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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.
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1 to 3 of 3 Research Studies DisplayedDorr DA, Richardson JE, Bobo M
Provider perspectives on patient- and provider-facing high blood pressure clinical decision support.
This study tried to partly address the challenge of developing a patient-facing clinician decision support (CDS) for persistent high blood pressure (HBP). The authors sought to understand provider variations and rationales related to HBP guideline recommendations and perceptions regarding patient role and use of digital tools. They implemented a pilot and final survey for hypertension experts and primary care physicians. Five clinical cases were presented that queried clinicians' attitudes related to actions; variations; prioritization; patient input; importance; and barriers for HBP diagnosis, monitoring, and treatment. Fifteen hypertension experts and 14 providers took the pilot and final versions of the survey. The majority (over 80%) of providers felt the recommendations were important yet found them difficult to follow-up to 90% of the time. Provider perceptions of relative amounts of patient input and patient work for effective HBP management ranged from 22 to 100%. Reasons for variation provided included adverse effects of treatment, patient comorbidities, shared decision-making, and health care cost and access issues. Respondents were generally positive toward patient use of electronic CDS applications but worried about access to health care, nuance of recommendations, and patient understanding of the tools.
AHRQ-funded; HS26849.
Citation: Dorr DA, Richardson JE, Bobo M .
Provider perspectives on patient- and provider-facing high blood pressure clinical decision support.
Appl Clin Inform 2022 Oct;13(5):1131-40. doi: 10.1055/a-1926-0199..
Keywords: Blood Pressure, Clinical Decision Support (CDS), Shared Decision Making, Provider: Physician
Dorr DA, D'Autremont C, Pizzimenti C
Assessing data adequacy for high blood pressure clinical decision support: a quantitative analysis.
This study examined guideline-based high blood pressure (HBP) and hypertension recommendations and evaluated the suitability and adequacy of the data and logic required for a Fast Healthcare Interoperable Resources-based, patient-facing clinical decision support HBP application. Findings showed that data quality from the electronic health record required to implement recommendations for HBP was highly inconsistent, reflecting a fragmented health care system and incomplete implementation of standard terminologies and workflows. Although imperfect, data were deemed adequate for two test use cases.
AHRQ-funded; HS026849.
Citation: Dorr DA, D'Autremont C, Pizzimenti C .
Assessing data adequacy for high blood pressure clinical decision support: a quantitative analysis.
Appl Clin Inform 2021 Aug;12(4):710-20. doi: 10.1055/s-0041-1732401..
Keywords: Blood Pressure, Clinical Decision Support (CDS), Shared Decision Making, Electronic Health Records (EHRs), Health Information Technology (HIT), Health Information Technology (HIT)
Ramirez M, Chen K, Follett RW
Impact of a "chart closure" hard stop alert on prescribing for elevated blood pressures among patients with diabetes: quasi-experimental study.
The aim of the study was to evaluate whether the implementation of the Best Practice Advisory (BPA) was associated with changes in angiotensin-converting enzyme inhibitor (ACEI) and angiotensin-receptor blocker (ARB) prescribing during primary care encounters for patients with diabetes. The investigators concluded that a BPA with a "chart closure" hard stop is a promising tool for the treatment of patients with comorbid diabetes and hypertension with an ACEI or ARB, especially when implemented within the context of team-based care, wherein clinical pharmacists support the work of primary care providers.
AHRQ-funded; HS00046.
Citation: Ramirez M, Chen K, Follett RW .
Impact of a "chart closure" hard stop alert on prescribing for elevated blood pressures among patients with diabetes: quasi-experimental study.
JMIR Med Inform 2020 Apr 17;8(4):e16421. doi: 10.2196/16421..
Keywords: Blood Pressure, Medication, Diabetes, Clinical Decision Support (CDS), Shared Decision Making, Chronic Conditions