, Primary Care