National Healthcare Quality and Disparities Report
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Topics
- Adverse Drug Events (ADE) (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 25 of 119 Research Studies DisplayedMcCoy RG, Van Houten HK, Ross JS
HbA1c overtesting and overtreatment among US adults with controlled type 2 diabetes, 2001-13: observational population based study.
The researchers sought to determine the extent and effect of excessive testing for glycated hemoglobin (HbA1c) among adults with controlled type 2 diabetes. They found that in a US cohort of adults with stable and controlled type 2 diabetes, more than 60% received too many HbA1c tests, a practice associated with potential overtreatment with hypoglycemic drugs.
AHRQ-funded; HS018339.
Citation: McCoy RG, Van Houten HK, Ross JS .
HbA1c overtesting and overtreatment among US adults with controlled type 2 diabetes, 2001-13: observational population based study.
BMJ 2015 Dec 8;351:h6138. doi: 10.1136/bmj.h6138..
Keywords: Chronic Conditions, Diabetes, Healthcare Utilization, Medication, Patient-Centered Outcomes Research
Quan J, Lee AK, Handley MA
Automated telephone self-management support for diabetes in a low-income health plan: a health care utilization and cost analysis.
The objective was to determine whether automated telephone self-management support for low-income, linguistically diverse health plan members with diabetes affects health care utilization or cost. It found no significant differences in emergency department visits and hospitalizations or in costs.
AHRQ-funded; HS020684; HS017261; HS022561.
Citation: Quan J, Lee AK, Handley MA .
Automated telephone self-management support for diabetes in a low-income health plan: a health care utilization and cost analysis.
Popul Health Manag 2015 Dec;18(6):412-20. doi: 10.1089/pop.2014.0154.
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Keywords: Diabetes, Chronic Conditions, Patient Self-Management, Low-Income, Healthcare Costs
Pillay J, Armstrong MJ, Butalia S
Behavioral programs for type 1 diabetes mellitus: a systematic review and meta-analysis.
The purpose of this review and meta-analysis was to determine the effects of behavioral programs for patients with type 1 diabetes on behavioral, clinical, and health outcomes and to investigate factors that might moderate effect. It concluded that behavioral programs for type 1 diabetes offer some benefit for glycemic control, at least at short-term follow-up, but improvement for other outcomes has not been shown.
AHRQ-funded; 2902012000131.
Citation: Pillay J, Armstrong MJ, Butalia S .
Behavioral programs for type 1 diabetes mellitus: a systematic review and meta-analysis.
Ann Intern Med 2015 Dec 1;163(11):836-47. doi: 10.7326/m15-1399..
Keywords: Diabetes, Education: Patient and Caregiver, Patient Self-Management, Patient-Centered Outcomes Research, Lifestyle Changes, Chronic Conditions
Pillay J, Armstrong MJ, Butalia S
Behavioral programs for type 2 diabetes mellitus: a systematic review and network meta-analysis.
The purpose of this review was to identify factors moderating the effectiveness of behavioral programs for adults with type 2 diabetes. It concluded that diabetes self-management education offering 10 or fewer hours of contact with delivery personnel provided little benefit. Behavioral programs seem to benefit persons with suboptimal or poor glycemic control more than those with good control.
AHRQ-funded; 2902012000131.
Citation: Pillay J, Armstrong MJ, Butalia S .
Behavioral programs for type 2 diabetes mellitus: a systematic review and network meta-analysis.
Ann Intern Med 2015 Dec 1;163(11):848-60. doi: 10.7326/m15-1400..
Keywords: Diabetes, Education: Patient and Caregiver, Patient Self-Management, Patient-Centered Outcomes Research, Lifestyle Changes, Chronic Conditions
Grainger R, Dalbeth N, Keen H
Imaging as an outcome measure in gout studies: Report from the OMERACT Gout Working Group.
Discussion in the Outcome Measures in Rheumatology (OMERACT) working group was focused to consider (1) features of gout that should be recorded using imaging, (2) best methods of measuring these features, and (3) joints that should be imaged. The working group identified 3 relevant domains for imaging in gout studies: urate deposition (tophus burden), joint inflammation, and structural joint damage.
AHRQ-funded; HS021110.
Citation: Grainger R, Dalbeth N, Keen H .
Imaging as an outcome measure in gout studies: Report from the OMERACT Gout Working Group.
J Rheumatol 2015 Dec;42(12):2460-4. doi: 10.3899/jrheum.141164..
Keywords: Imaging, Patient-Centered Outcomes Research, Outcomes, Chronic Conditions
Lo Re V, 3rd, Haynes K, Forde KA
Risk of acute liver failure in patients with drug-induced liver injury: evaluation of Hy's Law and a new prognostic model.
The researchers aimed to develop a highly sensitive model to identify drug-induced liver injury (DILI) patients at increased risk of acute liver failure (ALF). negative predictive value (0.99), but low level of sensitivity (0.68) and positive predictive value (0.02). Their model, comprising data on platelet count and total bilirubin level, identified patients with ALF with a C statistic of 0.87 and enabled calculation of a risk score (Drug-Induced Liver Toxicity ALF Score).
AHRQ-funded; HS018372.
Citation: Lo Re V, 3rd, Haynes K, Forde KA .
Risk of acute liver failure in patients with drug-induced liver injury: evaluation of Hy's Law and a new prognostic model.
Clin Gastroenterol Hepatol 2015 Dec;13(13):2360-8. doi: 10.1016/j.cgh.2015.06.020.
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Keywords: Antimicrobial Stewardship, Medication, Chronic Conditions, Adverse Drug Events (ADE), Clinical Decision Support (CDS)
Batsis JA, Mackenzie TA, Lopez-Jimenez F
Sarcopenia, sarcopenic obesity, and functional impairments in older adults: National Health and Nutrition Examination Surveys 1999-2004.
The researchers tested the hypothesis that the prevalence of sarcopenia and sarcopenic obesity would be similar based on the different NIH criteria, increase with age, and be associated with risk of impairment limitations. They concluded that the prevalence of sarcopenia and sarcopenic obesity varies greatly, and a uniform definition is needed to identify and characterize these high-risk populations.
AHRQ-funded; HS021695.
Citation: Batsis JA, Mackenzie TA, Lopez-Jimenez F .
Sarcopenia, sarcopenic obesity, and functional impairments in older adults: National Health and Nutrition Examination Surveys 1999-2004.
Nutr Res 2015 Dec;35(12):1031-9. doi: 10.1016/j.nutres.2015.09.003.
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Keywords: Elderly, Obesity, Chronic Conditions, Health Status
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
Turner JA, Comstock BA, Standaert CJ
Can patient characteristics predict benefit from epidural corticosteroid injections for lumbar spinal stenosis symptoms?
The study’s aim was to identify patient characteristics associated with benefits from epidural injections of corticosteroid with lidocaine versus epidural injections of lidocaine only for lumbar spinal stenosis symptoms. It found that among 21 baseline patient characteristics examined, none, including clinician rated spinal stenosis severity, were consistent predictors of benefit from epidural injections of lidocain corticosteroid versus lidocaine only.
AHRQ-funded; HS019222; HS022972.
Citation: Turner JA, Comstock BA, Standaert CJ .
Can patient characteristics predict benefit from epidural corticosteroid injections for lumbar spinal stenosis symptoms?
Spine J 2015 Nov;15(11):2319-31. doi: 10.1016/j.spinee.2015.06.050..
Keywords: Patient-Centered Outcomes Research, Decision Making, Medication, Back Health and Pain, Chronic Conditions
Ananth P, Melvin P, Feudtner C
Hospital use in the last year of life for children with life-threatening complex chronic conditions.
The researchers assessed hospital resource use in children by type and number of life-threatening complex chronic conditions (LT-CCCs). They found that hospital use for children with LT-CCCs in the last year of life varies significantly across the type and number of conditions. Children with hematologic/ immunologic or multiple conditions have the greatest hospital use.
AHRQ-funded; HS023092.
Citation: Ananth P, Melvin P, Feudtner C .
Hospital use in the last year of life for children with life-threatening complex chronic conditions.
Pediatrics 2015 Nov;136(5):938-46. doi: 10.1542/peds.2015-0260..
Keywords: Chronic Conditions, Children/Adolescents, Hospitalization, Palliative Care
Ajmera M, Sambamoorthi U, Metzger A
Multimorbidity and COPD Medication receipt among Medicaid beneficiaries with newly diagnosed COPD.
The aim of this study was to examine the association between multimorbidity and chronic obstructive pulmonary disease ( COPD) medication receipt among Medicaid beneficiaries with newly diagnosed COPD. It found that in this group 81.9 percen had at least one co-occurring chronic condition. After controlling for subject characteristics, adults with multimorbidity were less likely to receive COPD medications compared with those without any inflammation-related multimorbidity.
AHRQ-funded; HS022444.
Citation: Ajmera M, Sambamoorthi U, Metzger A .
Multimorbidity and COPD Medication receipt among Medicaid beneficiaries with newly diagnosed COPD.
Respir Care 2015 Nov;60(11):1592-602. doi: 10.4187/respcare.03788.
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Keywords: Chronic Conditions, Respiratory Conditions, Medication, Medicaid
LaFleur J, Hoop R, Korner E
Predictors of early discontinuation of pegylated interferon for reasons other than lack of efficacy in United States veterans with chronic hepatitis C.
The researchers determined whether selected patient characteristics predicted discontinued therapy for reasons other than lack of efficcacy (non-LOE) using national databases of U.S. veterans. They found that predictors of greatest magnitude included comorbidities of myocardial infarction/congestive heart failure, renal disease, platelets 100/mm or more, Black race, albumin 3.5 mg/dl or more, sleep aid use, and poor persistence with antidepressants and antihypertensive agents.
AHRQ-funded; HS018582.
Citation: LaFleur J, Hoop R, Korner E .
Predictors of early discontinuation of pegylated interferon for reasons other than lack of efficacy in United States veterans with chronic hepatitis C.
Gastroenterol Nurs 2015 Nov-Dec;38(6):417-28. doi: 10.1097/sga.0000000000000214.
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Keywords: Chronic Conditions, Hepatitis, Medication, Patient Adherence/Compliance
Kuo YF, Goodwin JS, Chen NW
Diabetes mellitus care provided by nurse practitioners vs primary care physicians.
The study objective was to compare processes and cost of care of older adults with diabetes mellitus cared for by nurse practitioners (NPs) with processes and cost of those cared for by primary care physicians (PCPs). It concluded that nurse practitioners were similar to PCPs or slightly lower in their rates of diabetes mellitus guideline–concordant care.
AHRQ-funded; HS020642; HS022134.
Citation: Kuo YF, Goodwin JS, Chen NW .
Diabetes mellitus care provided by nurse practitioners vs primary care physicians.
J Am Geriatr Soc 2015 Oct;63(10):1980-8. doi: 10.1111/jgs.13662..
Keywords: Chronic Conditions, Diabetes, Elderly, Primary Care, Practice Patterns
Whittle HJ, Palar K, Hufstedler LL
Food insecurity, chronic illness, and gentrification in the San Francisco Bay Area: an example of structural violence in United States public policy.
This study sought to explore the experiences and structural determinants of food insecurity among a group of low-income PLHIV in the San Francisco Bay Area. It found that the lived experience of food insecurity among participants included periods of insufficient quantity of food and resultant hunger, as well as long-term struggles with quality of food that led to concerns about the poor health effects of a cheap diet.
AHRQ-funded; HS000046.
Citation: Whittle HJ, Palar K, Hufstedler LL .
Food insecurity, chronic illness, and gentrification in the San Francisco Bay Area: an example of structural violence in United States public policy.
Soc Sci Med 2015 Oct;143:154-61. doi: 10.1016/j.socscimed.2015.08.027..
Keywords: Chronic Conditions, Policy, Social Determinants of Health, Nutrition, Vulnerable Populations
Wasserstein D, Huston LJ, Nwosu S
KOOS pain as a marker for significant knee pain two and six years after primary ACL reconstruction: a Multicenter Orthopaedic Outcomes Network (MOON) prospective longitudinal cohort study.
The researchers applied three different models of Knee injury and Osteoarthritis Outcome Score (KOOS) thresholds for significant knee pain to an anterior cruciate ligament reconstruction (ACLR) cohort to identify prevalence and risk factors. They concluded that significant knee pain is prevalent after ACLR; with those who undergo subsequent ipsilateral surgery at greatest risk.
AHRQ-funded; HS016075.
Citation: Wasserstein D, Huston LJ, Nwosu S .
KOOS pain as a marker for significant knee pain two and six years after primary ACL reconstruction: a Multicenter Orthopaedic Outcomes Network (MOON) prospective longitudinal cohort study.
Osteoarthritis Cartilage 2015 Oct;23(10):1674-84. doi: 10.1016/j.joca.2015.05.025..
Keywords: Arthritis, Surgery, Pain, Chronic Conditions, Outcomes
Heo HH, Sentell TL, Li D
Disparities in potentially preventable hospitalizations for chronic conditions among Korean Americans, Hawaii, 2010-2012.
The researchers compared preventable hospitalizations for chronic conditions in aggregate and for congestive heart failure (CHF) for Korean Americans and whites in Hawaii. They found that older Korean American patients may have significant disparities in preventable hospitalizations, which suggests poor access to or poor quality of primary health care.
AHRQ-funded; HS019990.
Citation: Heo HH, Sentell TL, Li D .
Disparities in potentially preventable hospitalizations for chronic conditions among Korean Americans, Hawaii, 2010-2012.
Prev Chronic Dis 2015 Sep 17;12:E152. doi: 10.5888/pcd12.150057.
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Keywords: Disparities, Racial and Ethnic Minorities, Hospitalization, Prevention, Chronic Conditions
Lipton BJ, Decker SL
AHRQ Author: Decker SL
Association between diagnosed diabetes and trouble seeing, National Health Interview Survey, 2011-13.
This study used nationally representative 2011–2013 data from the United States to estimate the association between diagnosed diabetes and trouble seeing. Diagnosed diabetes was associated with approximately double the odds of self-reported trouble seeing. Older age, less education, and a history of comorbid conditions were positively correlated, while male sex, being married, and having health insurance were negatively correlated with trouble seeing.
AHRQ-authored.
Citation: Lipton BJ, Decker SL .
Association between diagnosed diabetes and trouble seeing, National Health Interview Survey, 2011-13.
J Diabetes 2015 Sep;7(5):743-6. doi: 10.1111/1753-0407.12311.
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Keywords: Chronic Conditions, Diabetes, Elderly, Eye Disease and Health, Risk
Sawicki GS, Garvey KC, Toomey SL
Development and validation of the adolescent assessment of preparation for transition: a novel patient experience measure.
The authors developed an adolescent-reported measure of the quality of health care transition (HCT) preparation received from pediatric health care providers. They found that the Adolescent Assessment of Preparation for Transition (ADAPT) is a reliable, validated instrument measuring the quality of HCT preparation experiences reported by adolescents with chronic disease.
AHRQ-funded; HS020513.
Citation: Sawicki GS, Garvey KC, Toomey SL .
Development and validation of the adolescent assessment of preparation for transition: a novel patient experience measure.
J Adolesc Health 2015 Sep;57(3):282-7. doi: 10.1016/j.jadohealth.2015.06.004.
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Keywords: Children/Adolescents, Chronic Conditions, Patient Experience, Quality of Care, Transitions of Care
Chou R, Hashimoto R, Friedly J
Epidural corticosteroid injections for radiculopathy and spinal stenosis: a systematic review and meta-analysis.
The researchers reviewed evidence on the benefits and harms of epidural corticosteroid injections in adults with radicular low back pain or spinal stenosis of any duration. They concluded that epidural corticosteroid injections for radiculopathy were associated with immediate reductions in pain and function. However, benefits were small and not sustained, and there was no effect on long-term surgery risk.
AHRQ-funded; 290201200014I.
Citation: Chou R, Hashimoto R, Friedly J .
Epidural corticosteroid injections for radiculopathy and spinal stenosis: a systematic review and meta-analysis.
Ann Intern Med 2015 Sep 1;163(5):373-81. doi: 10.7326/m15-0934.
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Keywords: Medication, Back Health and Pain, Chronic Conditions, Comparative Effectiveness, Evidence-Based Practice
Deyo RA, Bryan M, Comstock BA
Trajectories of symptoms and function in older adults with low back disorders.
The researchers sought to determine whether there are distinct trajectories of back pain and function among older adults and to identify characteristics that distinguish among patients with substantially different prognoses. They found that, although most patients remained relatively stable over a year, latent class analysis identified small groups with major improvement in pain, function, or both.
AHRQ-funded; HS019222.
Citation: Deyo RA, Bryan M, Comstock BA .
Trajectories of symptoms and function in older adults with low back disorders.
Spine 2015 Sep 1;40(17):1352-62. doi: 10.1097/brs.0000000000000975.
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Keywords: Data, Elderly, Back Health and Pain, Chronic Conditions, Outcomes
Ancker JS, Witteman HO, Hafeez B
"You get reminded you're a sick person": personal data tracking and patients with multiple chronic conditions.
The researchers’ aim was to explore the perspectives of individuals with multiple chronic conditions (MCC) using a semistructured interview study. Their research questions were (1) How do individuals with MC track their own health and medical data? and (2) How do patients and providers perceive and use patient-tracked data? Their findings potentially explain relatively low adoption of consumer health information technology.
AHRQ-funded; HS021531.
Citation: Ancker JS, Witteman HO, Hafeez B .
"You get reminded you're a sick person": personal data tracking and patients with multiple chronic conditions.
J Med Internet Res 2015 Aug 19;17(8):e202. doi: 10.2196/jmir.4209..
Keywords: Chronic Conditions, Education: Patient and Caregiver, Health Information Technology (HIT), Patient Self-Management
Jolles MP, Haynes-Maslow L, Roberts MC
Mental health service use for adult patients with co-occurring depression and physical chronic health care needs, 2007-2010.
This study examines (1) whether the presence of chronic physical conditions is associated with mental health service use for individuals with depression who visit a primary care physician, and (2) whether race modifies this relationship. It found that most patient office visits (70 percent) where a depression diagnosis was recorded also had co-occurring chronic physical conditions recorded.
AHRQ-funded; HS000032.
Citation: Jolles MP, Haynes-Maslow L, Roberts MC .
Mental health service use for adult patients with co-occurring depression and physical chronic health care needs, 2007-2010.
Med Care 2015 Aug;53(8):708-12. doi: 10.1097/mlr.0000000000000389..
Keywords: Depression, Behavioral Health, Chronic Conditions, Primary Care
Shah ED, Siegel CA, Chong K
Patients with Crohn's disease are more likely to remain on biologics than immunomodulators: a meta-analysis of treatment durability.
The researchers aimed to clarify treatment durability by assessing subject discontinuations from clinical trials in the context of treatment efficacy. They found that for patients with Crohn’s disease, biologic therapies had higher durability than immunomodulators for induction and maintenance therapy.
AHRQ-funded; HS021747.
Citation: Shah ED, Siegel CA, Chong K .
Patients with Crohn's disease are more likely to remain on biologics than immunomodulators: a meta-analysis of treatment durability.
Dig Dis Sci 2015 Aug;60(8):2408-18. doi: 10.1007/s10620-015-3618-8..
Keywords: Patient Adherence/Compliance, Medication, Chronic Conditions, Comparative Effectiveness
Abdelsattar ZM, Hendren S, Wong SL
The impact of untreated obstructive sleep apnea on cardiopulmonary complications in general and vascular surgery: a cohort study.
The purpose of this study was to determine whether preoperatively untreated obstructive sleep apnea (OSA) affects postoperative outcomes. It found that compared with treated OSA, untreated OSA was independently associated with more cardiopulmonary complications (risk-adjusted rates 6.7 percent versus 4.0 percent; particularly unplanned reintubations and myocardial infarction.
AHRQ-funded; HS000053.
Citation: Abdelsattar ZM, Hendren S, Wong SL .
The impact of untreated obstructive sleep apnea on cardiopulmonary complications in general and vascular surgery: a cohort study.
Sleep 2015 Aug;38(8):1205-10. doi: 10.5665/sleep.4892..
Keywords: Sleep Problems, Surgery, Patient Safety, Risk, Heart Disease and Health, Respiratory Conditions, Chronic Conditions