National Healthcare Quality and Disparities Report
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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
76 to 95 of 95 Research Studies DisplayedMcCoy RG, Zhang Y, Herrin J
Changing trends in type 2 diabetes mellitus treatment intensification, 2002-2010.
This paper examined trends in hyperglycemia treatment intensification between 2002 and 2010. The investigators found a significant increase in diabetes treatment intensification during this time period. They concluded that the choice of secondline agents changed, with decreasing prevalence of thiazolidinedione and sulfonylurea use and rising prevalence of incretin use.
AHRQ-funded; HS018339; HS017628.
Citation: McCoy RG, Zhang Y, Herrin J .
Changing trends in type 2 diabetes mellitus treatment intensification, 2002-2010.
Am J Manag Care 2015 May;21(5):e288-96.
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Keywords: Diabetes, Medication, Treatments
Thorpe CT, Johnson H, Dopp AL
Medication oversupply in patients with diabetes.
This article describes the development of Child Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS), which included a national field test with 69 hospitals in 34 States, psychometric analysis, and end-user testing of the final survey. The final Child HCAHPS instrument has 62 items, including 39 patient experience items, 10 screeners, 12 demographic/descriptive items and 1 open-ended item.
AHRQ-funded; HS000083; HS018368; HS017646.
Citation: Thorpe CT, Johnson H, Dopp AL .
Medication oversupply in patients with diabetes.
Res Social Adm Pharm 2015 May-Jun;11(3):382-400. doi: 10.1016/j.sapharm.2014.09.002..
Keywords: Medication, Diabetes, Consumer Assessment of Healthcare Providers and Systems (CAHPS), Children/Adolescents, Hospitals
Romanelli RJ, Chung S, Pu J
Comparative effectiveness of early versus delayed metformin in the treatment of type 2 diabetes.
The purpose of this study was to quantify the effectiveness of early versus delayed initiation of metformin monotherapy on glycemic control (measured by change in HbA1c) and weight modification (change in body mass index [BMI]). It found that treatment with metformin earlier in the course of type 2 diabetes is associated with better glycemic control, more pronounced weight reduction, and a lower risk for therapy intensification than delayed treatment.
AHRQ-funded; HS019815.
Citation: Romanelli RJ, Chung S, Pu J .
Comparative effectiveness of early versus delayed metformin in the treatment of type 2 diabetes.
Diabetes Res Clin Pract 2015 Apr;108(1):170-8. doi: 10.1016/j.diabres.2014.12.019..
Keywords: Diabetes, Medication, Comparative Effectiveness, Obesity: Weight Management, Outcomes
Mayberry LS, Egede LE, Wagner JA
Stress, depression and medication nonadherence in diabetes: test of the exacerbating and buffering effects of family support.
The researchers tested the moderation hypotheses that the associations between stressors/depressive symptoms and nonadherence would be stronger in the context of more obstructive family behaviors (exacerbating hypothesis) and weaker in the context of more supportive family behaviors (buffering hypothesis). They found that stressors and nonadherence were only associated at higher levels of obstructive family behaviors. Similarly, depressive symptoms and nonadherence were only associated at higher levels of obstructive family behaviors.
AHRQ-funded; HS022990.
Citation: Mayberry LS, Egede LE, Wagner JA .
Stress, depression and medication nonadherence in diabetes: test of the exacerbating and buffering effects of family support.
J Behav Med 2015 Apr;38(2):363-71. doi: 10.1007/s10865-014-9611-4..
Keywords: Diabetes, Medication, Patient Adherence/Compliance, Depression, Stress
Adams AS, Soumerai SB, Zhang F
Effects of eliminating drug caps on racial differences in antidepressant use among dual enrollees with diabetes and depression.
This study aimed to evaluate the impact of removing a significant financial barrier to prescription medications (drug caps) on existing black-white disparities in antidepressant treatment rates among patients with diabetes and comorbid depression. It found that policies that remove financial barriers to medications may increase depression treatment rates among patients with diabetes overall while exacerbating treatment disparities.
AHRQ-funded; HS018577; HS018072.
Citation: Adams AS, Soumerai SB, Zhang F .
Effects of eliminating drug caps on racial differences in antidepressant use among dual enrollees with diabetes and depression.
Clin Ther 2015 Mar;37(3):597-609. doi: 10.1016/j.clinthera.2014.12.011..
Keywords: Medication, Disparities, Depression, Diabetes, Healthcare Costs
Prentice JC, Conlin PR, Gellad WF
Long-term outcomes of analogue insulin compared with NPH for patients with type 2 diabetes mellitus.
The researchers compared the effects of neutral protamine Hagedorn (NPH) and long-acting insulin analogues on long-term outcomes. They found no consistent difference in long-term health outcomes when comparing use of long-acting insulin analogues and NPH insulin. The higher cost of analogue insulin without demonstrable clinical benefit raises questions of its cost effectiveness in the treatment of patients with diabetes.
AHRQ-funded; HS019708.
Citation: Prentice JC, Conlin PR, Gellad WF .
Long-term outcomes of analogue insulin compared with NPH for patients with type 2 diabetes mellitus.
Am J Manag Care 2015 Mar;21(3):e235-43..
Keywords: Comparative Effectiveness, Diabetes, Healthcare Costs, Medication, Outcomes
Marcum ZA, Driessen J, Thorpe CT
Regional variation in use of a new class of antidiabetic medication among Medicare beneficiaries: the case of incretin mimetics.
After incretin mimetic medications (IMs), a new class of diabetes drugs, were introduced in 2005, researchers examining their use as well as their cost implications for Medicare Part D between 2005 and 2010 found substantial geographic variation existing in their use that was not accounted for by sociodemographic and health status factors. Also, IM use was associated with substantially greater costs for Part D plans and beneficiaries.
AHRQ-funded; HS018721.
Citation: Marcum ZA, Driessen J, Thorpe CT .
Regional variation in use of a new class of antidiabetic medication among Medicare beneficiaries: the case of incretin mimetics.
Ann Pharmacother 2015 Mar;49(3):285-92. doi: 10.1177/1060028014563951..
Keywords: Medication, Diabetes, Medicare
Tan A, Holmes HM, Kuo YF
Coadministration of co-trimoxazole with sulfonylureas: hypoglycemia events and pattern of use.
This study assessed the prevalence of coadministration of co-trimoxazole with sulfonylureas and risk of subsequent emergency room (ER) visits for hypoglycemia among older patients with diabetes. It found that the coadministration of co-trimoxazole with sulfonylureas is associated with increased risk of hypoglycemia. Such coadministration is prevalent among older diabetic patients and varies substantially across U.S. geographic regions.
AHRQ-funded; HS022134.
Citation: Tan A, Holmes HM, Kuo YF .
Coadministration of co-trimoxazole with sulfonylureas: hypoglycemia events and pattern of use.
J Gerontol A Biol Sci Med Sci 2015 Feb;70(2):247-54. doi: 10.1093/gerona/glu072..
Keywords: Comparative Effectiveness, Patient-Centered Outcomes Research, Diabetes, Medication
Przytula K, Bailey SC, Galanter WL
A primary care, electronic health record-based strategy to promote safe drug use: study protocol for a randomized controlled trial.
The researchers designed a health literacy-informed, electronic health record based strategy for promoting safe and effective prescription medication use among English and Spanish-speaking patients with diabetes mellitus. This paper provides an overview of their intervention, summarizes evaluation activities, and discusses the sustainability and potential dissemination of their novel strategy.
AHRQ-funded; HS021093.
Citation: Przytula K, Bailey SC, Galanter WL .
A primary care, electronic health record-based strategy to promote safe drug use: study protocol for a randomized controlled trial.
Trials 2015 Jan 27;16:17. doi: 10.1186/s13063-014-0524-x..
Keywords: Centers for Education and Research on Therapeutics (CERTs), Electronic Health Records (EHRs), Diabetes, Medication, Patient Safety
Chang SH, Luo S, O'Brian KK
Association between metformin use and progression of monoclonal gammopathy of undetermined significance to multiple myeloma in US veterans with diabetes mellitus: a population-based retrospective cohort study.
The authors assessed the association between metformin use and progression of monoclonal gammopathy of undetermined significance to multiple myeloma. They found that metformin use was associated with a reduced risk of progression to multiple myeloma.
AHRQ-funded; HS022330.
Citation: Chang SH, Luo S, O'Brian KK .
Association between metformin use and progression of monoclonal gammopathy of undetermined significance to multiple myeloma in US veterans with diabetes mellitus: a population-based retrospective cohort study.
Lancet Haematol 2015 Jan;2(1):e30-6. doi: 10.1016/s2352-3026(14)00037-4.
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Keywords: Diabetes, Medication, Outcomes, Risk
Casper GR, Flatley Brennan P, Perreault JO
vizHOME--a context-based home assessment: preliminary implications for informatics.
The focus of this paper is on the first phase of the vizHOME study, specifically on the exploration and documentation of the individual’s performance of self-management tasks including such things as medication management and use of a monitoring device. The researchers learned from the participants that while the tools may perform satisfactorily in usability assessment, they may not meet the needs of many users.
AHRQ-funded; HS022548.
Citation: Casper GR, Flatley Brennan P, Perreault JO .
vizHOME--a context-based home assessment: preliminary implications for informatics.
Stud Health Technol Inform 2015;216:842-6..
Keywords: Diabetes, Patient Self-Management, Home Healthcare, Health Information Technology (HIT), Medication
Prentice JC, Conlin PR, Gellad WF
Capitalizing on prescribing pattern variation to compare medications for type 2 diabetes.
This study used observational quasi-experimental methods using instrumental variables (IVs) to compare the effect of two hypoglycemic medications, sulfonylureas (SUs) and thiazolidinediones (TZDs), on long-term outcomes. It found that individuals who used an SU as a second-line agent experienced significantly more adverse long-term health outcomes than did individuals who started on a TZD.
AHRQ-funded; HS019708.
Citation: Prentice JC, Conlin PR, Gellad WF .
Capitalizing on prescribing pattern variation to compare medications for type 2 diabetes.
Value Health 2014 Dec;17(8):854-62. doi: 10.1016/j.jval.2014.08.2674..
Keywords: Diabetes, Medication, Outcomes, Comparative Effectiveness
Voils CI, Sleath B, Maciejewski ML
Patient perspectives on having multiple versus single prescribers of chronic disease medications: results of a qualitative study in a veteran population.
The researchers sought to understand the reasons why patients have increasing numbers of prescribers of medications and to understand patient perspectives on advantages and disadvantages of having multiple prescribers, including effects on medication supply. They found that, with patients from a Veterans Affairs (VA) Medical Center, multiple prescribers arose through referrals and patients actively seeking non-VA prescribers to maximize timeliness and access to medications, to provide access to medications not on the VA formulary, and to minimize out-of-pocket costs.
AHRQ-funded; HS019445.
Citation: Voils CI, Sleath B, Maciejewski ML .
Patient perspectives on having multiple versus single prescribers of chronic disease medications: results of a qualitative study in a veteran population.
BMC Health Serv Res 2014 Oct 25;14:490. doi: 10.1186/s12913-014-0490-8.
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Keywords: Chronic Conditions, Medication, Diabetes, Blood Pressure, Heart Disease and Health
Raebel MA, Ellis JL, Schroeder EB
Intensification of antihyperglycemic therapy among patients with incident diabetes: a Surveillance Prevention and Management of Diabetes Mellitus (SUPREME-DM) study.
The aim of this study was to characterize antihyperglycemic intensification during the first year after initiating oral antihyperglycemic therapy among adult patients with incident diabetes. The researchers found that 43.5 percent of patients with diabetes had treatment intensified within 1 year of starting antihyperglycemic medication. HbA1c of less than 7 percent was achieved in a very high proportion of patients (65.1 percent).
AHRQ-funded; HS019859
Citation: Raebel MA, Ellis JL, Schroeder EB .
Intensification of antihyperglycemic therapy among patients with incident diabetes: a Surveillance Prevention and Management of Diabetes Mellitus (SUPREME-DM) study.
Pharmacoepidemiol Drug Saf, 2014 Jul;23(7):699-710. doi: 10.1002/pds.3610..
Keywords: Diabetes, Prevention, Medication
Schmittdiel JA, Raebel MA, Dyer W
Prescription medication burden in patients with newly diagnosed diabetes: a SUrveillance, PREvention, and ManagEment of Diabetes Mellitus (SUPREME-DM) study.
The purpose of this study is to use electronic health records to examine how many classes of drugs are used by newly diagnosed patients with diabetes immediately before and after the diagnosis of diabetes. Before diagnosis, these patients are using an average of 5 drug classes, and afterwards, use rises to an average of 6.6. Between 2005 and 2009, the average number of drug classes used after diagnosis decreased slightly.
AHRQ-funded; HS01985
Citation: Schmittdiel JA, Raebel MA, Dyer W .
Prescription medication burden in patients with newly diagnosed diabetes: a SUrveillance, PREvention, and ManagEment of Diabetes Mellitus (SUPREME-DM) study.
J Am Pharm Assoc 2014 Jul-Aug;54(4):374-82. doi: 10.1331/JAPhA.2014.13195..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Diabetes, Medication
Camelo Castillo W, Boggess K, Stürmer T
Trends in glyburide compared with insulin use for gestational diabetes treatment in the United States, 2000-2011.
The researchers sought to characterize pharmacologic treatment of women with gestational diabetes (GDM) by describing trends in the use of glyburide compared with insulin over the past decade (2000-2011) and identifying predictors of initial choice of pharmacotherapy. They found that glyburide has replaced insulin as the more common pharmacotherapy for GDM among those privately insured.
AHRQ-funded; HS017950
Citation: Camelo Castillo W, Boggess K, Stürmer T .
Trends in glyburide compared with insulin use for gestational diabetes treatment in the United States, 2000-2011.
Obstet Gynecol. 2014 Jun;123(6):1177-84. doi: 10.1097/AOG.0000000000000285..
Keywords: Diabetes, Maternal Care, Medication, Practice Patterns, Pregnancy, Women
Zhang Y, McCoy RG, Mason JE
Second-line agents for glycemic control for type 2 diabetes: are newer agents better?
The researchers aimed to assess the benefits and harms of four commonly used antihyperglycemia treatment regimens considering clinical effectiveness, quality of life, and cost. According to the model used by the researchers, all regimens resulted in similar life years and quality-adjusted life years (QALYs) regardless of glycemic control goal, but the regimen with sulfonylurea incurred significantly lower cost per QALY.
AHRQ-funded; HS017628.
Citation: Zhang Y, McCoy RG, Mason JE .
Second-line agents for glycemic control for type 2 diabetes: are newer agents better?
Diabetes Care 2014;37(5):1338-45. doi: 10.2337/dc13-1901..
Keywords: Diabetes, Comparative Effectiveness, Quality of Life, Medication
Bobo WV, Cooper WO, Stein CM
Antipsychotics and the risk of type 2 diabetes mellitus in children and youth.
This study found that in a group of 25, 834 Medicaid-enrolled children and youth who had recently initiated use of either an antipsychotic or a control psychotropic drug, antipsychotic users had a risk of a newly diagnosed type 2 diabetes 3 times greater than the propensity-score matched controls. This group was confined to those who had not been diagnosed with conditions for which antipsychotics were the only recognized pharmacotherapy.
AHRQ-funded; HS0116974
Citation: Bobo WV, Cooper WO, Stein CM .
Antipsychotics and the risk of type 2 diabetes mellitus in children and youth.
JAMA Psychiatry. 2013 Oct;70(10):1067-75. doi: 10.1001/jamapsychiatry.2013.2053..
Keywords: Children/Adolescents, Behavioral Health, Diabetes, Medication, Medicaid
Raebel MA, Xu S, Goodrich GK
Initial antihyperglycemic drug therapy among 241 327 adults with newly identified diabetes from 2005 through 2010: a surveillance, prevention, and management of diabetes mellitus (SUPREME-DM) study.
This study sought to identify predictors of initiating any antihyperglycemic medication, and specifically sulfonylurea versus metformin in patients with newly diagnosed with diabetes. Most (59.7 percent) patients with newly diagnosed diabetes did not start any antihyperglycemic medication. Among those who did, metformin was generally the first antihyperglycemic initiated.
AHRQ-funded; HS019859
Citation: Raebel MA, Xu S, Goodrich GK .
Initial antihyperglycemic drug therapy among 241 327 adults with newly identified diabetes from 2005 through 2010: a surveillance, prevention, and management of diabetes mellitus (SUPREME-DM) study.
Ann Pharmacother. 2013 Oct;47(10):1280-91. doi: 10.1177/1060028013503624..
Keywords: Diabetes, Medication, Comparative Effectiveness
Osborn CY, Mayberry LS, Wallston KA
Understanding patient portal use: implications for medication management.
The authors sought to (1) understand who uses an existing patient portal and reasons for use and nonuse, (2) understand how portal users are using a portal to manage their medications, and (3) explore participants' ideas for improving portal functionality for medication management and adherence support. They found that patients use portals to manage their medications, are enthusiastic about further leveraging portals to support medication management and adherence, and those who use a portal more frequently have better glycemic control.
AHRQ-funded; HS018168; HS013833.
Citation: Osborn CY, Mayberry LS, Wallston KA .
Understanding patient portal use: implications for medication management.
J Med Internet Res 2013 Jul 3;15(7):e133. doi: 10.2196/jmir.2589.
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Keywords: Diabetes, Health Information Technology (HIT), Medication, Patient Adherence/Compliance, Web-Based