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
1 to 25 of 93 Research Studies DisplayedTamirisa NP, Goodwin JS, Kandalam A
Patient and physician views of shared decision making in cancer.
The aim of the study was to explore patient and physician perceptions of shared decision making in clinical encounters for cancer care. Among the study’s multiple conclusions was that most physicians reported providing patients with written information, however, most patients reported that written information was too detailed and felt that the physicians did not assess the level of information they wished to receive.
AHRQ-funded; HS022134.
Citation: Tamirisa NP, Goodwin JS, Kandalam A .
Patient and physician views of shared decision making in cancer.
Health Expect 2017 Dec;20(6):1248-53. doi: 10.1111/hex.12564..
Keywords: Cancer, Decision Making, Patient-Centered Healthcare, Patient Experience, Clinician-Patient Communication
Slota C, Davis SA, Blalock SJ
Patient-physician communication on medication cost during glaucoma visits.
The aim of this secondary analysis was to describe the frequency and nature of patient-physician communication regarding medication cost during glaucoma office visits. Most participants did not discuss medication cost during their glaucoma office visit. The majority of the subjects who discussed cost had mild disease severity (51 percent), took one glaucoma medication (63 percent), and had Medicare (49 percent) as well as a form of prescription insurance (78 percent).
AHRQ-funded; HS023054.
Citation: Slota C, Davis SA, Blalock SJ .
Patient-physician communication on medication cost during glaucoma visits.
Optom Vis Sci 2017 Dec;94(12):1095-101. doi: 10.1097/opx.0000000000001139.
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Keywords: Eye Disease and Health, Healthcare Costs, Medication, Patient and Family Engagement, Clinician-Patient Communication
Colla CH, Mainor AJ
Choosing Wisely Campaign: valuable for providers who knew about it, but awareness remained constant, 2014-17.
The Choosing Wisely campaign has codified recommendations of which health care services' use should be questioned and discussed with patients. The ABIM Foundation administered surveys in 2014 and 2017 to examine physicians' attitudes toward and awareness of the use of low-value care. There were no significant changes between 2014 and 2017 in awareness of the campaign among physicians or physician-reported difficulty in talking to patients about avoiding a low-value service.
AHRQ-funded; HS023812.
Citation: Colla CH, Mainor AJ .
Choosing Wisely Campaign: valuable for providers who knew about it, but awareness remained constant, 2014-17.
Health Aff 2017 Nov;36(11):2005-11. doi: 10.1377/hlthaff.2017.0945.
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Keywords: Decision Making, Guidelines, Quality of Care, Health Services Research (HSR), Clinician-Patient Communication
Wolinsky FD, Lou Y, Edmonds SW
Activating patients with a tailored bone density test results letter and educational brochure: the PAADRN Randomized Controlled Trial.
This study examined whether a tailored patient-activation letter communicating bone mineral density (BMD) test results plus an educational brochure improved patient activation scores and levels at 12 and 52 wk post-baseline as the mechanism leading to enhanced bone healthcare.
AHRQ-funded; HS023009.
Citation: Wolinsky FD, Lou Y, Edmonds SW .
Activating patients with a tailored bone density test results letter and educational brochure: the PAADRN Randomized Controlled Trial.
J Clin Densitom 2017 Oct/Dec;20(4):464-71. doi: 10.1016/j.jocd.2016.08.012..
Keywords: Education: Patient and Caregiver, Health Literacy, Patient-Centered Healthcare, Patient and Family Engagement, Clinician-Patient Communication
Mogul DB, Nagy PG, Bridges JFP
Building stronger online communities through the creation of Facebook-integrated health applications.
Social media, such as Facebook, provides a powerful mechanism to connect individuals with similar diseases, but current platforms do not achieve their full potential to help patients communicate with one another or with the medical community. The authors of this viewpoint article believe that an opportunity exists for health care professionals to strengthen online communities by creating apps that use the Facebook platform or a programming interface. Development of such apps are discussed, with an eye toward the needs of the patient, parent, or caregiver as end-users and involving their input.
AHRQ-funded; HS023876.
Citation: Mogul DB, Nagy PG, Bridges JFP .
Building stronger online communities through the creation of Facebook-integrated health applications.
JAMA Pediatr 2017 Oct;171(10):933-34. doi: 10.1001/jamapediatrics.2017.2300..
Keywords: Clinician-Patient Communication, Communication, Education: Patient and Caregiver, Health Information Technology (HIT), Social Media, Web-Based
Chung S, Panattoni L, Chi J
Can secure patient-provider messaging improve diabetes care?
The authors examined whether messaging with physicians for medical advice is associated with fewer face-to-face visits and better diabetes management. Patients with diabetes using an online portal were studied; 72% used messaging, and those who made frequent visits were also more likely to message. No messaging at all was negatively associated with the likelihood of meeting an HbA1c target. Among message users, additional messages were associated with better outcome, with a stronger relationship for noninsulin users. Physician-initiated messages had effects similar to those for patient-initiated messages.
AHRQ-funded; HS019815.
Citation: Chung S, Panattoni L, Chi J .
Can secure patient-provider messaging improve diabetes care?
Diabetes Care 2017 Oct;40(10):1342-48. doi: 10.2337/dc17-0140.
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Keywords: Communication, Diabetes, Clinician-Patient Communication, Electronic Health Records (EHRs)
Liang L, Brach C
AHRQ Author: Liang L, Brach C
Health literacy universal precautions are still a distant dream: analysis of U.S. data on health literate practices.
This study sought to examine whether there has been an increase in the delivery of health literate care and whether recommendations for health literacy universal precautions are being followed. It found that the proportion of adults in the U.S. who reported receiving health literate care increased from 2011 to 2014, but fell far short of health literacy universal precautions recommendations of delivering health literate care to everyone.
AHRQ-authored.
Citation: Liang L, Brach C .
Health literacy universal precautions are still a distant dream: analysis of U.S. data on health literate practices.
Health Lit Res Pract 2017 Oct;1(4):e216-e30. doi: 10.3928/24748307-20170929-01.
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Keywords: Healthcare Delivery, Health Literacy, Medical Expenditure Panel Survey (MEPS), Clinician-Patient Communication
Khan A, Furtak SL, Melvin P
Parent-provider miscommunications in hospitalized children.
The objectives of this study were to: (1) examine characteristics of parent-provider miscommunications about hospitalized children; (2) describe associations among parent-provider miscommunications, parent-reported errors, and hospital experience; and (3) compare parent and attending physician reports of parent-provider miscommunications. The investigators found that parent-provider miscommunications were associated with parent-reported errors and suboptimal hospital experience. Parents reported parent-provider miscommunications more often than attending physicians did.
AHRQ-funded; HS022986; HS000063.
Citation: Khan A, Furtak SL, Melvin P .
Parent-provider miscommunications in hospitalized children.
Hosp Pediatr 2017 Sep;7(9):505-15. doi: 10.1542/hpeds.2016-0190..
Keywords: Adverse Events, Caregiving, Children/Adolescents, Clinician-Patient Communication, Communication, Hospitalization, Hospitals, Medical Errors, Patient Safety
Cook SC, Gunter KE, Lopez FY
Establishing effective health care partnerships with sexual and gender minority patients: recommendations for obstetrician gynecologists.
Sexual and gender minority patients have historically experienced high rates of inappropriate and low-quality care, disrespect, and discrimination in health care settings, as well as significant health disparities. This article documented multiple suggestions and resources that health care teams can use to improve the health and health care of their sexual and gender minority patients.
AHRQ-funded; HS023050.
Citation: Cook SC, Gunter KE, Lopez FY .
Establishing effective health care partnerships with sexual and gender minority patients: recommendations for obstetrician gynecologists.
Semin Reprod Med 2017 Sep;35(5):397-407. doi: 10.1055/s-0037-1604464..
Keywords: Racial and Ethnic Minorities, Patient-Centered Healthcare, Clinician-Patient Communication, Women
Squires A
Evidence-based approaches to breaking down language barriers.
This article provides background information about language barriers between nurses and patients and some strategies for addressing these gaps. After detailing how these barriers affect patient outcomes, practice-based strategies are offered to improve outcomes and reduce readmissions. Although the article doesn’t address barriers to communicating with patients with hearing loss, many of the same principles apply to these patients.
AHRQ-funded; HS023593.
Citation: Squires A .
Evidence-based approaches to breaking down language barriers.
Nursing 2017 Sep;47(9):34-40. doi: 10.1097/01.NURSE.0000522002.60278.ca.
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Keywords: Communication, Cultural Competence, Evidence-Based Practice, Nursing, Clinician-Patient Communication
Grande SW, Castaldo MG, Carpenter-Song E
A digital advocate? Reactions of rural people who experience homelessness to the idea of recording clinical encounters.
This study examines the reactions of homeless people to the idea of using a smartphone to record their own clinical encounter, either covertly or with permission from their physician. The researchers conducted semi-structured interviews with individuals at a temporary housing shelter in Northern New England. The study found that while many rural, disadvantaged individuals felt marginalized by the wide social distance between themselves and their clinicians, recording technology may serve as an advocate by holding both patients and doctors accountable and by permitting the burden of clinical proof to be shared.
AHRQ-funded; HS021695.
Citation: Grande SW, Castaldo MG, Carpenter-Song E .
A digital advocate? Reactions of rural people who experience homelessness to the idea of recording clinical encounters.
Health Expect 2017 Aug;20(4):618-25. doi: 10.1111/hex.12492..
Keywords: Health Information Exchange (HIE), Clinician-Patient Communication, Rural Health, Vulnerable Populations
Squires A, Peng TR, Barrón-Vaya Y
An exploratory analysis of patient-provider language-concordant home health care visit patterns.
In a 2-year period, this study showed that among the 238,513 visits with 18,132 limited English proficiency patients, only 20 percent of visits were language concordant. The study suggests that home health care services may not be meeting the demand for language services, but more research is needed to determine the right “dose” of bilingual home care visits to optimize home care outcomes and establish a standard for care.
AHRQ-funded; HS023593.
Citation: Squires A, Peng TR, Barrón-Vaya Y .
An exploratory analysis of patient-provider language-concordant home health care visit patterns.
Home Health Care Management & Practice 2017 Aug 1;29(3):161-67. doi: 10.1177/1084822317696706.
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Keywords: Cultural Competence, Home Healthcare, Clinician-Patient Communication, Racial and Ethnic Minorities, Urban Health
Berger ZD, Boss EF, Beach MC
Communication behaviors and patient autonomy in hospital care: a qualitative study.
Researchers conducted an observational study of patient-doctor communication on an inpatient medicine service among 18 hospitalized patients and 9 physicians. They concluded that shared decision-making may not be the norm in hospital care. Although physicians do explain treatment plans, many hospitalized patients do not understand enough to share in decisions. When patients do assert their opinion, it can result in conflict.
AHRQ-funded; HS022932.
Citation: Berger ZD, Boss EF, Beach MC .
Communication behaviors and patient autonomy in hospital care: a qualitative study.
Patient Educ Couns 2017 Aug;100(8):1473-81. doi: 10.1016/j.pec.2017.03.006.
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Keywords: Communication, Decision Making, Inpatient Care, Clinician-Patient Communication
Wong MS, Showell NN, Bleich SN
The association between parent-reported provider communication quality and child obesity status: variation by parent obesity and child race/ethnicity.
This study examined the association between healthcare provider communication quality and child obesity status, and the role of parent obesity and child race/ethnicity regarding this association. It found that parents of obese children experienced better communication if parents were non-obese or children were non-Hispanic Black or Asian.
AHRQ-funded; HS000029.
Citation: Wong MS, Showell NN, Bleich SN .
The association between parent-reported provider communication quality and child obesity status: variation by parent obesity and child race/ethnicity.
Patient Educ Couns 2017 Aug;100(8):1588-97. doi: 10.1016/j.pec.2017.03.015.
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Keywords: Children/Adolescents, Medical Expenditure Panel Survey (MEPS), Obesity, Clinician-Patient Communication, Racial and Ethnic Minorities
Bush RA, Connelly CD, Perez A
Physician perception of the role of the patient portal in pediatric health.
Little information regarding physician opinion of the patient portal is available, with almost no information gathered in the pediatric environment. Using a mixed-methods approach, physicians in a large pediatric medical facility and integrated delivery network were surveyed by online quantitative questionnaire and structured interviews. Physicians reported the portal's role in more communication efficiency for patients, parents, and providers.
AHRQ-funded; HS022404.
Citation: Bush RA, Connelly CD, Perez A .
Physician perception of the role of the patient portal in pediatric health.
J Ambul Care Manage 2017 Jul/Sep;40(3):238-45. doi: 10.1097/jac.0000000000000175.
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Keywords: Children/Adolescents, Electronic Health Records (EHRs), Provider: Health Personnel, Clinician-Patient Communication, Web-Based
Berry ABL, Lim C, Hartzler AL
Creating conditions for patients' values to emerge in clinical conversations: perspectives of health care team members.
The researchers sought to inform the design of interventions to support conversations about patient values between patients with multiple chronic conditions and their health care providers. Their paper contributes a practice-based account of ways in which providers engage with patient values, and discusses how future work in interactive systems design might extend and enrich these engagements.
AHRQ-funded; HS022364.
Citation: Berry ABL, Lim C, Hartzler AL .
Creating conditions for patients' values to emerge in clinical conversations: perspectives of health care team members.
DIS (Des Interact Syst Conf) 2017 Jun;2017:1165-74. doi: 10.1145/3064663.3064669.
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Keywords: Chronic Conditions, Clinician-Patient Communication, Patient Self-Management, Patient and Family Engagement
Bossick AS, Barone C, Alexander GL
Teen, parent, and clinician expectations about obesity and related conditions during the annual well-child visit.
This study examined family (patient and parent/guardian) and clinician preferences for identification and management of obesity and obesity-related conditions during the well-child visit. Teens and parents expect weight to be discussed at well-child visits, and prefer discussions to come from a trusted clinician who uses serious, consistent language. Providers recognize several challenges and barriers to discussing weight management in the well-child visit.
AHRQ-funded; HS022417.
Citation: Bossick AS, Barone C, Alexander GL .
Teen, parent, and clinician expectations about obesity and related conditions during the annual well-child visit.
J Patient Cent Res Rev 2017 Summer;4(3):114-24. doi: 10.17294/2330-0698.1444.
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Keywords: Children/Adolescents, Clinician-Patient Communication, Obesity, Obesity: Weight Management, Patient-Centered Healthcare
Shih YT, Chien CR
A review of cost communication in oncology: patient attitude, provider acceptance, and outcome assessment.
This review identified 15 articles that covered 3 topics related to patient-physician cost communication: patient attitude, physician acceptance, and the associated outcomes. The data suggested that cost communication was associated with improved patient satisfaction, lower out-of-pocket expenses, and a higher likelihood of medication nonadherence; none of the studies established causality.
AHRQ-funded; HS020263.
Citation: Shih YT, Chien CR .
A review of cost communication in oncology: patient attitude, provider acceptance, and outcome assessment.
Cancer 2017 May 15;123(6):928-39. doi: 10.1002/cncr.30423.
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Keywords: Cancer, Communication, Healthcare Costs, Outcomes, Clinician-Patient Communication
Hong MK, Feustel C, Agnihotri M
Supporting families in reviewing and communicating about radiology imaging studies.
Diagnostic radiology reports are increasingly being made available to patients and their family members. However, these reports are not typically comprehensible to lay recipients, impeding effective communication about report findings. In this paper, the investigators present three studies informing the design of a prototype to foster patient-clinician communication about radiology report content.
AHRQ-funded; HS021393.
Citation: Hong MK, Feustel C, Agnihotri M .
Supporting families in reviewing and communicating about radiology imaging studies.
Proc SIGCHI Conf Hum Factor Comput Syst 2017 May 2;2017:5245-56. doi: 10.1145/3025453.3025754..
Keywords: Communication, Family Health and History, Imaging, Clinician-Patient Communication
Cox ED, Jacobsohn GC, Rajamanickam VP
A family-centered rounds checklist, family engagement, and patient safety: a randomized trial.
The researchers examined the impact of the family-centered rounds (FCRs) checklist intervention, a checklist and associated provider training, on performance of FCR elements, family engagement, and patient safety. They found that the performance of FCR checklist elements was enhanced by checklist implementation and associated with changes in family engagement and more positive perceptions of safety climate.
AHRQ-funded; HS018680.
Citation: Cox ED, Jacobsohn GC, Rajamanickam VP .
A family-centered rounds checklist, family engagement, and patient safety: a randomized trial.
Pediatrics 2017 May;139(5). doi: 10.1542/peds.2016-1688.
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Keywords: Quality of Care, Patient Safety, Patient and Family Engagement, Clinician-Patient Communication, Training
Morgan DJ, Leppin AL, Smith CD
A practical framework for understanding and reducing medical overuse: conceptualizing overuse through the patient-clinician interaction.
The authors used an iterative, expert-informed, evidence-based process to develop a framework for conceptualizing interventions to reduce medical overuse. Given the complexity of defining and identifying overused care in nuanced clinical situations and the need to define care appropriateness in the context of an individual patient, this framework conceptualizes the patient-clinician interaction as the nexus of decisions regarding inappropriate care.
AHRQ-funded; HS018111.
Citation: Morgan DJ, Leppin AL, Smith CD .
A practical framework for understanding and reducing medical overuse: conceptualizing overuse through the patient-clinician interaction.
J Hosp Med 2017 May;12(5):346-51. doi: 10.12788/jhm.2738.
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Keywords: Decision Making, Healthcare Delivery, Quality of Care, Healthcare Utilization, Clinician-Patient Communication
Khan A, Baird J, Rogers JE
Parent and provider experience and shared understanding after a family-centered nighttime communication intervention.
This study assessed parent and provider experience and shared understanding after a family-centered, multidisciplinary nighttime communication intervention (nurse-physician brief, family huddle, family update sheet). It concluded that a family-centered, multidisciplinary nighttime communication intervention was associated with improvements in some, but not all, domains of parent/provider experience and shared understanding, particularly provider experience and nurse-family shared understanding.
AHRQ-funded; HS022986; HS000063.
Citation: Khan A, Baird J, Rogers JE .
Parent and provider experience and shared understanding after a family-centered nighttime communication intervention.
Acad Pediatr 2017 May - Jun;17(4):389-402. doi: 10.1016/j.acap.2017.01.012.
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Keywords: Children/Adolescents, Hospitalization, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Clinician-Patient Communication
Tai-Seale M, Olson CW, Li J
Electronic health record logs indicate that physicians split time evenly between seeing patients and desktop medicine.
The researchers used data on physicians' time allocation patterns captured by over thirty-one million EHR transactions in the period 2011-14 recorded by 471 primary care physicians, who collectively worked on 765,129 patients' EHRs. Their results suggest that the physicians logged an average of 3.08 hours on office visits and 3.17 hours on desktop medicine each day.
AHRQ-funded; HS019167.
Citation: Tai-Seale M, Olson CW, Li J .
Electronic health record logs indicate that physicians split time evenly between seeing patients and desktop medicine.
Health Aff 2017 Apr;36(4):655-62. doi: 10.1377/hlthaff.2016.0811.
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Keywords: Clinician-Patient Communication, Electronic Health Records (EHRs), Health Information Technology (HIT), Primary Care, Practice Patterns
Federman AD, Sanchez-Munoz A, Jandorf L
Patient and clinician perspectives on the outpatient after-visit summary: a qualitative study to inform improvements in visit summary design.
The researchers explored patients' and clinicians' perspectives on electronic health record (EHR)-generated outpatient after-visit summaries (AVSs) to inform efforts to maximize the document's utility. They learned that core themes included the use and purpose of the AVS, content modification and prioritization, formatting improvements, customization, privacy and accuracy concerns, and clinician workflow concerns.
AHRQ-funded; HS023844.
Citation: Federman AD, Sanchez-Munoz A, Jandorf L .
Patient and clinician perspectives on the outpatient after-visit summary: a qualitative study to inform improvements in visit summary design.
J Am Med Inform Assoc 2017 Apr;24(e1):e61-e68. doi: 10.1093/jamia/ocw106.
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Keywords: Electronic Health Records (EHRs), Ambulatory Care and Surgery, Primary Care, Clinician-Patient Communication, Education: Patient and Caregiver
Spatz ES, Krumholz HM, Moulton BW
Prime time for shared decision making.
To guide the implementation of high-quality and achievable shared decision making, policy makers and health systems may consider the following key steps: 1) clearly define shared decision making; 2) certify decision aids and provide incentives for their evaluation and maintenance; 3) promote competency in shared decision making; 4) develop measures of shared decisionmaking; and 5) foster a culture of shared decisionmaking through easy additions to work flow and positive incentives.
AHRQ-funded; HS023000.
Citation: Spatz ES, Krumholz HM, Moulton BW .
Prime time for shared decision making.
JAMA 2017 Apr;317(13):1309-10. doi: 10.1001/jama.2017.0616.
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Keywords: Decision Making, Clinician-Patient Communication, Patient and Family Engagement, Patient-Centered Outcomes Research