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
51 to 65 of 65 Research Studies DisplayedCochran G, Cole ES, Warwick J
Rural access to MAT in Pennsylvania (RAMP): a hybrid implementation study protocol for medication assisted treatment adoption among rural primary care providers.
This paper reports the design and protocol of an implementation study seeking to advance availability of medication-assisted treatment (MAT) for opioid use disorder (OUD) in rural Pennsylvania counties for patients insured by Medicaid in primary care settings. Results showed an urgent need in the US to expand access to high quality, evidence-based OUD treatment, particularly in rural areas where capacity is limited for service delivery, in order to improve patient health and protect lives. Further, results of this study will provide needed evidence in the field for appropriate methods for implementing MAT among a large number of rural primary care providers.
AHRQ-funded; HS025072.
Citation: Cochran G, Cole ES, Warwick J .
Rural access to MAT in Pennsylvania (RAMP): a hybrid implementation study protocol for medication assisted treatment adoption among rural primary care providers.
Addict Sci Clin Pract 2019 Aug 1;14(1):25. doi: 10.1186/s13722-019-0154-4..
Keywords: Opioids, Substance Abuse, Rural Health, Medication, Access to Care, Implementation, Primary Care, Healthcare Delivery, Medicaid
Cole ES, DiDomenico E, Cochran G
The role of primary care in improving access to medication-assisted treatment for rural Medicaid enrollees with opioid use disorder.
The authors examined the degree to which rural residents with opioid use disorder (OUD) are engaged with primary care providers (PCPs); they also described the role of rural PCPs in medication-assisted treatment (MAT) delivery, and estimated the association between enrollee distance to MAT prescribers and MAT utilization. They concluded that PCP utilization among rural Medicaid enrollees diagnosed with OUD is high, presenting a potential intervention point to treat OUD, particularly if the enrollee's PCP is located nearer than their MAT prescriber.
AHRQ-funded; HS025072.
Citation: Cole ES, DiDomenico E, Cochran G .
The role of primary care in improving access to medication-assisted treatment for rural Medicaid enrollees with opioid use disorder.
J Gen Intern Med 2019 Jun;34(6):936-43. doi: 10.1007/s11606-019-04943-6..
Keywords: Opioids, Substance Abuse, Rural Health, Medication, Access to Care, Implementation, Primary Care, Healthcare Delivery, Medicaid
Borsky AE, Flores EJ, Berliner E
AHRQ Author: Borsky AE, Berliner E, Chang C, Chang SM
Next steps in improving healthcare value: AHRQ Evidence-based Practice Center Program-applying the knowledge to practice to data cycle to strengthen the value of patient care.
This paper discusses AHRQ’s Evidence-based Practice Center (EPC) Program which has been in existence for over 20 years. The EPC program and its objectives are described. The three phases of the Learning Healthcare System cycle is described. A sample topic (hospital medicine Clostridium difficile colitis prevention and treatment) is used to describe the process and results of the effectiveness of the EPC program.
AHRQ-authored.
Citation: Borsky AE, Flores EJ, Berliner E .
Next steps in improving healthcare value: AHRQ Evidence-based Practice Center Program-applying the knowledge to practice to data cycle to strengthen the value of patient care.
J Hosp Med 2019 May;14(5):311-14. doi: 10.12788/jhm.3157..
Keywords: Evidence-Based Practice, Learning Health Systems, Implementation
Rogal SS, Yakovchenko V, Waltz TJ
Longitudinal assessment of the association between implementation strategy use and the uptake of hepatitis C treatment: year 2.
The goal of the evaluation described in this article was to assess how site-level implementation strategies from providers in the VA’s Hepatitis Innovation Team (HIT) Collaborative were associated with hepatitis C (HCV) treatment initiation and how the use of these strategies changed over time. Key HCV providers at each of the 130 VA sites was asked in two consecutive fiscal years to complete an online survey which examined the use of 73 implementation strategies; providers reported on whether or not the use of each implementation strategy was due to the HIT Collaborative. The number of veterans initiating treatment for HCV at each site was captured using national data. The strategies that were more likely to be used in the second year included promoting adaptability, sharing knowledge between sites, tailoring strategies to deliver HCV care, and using mass media. The total number of veterans initiating treatment was positively correlated with the total number of strategies used in both years. The authors conclude that their results suggest the measuring of implementation strategies over time is a useful way to catalog implementation of evidence-based practices over time and over multiple settings.
AHRQ-funded; HS019461.
Citation: Rogal SS, Yakovchenko V, Waltz TJ .
Longitudinal assessment of the association between implementation strategy use and the uptake of hepatitis C treatment: year 2.
Implement Sci 2019 Apr 8;14(1):36. doi: 10.1186/s13012-019-0881-7..
Keywords: Evidence-Based Practice, Hepatitis, Implementation
Jue JJ, Cunningham S, Lohr K
AHRQ Author: Nix M
Developing and testing the Agency for Healthcare Research and Quality's National Guideline Clearinghouse Extent of Adherence to Trustworthy Standards (NEATS) Instrument.
In 2011, the Institute of Medicine (IOM) (now the National Academy of Medicine) published standards for trustworthy guidelines and recommended that the National Guideline Clearinghouse (NGC) of the Agency for Healthcare Research and Quality clearly indicate the extent to which guidelines adhere to these standards. To accomplish this, the authors developed and tested the NGC Extent of Adherence to Trustworthy Standards (NEATS) instrument which they discuss in this paper.
AHRQ-authored; AHRQ-funded; 290-2013-00006C.
Citation: Jue JJ, Cunningham S, Lohr K .
Developing and testing the Agency for Healthcare Research and Quality's National Guideline Clearinghouse Extent of Adherence to Trustworthy Standards (NEATS) Instrument.
Ann Intern Med 2019 Apr 2. doi: 10.7326/m18-2950..
Keywords: Implementation, Evidence-Based Practice, Guidelines
Perry CK, Damschroder LJ, Hemler JR
Specifying and comparing implementation strategies across seven large implementation interventions: a practical application of theory.
This study used empirical data to test how the Expert Recommendations for Implementing Change (ERIC) taxonomy applies to a large dissemination and implementation initiative aimed at taking cardiac prevention to scale in primary care practice. The ERIC taxonomy was applied to the seven cooperatives funded by AHRQ’s EvidenceNOW initiative. The cooperatives' implementation strategies were identified using ERIC; a matrix of the specified ERIC strategies across the cooperatives was then mapped and compiled, and implementation strategies grouped according to outcomes and justifications. The findings suggest revisions to be made to the ERIC implementation strategies to reflect their utilization in real-work dissemination and implementation efforts.
AHRQ-funded; HS023940.
Citation: Perry CK, Damschroder LJ, Hemler JR .
Specifying and comparing implementation strategies across seven large implementation interventions: a practical application of theory.
Implement Sci 2019 Mar 21;14(1):32. doi: 10.1186/s13012-019-0876-4..
Keywords: Cardiovascular Conditions, Evidence-Based Practice, Prevention, Primary Care, Implementation
Fiori K, Patel M, Sanderson D
From policy statement to practice: integrating social needs screening and referral assistance with community health workers in an urban academic health center.
The authors described their experience implementing a novel social needs screening program at an academic pediatric clinic. They found that, on average, 76% of providers had their patients screened on more than half of eligible well-child visits. Their experience suggested that screening for social needs at well-child visits is feasible as part of routine primary care. They recommended that success would best be achieved by leveraging resources, obtaining provider buy-in, and defining program components to sustain activities.
AHRQ-funded; HS026396.
Citation: Fiori K, Patel M, Sanderson D .
From policy statement to practice: integrating social needs screening and referral assistance with community health workers in an urban academic health center.
J Prim Care Community Health 2019 Jan-Dec;10:2150132719899207. doi: 10.1177/2150132719899207..
Keywords: Children/Adolescents, Community-Based Practice, Healthcare Delivery, Implementation, Screening, Social Determinants of Health, Urban Health, Workflow, Primary Care
Rangachari P
Using social knowledge networking technology to enable meaningful use of electronic health record technology in hospitals and health systems.
In this paper, Rangachari (1) reviewed the theoretical literatures on technology use & implementation, and identified a framework for understanding & overcoming unintended adverse consequences of implementing Electronic Health Records; (2) outlined a broad project proposal to test the applicability of the framework in enabling "meaningful use" of Electronic Health Records in a healthcare context; and (3) identified strategies for successful implementation of Electronic Health Records in hospitals & health systems, based on the literature review and application.
AHRQ-funded; HS024335.
Citation: Rangachari P .
Using social knowledge networking technology to enable meaningful use of electronic health record technology in hospitals and health systems.
J Hosp Adm 2014 Dec;3(6):66-78. doi: 10.5430/jha.v3n6p66.
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Keywords: Health Systems, Electronic Health Records (EHRs), Health Information Technology (HIT), Hospitals, Implementation
Mold JW, Aspy CB, Smith PD
Leveraging practice-based research networks to accelerate implementation and diffusion of chronic kidney disease guidelines in primary care practices: a prospective cohort study.
This study was conducted to determine whether practice-based research networks (PBRNs) could increase dissemination, implementation, and diffusion of evidence-based treatment guidelines for chronic kidney disease by leveraging early adopter practices. After the intervention, the initial four PBRNs increased the use of ACEIs/ARBs, discontinuation of NSAIDs, testing for anemia, and testing and/or treatment for vitamin D deficiency. Most were able to recruit two additional practices, which also increased their use of ACEIs/ARBs and testing and/or treatment of vitamin D deficiency. The researchers concluded that, with some assistance, early adopter practices can facilitate the diffusion of evidence-based approaches to other practices.
AHRQ-funded; HS019945.
Citation: Mold JW, Aspy CB, Smith PD .
Leveraging practice-based research networks to accelerate implementation and diffusion of chronic kidney disease guidelines in primary care practices: a prospective cohort study.
Implement Sci 2014 Nov 23;9:169. doi: 10.1186/s13012-014-0169-x.
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Keywords: Practice-Based Research Network (PBRN), Primary Care, Kidney Disease and Health, Chronic Conditions, Guidelines, Implementation
Werner JJ, Stange KC
Praxis-based research networks: an emerging paradigm for research that is rigorous, relevant, and inclusive.
The authors argue that praxis-based research networks (PBRNs) are dynamically evolving to meet the needs of communities by partnering to generate new knowledge that can benefit community and population health. Furthermore, the praxis-based research network model facilitates adaptive partnering and provides a learning mechanism that enables the formation of new collaborations while remaining true to the core values of PBRNs.
AHRQ-funded; HS021648.
Citation: Werner JJ, Stange KC .
Praxis-based research networks: an emerging paradigm for research that is rigorous, relevant, and inclusive.
J Am Board Fam Med 2014 Nov-Dec;27(6):730-5. doi: 10.3122/jabfm.2014.06.140034..
Keywords: Practice-Based Research Network (PBRN), Implementation, Community Partnerships
Holzer JK, Ellis L, Merritt MW
Why we need community engagement in medical research.
The aim of this article was to illustrate how community engagement can help to remedy shortfalls of community trust, participant enrollment, and uptake of research findings. After briefly describing these shortfalls, the authors considered 3 case examples that demonstrate the potential of community engagement to address each. They also discussed the ethical importance and implications of demonstrating respect for the community.
AHRQ-funded; HS017589.
Citation: Holzer JK, Ellis L, Merritt MW .
Why we need community engagement in medical research.
J Investig Med 2014 Aug;62(6):851-5. doi: 10.1097/jim.0000000000000097..
Keywords: Health Services Research (HSR), Patient-Centered Outcomes Research, Research Methodologies, Implementation
Weng C, Payne PR, Velez M
Towards symbiosis in knowledge representation and natural language processing for structuring clinical practice guidelines.
This vision paper discusses the value and feasibility of supporting symbiosis in text-based knowledge acquisition (KA) and knowledge representation (KR). It concludes that KA for KR should be made explicit, scalable, elastic, iterative, and “just expressive enough” to allow NLP-assisted knowledge engineering and increase the facility by which clinical practice guidelines are translated from research into practice.
AHRQ-funded; HS022961.
Citation: Weng C, Payne PR, Velez M .
Towards symbiosis in knowledge representation and natural language processing for structuring clinical practice guidelines.
Stud Health Technol Inform 2014;201:461-9..
Keywords: Evidence-Based Practice, Guidelines, Implementation, Health Information Technology (HIT)
Randhawa G
AHRQ Author: Randhawa G
Moving to a user-driven research paradigm.
The combination of changes in research practice and in health care delivery, growing complexity in decision-making, increasing use of electronic health records, and growing resource constraints necessitate a shift to a user-driven research paradigm to generate new knowledge. This article's conceptual framework was created to clarify the perspective of the decision makers as well as the range of factors and the variability in thresholds used to make decisions. It may help researchers in creating actionable information to meet the needs of decision makers, which is needed for the transition to a user-driven research paradigm.
AHRQ-authored.
Citation: Randhawa G .
Moving to a user-driven research paradigm.
EGEMS 2013 Oct;1(2):1017. doi: 10.13063/2327-9214.1017.
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Keywords: Shared Decision Making, Electronic Health Records (EHRs), Evidence-Based Practice, Healthcare Delivery, Implementation
Katz DF, Sun J, Khatri V
QTc interval screening in an opioid treatment program.
This pilot study supports the feasibility of implementing a population-based electrocardiographic monitoring program in order to decrease the QTc interval in high-risk patients undergoing methadone maintenance in an opioid treatment program. Clinical characteristics alone were inadequate to identify patients in need of electrocardiographic screening.
AHRQ-funded; HS021138
Citation: Katz DF, Sun J, Khatri V .
QTc interval screening in an opioid treatment program.
Am J Cardiol. 2013 Oct 1;112(7):1013-8. doi: 10.1016/j.amjcard.2013.05.037..
Keywords: Opioids, Medication, Substance Abuse, Screening, Adverse Drug Events (ADE), Adverse Events, Medication: Safety, Risk, Implementation
Clancy CM, Margolis PA, Miller M
AHRQ Author: Clancy CM
Collaborative networks for both improvement and research.
The authors discuss collaborative improvement networks, which can serve as large-scale, health system laboratories to engage clinicians, researchers, patients, and parents in testing approaches to translate research into practice. Creation of total population registries in collaborative network sites provides large, representative study samples with high-quality data which can be used to generate evidence and to inform clinical decision-making. Collaborative networks for improvement and research offer the opportunity not only to make improvements but also to study improvements to determine which interventions and combination of strategies work best in which settings.
AHRQ-authored; AHRQ-funded; HS021114.
Citation: Clancy CM, Margolis PA, Miller M .
Collaborative networks for both improvement and research.
Pediatrics 2013 Jun;131 Suppl 4:S210-4. doi: 10.1542/peds.2012-3786H.
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Keywords: Evidence-Based Practice, Health Services Research (HSR), Patient-Centered Outcomes Research, Children/Adolescents, Implementation