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 150 Research Studies DisplayedCooper LB, Lippmann SJ, Greiner MA
Use of mineralocorticoid receptor antagonists in patients with heart failure and comorbid diabetes mellitus or chronic kidney disease.
Perceived risks of hyperkalemia and acute renal insufficiency may limit use of mineralocorticoid receptor antagonist (MRA) therapy in patients with heart failure, especially those with diabetes mellitus or chronic kidney disease. In their study, the investigators found that among patients with heart failure and diabetes mellitus or chronic kidney disease, MRA use was associated with lower risk of all-cause readmission despite greater risk of hyperkalemia and acute renal insufficiency.
AHRQ-funded; HS021092.
Citation: Cooper LB, Lippmann SJ, Greiner MA .
Use of mineralocorticoid receptor antagonists in patients with heart failure and comorbid diabetes mellitus or chronic kidney disease.
J Am Heart Assoc 2017 Dec 23;6(12):pii: e006540. doi: 10.1161/jaha.117.006540..
Keywords: Cardiovascular Conditions, Chronic Conditions, Diabetes, Evidence-Based Practice, Heart Disease and Health, Kidney Disease and Health, Outcomes, Patient-Centered Outcomes Research, Registries
Gartlehner G, Patel SV, Feltner C
Hormone therapy for the primary prevention of chronic conditions in postmenopausal women: evidence report and systematic review for the US Preventive Services Task Force.
This review updated evidence for the US Preventive Services Task Force on the benefits and harms of hormone therapy in reducing risks for chronic conditions. It concluded that hormone therapy for the primary prevention of chronic conditions in menopausal women is associated with some beneficial effects but also with a substantial increase of risks for harms. The available evidence regarding benefits and harms of early initiation of hormone therapy is inconclusive.
AHRQ-funded; 290201200015I.
Citation: Gartlehner G, Patel SV, Feltner C .
Hormone therapy for the primary prevention of chronic conditions in postmenopausal women: evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2017 Dec 12;318(22):2234-49. doi: 10.1001/jama.2017.16952.
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Keywords: Chronic Conditions, Evidence-Based Practice, Guidelines, Prevention, U.S. Preventive Services Task Force (USPSTF), Women
Vakharia PP, Chopra R, Sacotte R
Burden of skin pain in atopic dermatitis.
This study sought to characterize the patient burden of skin pain in AD. It found that twenty-four (16.8 percent) patients thought the skin pain was part of their itch, 16 (11.2 percent) from scratching, and 77 (72.0 percent) from both. Patients with skin pain were more likely to describe their itch using terms that resembled neuropathic pain.
AHRQ-funded; HS023011.
Citation: Vakharia PP, Chopra R, Sacotte R .
Burden of skin pain in atopic dermatitis.
Ann Allergy Asthma Immunol 2017 Dec;119(6):548-52.e3. doi: 10.1016/j.anai.2017.09.076.
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Keywords: Chronic Conditions, Pain, Quality of Life, Skin Conditions
Donovan LM, Rise PJ, Carson SS
Sleep disturbance in smokers with preserved pulmonary function and chronic obstructive pulmonary disease.
This study compared the magnitude and correlates of sleep disturbance between smokers with preserved pulmonary function and those with airflow obstruction. It found that among smokers with clinically identified chronic obstructive pulmonary disease (COPD), the severity of sleep disturbance is greater among those with preserved pulmonary function compared to those with airflow obstruction. Non-respiratory symptoms, such as depression, were associated with sleep disturbance in both groups.
AHRQ-funded; HS017894.
Citation: Donovan LM, Rise PJ, Carson SS .
Sleep disturbance in smokers with preserved pulmonary function and chronic obstructive pulmonary disease.
Ann Am Thorac Soc 2017 Dec;14(12):1836-43. doi: 10.1513/AnnalsATS.201706-453OC.
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Keywords: Respiratory Conditions, Sleep Problems, Tobacco Use, Chronic Conditions
Ratanawongsa N, Chan LL, Fouts MM
The challenges of electronic health records and diabetes electronic prescribing: implications for safety net care for diverse populations.
This review highlights how the EHR electronic prescribing transformation has affected diabetes care for vulnerable patients and offers recommendations for improving patient safety through EHR electronic prescribing design, implementation, policy, and research. Specifically, it presents evidence for the adoption of RxNorm and standardized naming and picklist options for high alert medications such as insulin.
AHRQ-funded; HS022561; HS023558.
Citation: Ratanawongsa N, Chan LL, Fouts MM .
The challenges of electronic health records and diabetes electronic prescribing: implications for safety net care for diverse populations.
J Diabetes Res 2017;2017:8983237. doi: 10.1155/2017/8983237.
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Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Vulnerable Populations, Diabetes, Patient Safety, Chronic Conditions
Ganapathy D, Acharya C, Lachar J
The patient buddy app can potentially prevent hepatic encephalopathy-related readmissions.
The researchers aimed to define the feasibility of using the Patient Buddy App and its impact on 30-day readmissions by engaging and educating cirrhotic inpatients and caregivers in a pilot study. In their proof-of-concept trial, the use of Patient Buddy is feasible in recently discharged patients with cirrhosis and their caregivers. Eight hepatic encephalopathy-related readmissions were potentially avoided after the use of the App.
AHRQ-funded; HS024004.
Citation: Ganapathy D, Acharya C, Lachar J .
The patient buddy app can potentially prevent hepatic encephalopathy-related readmissions.
Liver Int 2017 Dec;37(12):1843-51. doi: 10.1111/liv.13494.
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Keywords: Caregiving, Chronic Conditions, Health Information Technology (HIT), Patient and Family Engagement, Hospital Readmissions
Lim CY, Berry ABL, Hirsch T
Understanding what is most important to individuals with multiple chronic conditions: a qualitative study of patients' perspectives.
This qualitative study aimed to identify what patients with multiple chronic conditions describe as most important to their well-being and health. The findings described the range and types of personal values multimorbid older adults deem important to well-being and health. Understanding patients' personal values across these domains may be useful for providers when developing, sharing, and following up on care plans.
AHRQ-funded; HS022364.
Citation: Lim CY, Berry ABL, Hirsch T .
Understanding what is most important to individuals with multiple chronic conditions: a qualitative study of patients' perspectives.
J Gen Intern Med 2017 Dec;32(12):1278-84. doi: 10.1007/s11606-017-4154-3..
Keywords: Chronic Conditions, Elderly, Quality Improvement
Taylor HA, Morales C, Wilfond BS
A trial to test a novel approach to diabetes prevention.
This report presents a case introduction and summary in which the study under consideration planned to randomize patients at risk of diabetes (Type 2) to positive airway pressure (PAP) therapy to prevent the progression from prediabetes to diabetes (Type 2).
AHRQ-funded; HS000029.
Citation: Taylor HA, Morales C, Wilfond BS .
A trial to test a novel approach to diabetes prevention.
Am J Bioeth 2017 Oct;17(10):74-75. doi: 10.1080/15265161.2017.1366200..
Keywords: Diabetes, Prevention, Chronic Conditions
Kangovi S, Mitra N, Grande D
Community health worker support for disadvantaged patients with multiple chronic diseases: a randomized clinical trial.
The researchers sought to determine whether a community health worker (CHW) intervention improved outcomes in a low-income population with multiple chronic conditions. They concluded that a standardized CHW intervention improved chronic disease control, mental health, quality of care, and hospitalizations and could be a useful population health management tool for health care systems.
AHRQ-funded; HS021706.
Citation: Kangovi S, Mitra N, Grande D .
Community health worker support for disadvantaged patients with multiple chronic diseases: a randomized clinical trial.
Am J Public Health 2017 Oct;107(10):1660-67. doi: 10.2105/ajph.2017.303985.
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Keywords: Chronic Conditions, Community-Based Practice, Low-Income, Patient-Centered Outcomes Research
Rudin RS, Fanta CH, Predmore Z
Core components for a clinically integrated mhealth app for asthma symptom monitoring.
The aim of the study was to apply user-centered design principles to efficiently identify core components for a mHealth-based asthma symptom-monitoring intervention using patient-reported outcomes (PROs).
AHRQ-funded; HS023960.
Citation: Rudin RS, Fanta CH, Predmore Z .
Core components for a clinically integrated mhealth app for asthma symptom monitoring.
Appl Clin Inform 2017 Oct;8(4):1031-43. doi: 10.4338/aci-2017-06-ra-0096.
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Keywords: Asthma, Chronic Conditions, Health Information Technology (HIT), System Design
Wisk LE, Weitzman ER
Expectancy and achievement gaps in educational attainment and subsequent adverse health effects among adolescents with and without chronic medical conditions.
This study sought to investigate educational aspirations, expectations, and attainment among youth with and without chronic conditions and to determine if these relationships mediated subsequent disparities in health and well-being. Findings suggest an important risk mechanism through which youth with chronic medical conditions may acquire socioeconomic disadvantage as they develop and progress through educational settings.
AHRQ-funded; HS022986; HS000063.
Citation: Wisk LE, Weitzman ER .
Expectancy and achievement gaps in educational attainment and subsequent adverse health effects among adolescents with and without chronic medical conditions.
J Adolesc Health 2017 Oct;61(4):461-70. doi: 10.1016/j.jadohealth.2017.04.006..
Keywords: Children/Adolescents, Chronic Conditions, Disparities, Education, Health Status
McKernan LC, Finn MTM, Carr ER
Personality and affect when the central nervous system is sensitized: an analysis of central sensitization syndromes in a substance use disorder population.
This article examined the impact of central sensitivity syndromes (CSS) on the clinical presentation of individuals presenting to treatment for a substance use disorder (SUD), with an emphasis on personality and emotional functioning. Exploratory analyses indicated which personality traits most strongly predicted the presence of CSS. The authors discuss these findings using descriptive psychopathology literature, with recommendations for future research.
AHRQ-funded; HS022990.
Citation: McKernan LC, Finn MTM, Carr ER .
Personality and affect when the central nervous system is sensitized: an analysis of central sensitization syndromes in a substance use disorder population.
Psychodyn Psychiatry 2017 Fall;45(3):385-409. doi: 10.1521/pdps.2017.45.3.385..
Keywords: Anxiety, Behavioral Health, Chronic Conditions, Substance Abuse
Ndefo UA, Moultry AM, Davis PN
Provision of medication therapy management by pharmacists to patients with type-2 diabetes mellitus in a federally qualified health center.
This article describes a medication therapy management (MTM) pilot program that was implemented at a federally qualified health center. This program was implemented at three clinics involving patients with uncontrolled diabetes, defined as hemoglobin A1c (HbA1c) greater than 8 percent. Fifty-seven patients met the established criteria and were enrolled in the six-month program. Thirty-seven patients completed the program and had an average 15 percent reduction in HbA1c.
AHRQ-funded; 290201100001C.
Citation: Ndefo UA, Moultry AM, Davis PN .
Provision of medication therapy management by pharmacists to patients with type-2 diabetes mellitus in a federally qualified health center.
P&T 2017 Oct;42(10):632-37.
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Keywords: Diabetes, Medication, Chronic Conditions, Patient-Centered Healthcare, Provider: Pharmacist
Balbale SN, Trivedi I, O'Dwyer LC
Strategies to identify and reduce opioid misuse among patients with gastrointestinal disorders: a systematic scoping review.
In this study, the investigators conducted a systematic scoping review to describe published scientific literature on strategies to identify and reduce opioid misuse among patients with gastrointestinal (GI) symptoms and disorders. They concluded that prescription drug monitoring and self-management interventions may be promising strategies to identify and reduce opioid misuse in GI care. They suggest that rigorous, empirical research is needed to evaluate the longer-term impact of these strategies.
AHRQ-funded; HS000084.
Citation: Balbale SN, Trivedi I, O'Dwyer LC .
Strategies to identify and reduce opioid misuse among patients with gastrointestinal disorders: a systematic scoping review.
Dig Dis Sci 2017 Oct;62(10):2668-85. doi: 10.1007/s10620-017-4705-9..
Keywords: Behavioral Health, Chronic Conditions, Digestive Disease and Health, Medication, Medication: Safety, Opioids, Patient Self-Management, Prevention, Substance Abuse
Xue Y, Goodwin JS, Adhikari D
Trends in primary care provision to Medicare beneficiaries by physicians, nurse practitioners, or physician assistants: 2008-2014.
This study documented the temporal trends in alternative primary care models in which physicians, nurse practitioners (NPs), or physician assistants (PAs) engaged in care provision to the elderly, and examined the role of these models in serving elders with multiple chronic conditions. It found a decrease in the physician model and an increase in the shared care model and NP/PA model from 2008 to 2014.
AHRQ-funded; HS020642; HS022134.
Citation: Xue Y, Goodwin JS, Adhikari D .
Trends in primary care provision to Medicare beneficiaries by physicians, nurse practitioners, or physician assistants: 2008-2014.
J Prim Care Community Health 2017 Oct;8(4):256-63. doi: 10.1177/2150131917736634.
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Keywords: Chronic Conditions, Elderly, Healthcare Delivery, Primary Care, Medicare
Miake-Lye IM, Chuang E, Rodriguez HP
Random or predictable?: Adoption patterns of chronic care management practices in physician organizations.
This exploratory paper leverages the natural variation in uptake to describe inter-organizational patterns in adoption of care management practices (CMPs) and to better understand how adoption choices may be related to one another. Within disease focus scales, patient reminders were ranked as the most adoptable CMP, while clinician feedback and patient education were ranked the least adoptable.
AHRQ-funded; HS024176.
Citation: Miake-Lye IM, Chuang E, Rodriguez HP .
Random or predictable?: Adoption patterns of chronic care management practices in physician organizations.
Implement Sci 2017 Aug 24;12(1):106. doi: 10.1186/s13012-017-0639-z.
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Keywords: Care Management, Chronic Conditions, Practice Patterns
Hatch B, Marino M, Killerby M
Medicaid's impact on chronic disease biomarkers: a cohort study of community health center patients.
This study assessed changes in biomarkers of chronic disease among community health center (CHC) patients who gained Medicaid coverage with the Oregon Medicaid expansion (2008-2011). It found that patients with uncontrolled chronic conditions experienced objective health improvements over time. In two of three chronic disease cohorts, those who gained Medicaid coverage were more likely to achieve a controlled measurement than those who remained uninsured.
AHRQ-funded; HS024270.
Citation: Hatch B, Marino M, Killerby M .
Medicaid's impact on chronic disease biomarkers: a cohort study of community health center patients.
J Gen Intern Med 2017 Aug;32(8):940-47. doi: 10.1007/s11606-017-4051-9.
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Keywords: Medicaid, Chronic Conditions, Access to Care, Policy
Hewner S, Casucci S, Sullivan S
Integrating social determinants of health into primary care clinical and informational workflow during care transitions.
Care continuity during transitions between the hospital and home requires reliable communication between providers and settings and an understanding of social determinants that influence recovery. This paper describes the coordinating transitions intervention which uses real time alerts, delivered directly to the primary care practice for complex chronically ill patients discharged from an acute care setting, to facilitate nurse care coordinator led telephone outreach.
AHRQ-funded; HS022575.
Citation: Hewner S, Casucci S, Sullivan S .
Integrating social determinants of health into primary care clinical and informational workflow during care transitions.
eGEMS 2017 Jul 4;5(2):2. doi: 10.13063/2327-9214.1282..
Keywords: Care Coordination, Chronic Conditions, Patient-Centered Healthcare, Social Determinants of Health, Transitions of Care
Berry JG, Ash AS, Cohen E
Contributions of children with multiple chronic conditions to pediatric hospitalizations in the United States: a retrospective cohort analysis.
Researchers assessed how much of US pediatric inpatient care is used by children with multiple chronic conditions (CMCC) and which chronic conditions are the key drivers of hospital use. CMCC accounted for over one-fourth of acute-care hospitalizations and one-half of all hospital dollars for US pediatric care in 2012. Substantial CMCC hospital resource use involves children with mental health-related conditions.
AHRQ-funded; HS023092.
Citation: Berry JG, Ash AS, Cohen E .
Contributions of children with multiple chronic conditions to pediatric hospitalizations in the United States: a retrospective cohort analysis.
Hosp Pediatr 2017 Jul;7(7):365-72. doi: 10.1542/hpeds.2016-0179.
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Keywords: Children/Adolescents, Chronic Conditions, Healthcare Cost and Utilization Project (HCUP), Healthcare Costs, Behavioral Health
Simon TD, Cawthon ML, Popalisky J
Development and validation of the Pediatric Medical Complexity Algorithm (PMCA) Version 2.0.
The Pediatric Medical Complexity Algorithm (PMCA) was developed to stratify children by level of medical complexity. The researchers sought to refine PMCA and evaluate its performance based on the duration of eligibility and completeness of Medicaid data. They concluded that PMCA version 2.0 identifies children with C-CD with good sensitivity and very good specificity when applied to Medicaid data.
AHRQ-funded; HS020506.
Citation: Simon TD, Cawthon ML, Popalisky J .
Development and validation of the Pediatric Medical Complexity Algorithm (PMCA) Version 2.0.
Hosp Pediatr 2017 Jul;7(7):373-77. doi: 10.1542/hpeds.2016-0173.
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Keywords: Chronic Conditions, Hospitals, Medicaid, Ambulatory Care and Surgery, Children/Adolescents
Silverberg JI
Selected comorbidities of atopic dermatitis: atopy, neuropsychiatric, and musculoskeletal disorders.
Atopic dermatitis (AD) is a chronic pruritic inflammatory skin disease with substantial morbidity and quality of life impairment. This review summarizes recent developments in the atopic and neuropsychiatric comorbidities of AD. For example, it concludes that persons with AD appear to be at higher risk for multiple neuropsychiatric disorders, including depression, attention-deficit/hyperactivity disorder, speech disorders in childhood, headaches, and seizures.
AHRQ-funded; HS023011.
Citation: Silverberg JI .
Selected comorbidities of atopic dermatitis: atopy, neuropsychiatric, and musculoskeletal disorders.
Clin Dermatol 2017 Jul - Aug;35(4):360-66. doi: 10.1016/j.clindermatol.2017.03.008.
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Keywords: Skin Conditions, Chronic Conditions, Behavioral Health, Quality of Life, Children/Adolescents
Goldmann E, Roberts ET, Parikh NS
Chronic physical illness burden and suicidal ideation among Dominicans in New York City.
This study used data from a community survey of 2753 Dominican adults in New York City to investigate the association between chronic illness and suicidal ideation. The investigators concluded that the association of interest did not differ significantly between younger and older adults. They suggest that screening for SI in health care practice, particularly among Dominican men with multiple chronic health conditions, may be warranted.
AHRQ-funded; HS022961.
Citation: Goldmann E, Roberts ET, Parikh NS .
Chronic physical illness burden and suicidal ideation among Dominicans in New York City.
J Immigr Minor Health 2017 Jun;19(3):616-22. doi: 10.1007/s10903-016-0477-0..
Keywords: Chronic Conditions, Depression, Behavioral Health, Racial and Ethnic Minorities, Risk
Shortell SM, Poon BY, Ramsay PP
A multilevel analysis of patient engagement and patient-reported outcomes in primary care practices of accountable care organizations.
For adult primary care practices seeing patients with diabetes and/or cardiovascular disease, researchers examined the relationship between selected practice characteristics, patient engagement, and patient-reported outcomes of care. They found that having a patient-centered culture was positively associated with fewer depression symptoms and better physical function scores. Patient activation was positively associated with fewer depression symptoms.
AHRQ-funded; HS024075.
Citation: Shortell SM, Poon BY, Ramsay PP .
A multilevel analysis of patient engagement and patient-reported outcomes in primary care practices of accountable care organizations.
J Gen Intern Med 2017 Jun;32(6):640-47. doi: 10.1007/s11606-016-3980-z.
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Keywords: Patient and Family Engagement, Patient-Centered Outcomes Research, Primary Care, Chronic Conditions, Diabetes, Cardiovascular Conditions
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
Olfson M, Wall M, Wang S
Service use preceding opioid-related fatality.
The authors analyzed health service patterns before opioid-related death among nonelderly individuals in the Medicaid program, focusing on decedents with and without past-year diagnoses of non-cancer chronic pain. They found that persons dying of opioid-related causes, particularly those who were diagnosed with chronic pain conditions, commonly received services related to drug use disorders and mental disorders in the last year of life, though opioid use disorder diagnoses near the time of death were rare.
AHRQ-funded; HS021112.
Citation: Olfson M, Wall M, Wang S .
Service use preceding opioid-related fatality.
Am J Psychiatry 2017 Jun;175(6):538-44. doi: 10.1176/appi.ajp.2017.17070808.
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Keywords: Chronic Conditions, Opioids, Medicaid, Mortality, Substance Abuse