National Healthcare Quality and Disparities Report
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Topics
- (-) Arthritis (36)
- Back Health and Pain (1)
- Cancer (2)
- Cancer: Breast Cancer (1)
- Cardiovascular Conditions (1)
- Care Management (1)
- Children/Adolescents (2)
- Chronic Conditions (4)
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- Electronic Health Records (EHRs) (1)
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- Kidney Disease and Health (1)
- Lifestyle Changes (1)
- Medication (10)
- Mortality (1)
- Obesity (2)
- Obesity: Weight Management (1)
- Outcomes (3)
- Pain (2)
- Patient-Centered Outcomes Research (9)
- Patient Adherence/Compliance (1)
- Patient and Family Engagement (2)
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- Practice Patterns (1)
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- Quality Improvement (1)
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- Surgery (7)
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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 36 Research Studies DisplayedSchmajuk G, Tonner C, Miao Y
Folic acid supplementation is suboptimal in a national cohort of older veterans receiving low dose oral methotrexate.
The authors aimed to determine the prevalence, predictors of, and persistence of folic acid use in a population-based cohort of methotrexate (MTX) users with rheumatic diseases. They found that patients who did not see a rheumatologist were 23% less likely to receive folic acid compared to patients who did have a rheumatologist visit during the baseline period, and after 20 months, only 50% of patients continued to receive folic acid. The authors recommend improving patient safety for users of MTX by standardizing workflows for folic acid supplementation.
AHRQ-funded; HS024412.
Citation: Schmajuk G, Tonner C, Miao Y .
Folic acid supplementation is suboptimal in a national cohort of older veterans receiving low dose oral methotrexate.
PLoS One 2016 Dec 15;11(12):e0168369. doi: 10.1371/journal.pone.0168369.
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Keywords: Elderly, Healthcare Utilization, Medication, Arthritis
Herrinton LJ, Harrold L, Salman C
Population variations in rheumatoid arthritis treatment and outcomes, Northern California, 1998-2009.
This study assessed variations in rheumatoid arthritis treatment and outcomes at the community level from 1998 through 2009. It found that disease-modifying anti-rheumatic drug use increased in the typical patient from 38 to 63 percent of the time, and oral prednisone use declined from 23 to 15 percent of the time, whereas opioid use initially rose but then fell to 23 percent of the time.
AHRQ-funded; HS019912; HS010391; HS021590; HS018517; HS017919.
Citation: Herrinton LJ, Harrold L, Salman C .
Population variations in rheumatoid arthritis treatment and outcomes, Northern California, 1998-2009.
Perm J 2016 Winter;20(1):4-12. doi: 10.7812/tpp/15-028.
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Keywords: Arthritis, Medication, Comparative Effectiveness, Outcomes
Yazdany J, Bansback N, Clowse M
Rheumatology informatics system for effectiveness: a national informatics-enabled registry for quality improvement.
The authors reported on the Rheumatology Informatics System for Effectiveness (RISE) registry's architecture and initial data and demonstrated how RISE is being used to improve care quality. They concluded that RISE provides critical infrastructure for improving care quality in rheumatology and is a unique data source to generate new knowledge.
AHRQ-funded; HS024412.
Citation: Yazdany J, Bansback N, Clowse M .
Rheumatology informatics system for effectiveness: a national informatics-enabled registry for quality improvement.
Arthritis Care Res 2016 Dec;68(12):1866-73. doi: 10.1002/acr.23089.
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Keywords: Quality of Care, Health Information Technology (HIT), Quality Improvement, Registries, Arthritis
Ware JE, Jr., Gandek B, Allison J
The validity of disease-specific quality of life attributions among adults with multiple chronic conditions.
The objective of this study was to evaluate the convergent and discriminant validity of QOL attributions to specific diseases among adults with multiple chronic conditions (MCC). It concluded that, collectively, convergent and discriminant test results support the construct validity of disease-specific QOL impact attributions across MCC within the eight pre-identified conditions.
AHRQ-funded; HS023117.
Citation: Ware JE, Jr., Gandek B, Allison J .
The validity of disease-specific quality of life attributions among adults with multiple chronic conditions.
Int J Stat Med Res 2016;5(1):17-40..
Keywords: Quality of Life, Chronic Conditions, Arthritis, Kidney Disease and Health, Heart Disease and Health
Rolfson O, Wissig S, van Maasakkers L
Defining an international standard set of outcome measures for patients with hip or knee osteoarthritis: consensus of the International Consortium for Health Outcomes Measurement Hip and Knee Osteoarthritis Working Group.
The researchers defined a minimum Standard Set of outcome measures and case-mix factors for monitoring, comparing, and improving healthcare for patients with clinically diagnosed hip or knee osteoarthritis (OA) with a focus on defining the outcomes that matter most to patients. The Working Group reached consensus on a concise set of outcome measures to evaluate patients' joint pain, physical functioning, health-related quality of life, work status, mortality, reoperations, readmissions, and overall satisfaction with treatment result.
AHRQ-funded; HS018910.
Citation: Rolfson O, Wissig S, van Maasakkers L .
Defining an international standard set of outcome measures for patients with hip or knee osteoarthritis: consensus of the International Consortium for Health Outcomes Measurement Hip and Knee Osteoarthritis Working Group.
Arthritis Care Res 2016 Nov;68(11):1631-39. doi: 10.1002/acr.22868.
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Keywords: Arthritis, Care Management, Chronic Conditions, Patient-Centered Outcomes Research
Yazdany J, Robbins M, Schmajuk G
Development of the American College of Rheumatology's rheumatoid arthritis electronic clinical quality measures.
The researchers sought to develop and test electronic clinical quality measures for rheumatoid arthritis. Disease activity assessment, functional status assessment, disease-modifying antirheumatic durg use, and tuberculosis screening measures have achieved national endorsement and are recommended for use in federal quality reporting programs.
AHRQ-funded; HS024412.
Citation: Yazdany J, Robbins M, Schmajuk G .
Development of the American College of Rheumatology's rheumatoid arthritis electronic clinical quality measures.
Arthritis Care Res 2016 Nov;68(11):1579-90. doi: 10.1002/acr.22984.
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Keywords: Electronic Health Records (EHRs), Medication, Quality Measures, Arthritis, Outcomes
Nguyen UD, Ayers DC, Li W
Preoperative pain and function: profiles of patients selected for total knee arthroplasty.
The researchers examined patient-reported preoperative pain and function profiles to understand symptom severity at the time of total knee arthroplasty (TKA) decision. Of 6,936 patients, 77 percent had high pain and poor function (group 4), 19 percent had high pain "or" poor function (groups 2-3), and 5 percent had little pain and high function before TKA (group 1).
AHRQ-funded; HS018910.
Citation: Nguyen UD, Ayers DC, Li W .
Preoperative pain and function: profiles of patients selected for total knee arthroplasty.
J Arthroplasty 2016 Nov;31(11):2402-07.e2. doi: 10.1016/j.arth.2016.04.015.
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Keywords: Pain, Surgery, Arthritis, Comparative Effectiveness, Patient-Centered Outcomes Research
Suter LG, Barber CE, Herrin J
American College of Rheumatology white paper on performance outcome measures in rheumatology.
The objective of this study was to highlight the opportunities and challenges of developing and implementing performance outcome measures in rheumatology for accountability purposes. The authors' hypothetical outcome measure was a measure of rheumatoid arthritis disease activity intended for evaluating Accountable Care Organization performance. They provided a summary table of key take-home points for clinicians and policymakers. The authors concluded that the most effective and meaningful measures can only be created through the close collaboration of patients, providers, measure developers, and policymakers.
AHRQ-funded; HS024412.
Citation: Suter LG, Barber CE, Herrin J .
American College of Rheumatology white paper on performance outcome measures in rheumatology.
Arthritis Care Res 2016 Oct;68(10):1390-401. doi: 10.1002/acr.22936.
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Keywords: Quality of Care, Quality Measures, Outcomes, Arthritis
Mamtani R, Clark AS, Scott FI
Association between breast cancer recurrence and immunosuppression in rheumatoid arthritis and inflammatory bowel disease: a cohort study.
The researchers examined the rates of breast cancer recurrence in patients with immune-mediated disease and treated breast cancer who received therapy with methotrexate, thiopurines, or anti-tumor necrosis factor (anti-TNF). They found that the risk of breast cancer recurrence in patients who received methotrexate, thiopurine, or anti-TNF therapy was not statistically significantly increased, although they did not rule out a 2-fold or greater increased risk in those treated with thiopurines.
AHRQ-funded; HS021110; HS018517.
Citation: Mamtani R, Clark AS, Scott FI .
Association between breast cancer recurrence and immunosuppression in rheumatoid arthritis and inflammatory bowel disease: a cohort study.
Arthritis Rheumatol 2016 Oct;68(10):2403-11. doi: 10.1002/art.39738.
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Keywords: Cancer: Breast Cancer, Digestive Disease and Health, Medication, Patient-Centered Outcomes Research, Arthritis
Mannion ML, Xie F, Baddley J
Analysis of health care claims during the peri-transfer stage of transition from pediatric to adult care among juvenile idiopathic arthritis patients.
This study investigated the utilization of health care services before and after transfer from pediatric to adult rheumatology care in clinical practice. It found that individuals with juvenile idiopathic arthritis (JIA) who transferred to adult care were more likely receive a diagnosis of rheumatoid arthritis instead of juvenile rheumatoid arthritis and were less likely to receive NSAIDs, but had no significant immediate changes to other medication use.
AHRQ-funded; HS021110.
Citation: Mannion ML, Xie F, Baddley J .
Analysis of health care claims during the peri-transfer stage of transition from pediatric to adult care among juvenile idiopathic arthritis patients.
Pediatr Rheumatol Online J 2016 Sep 5;14(1):49. doi: 10.1186/s12969-016-0107-3.
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Keywords: Healthcare Utilization, Arthritis, Children/Adolescents
Yun H, Yang S, Chen L
Risk of herpes zoster in autoimmune and inflammatory diseases: implications for vaccination.
This study was undertaken to evaluate the age-stratified incidence of herpes zoster (HZ) in patients with autoimmune or inflammatory (AI) diseases as compared to older adults for whom the HZ vaccine is currently recommended by the US Centers for Disease Control and Prevention. The researchers found that systemic lupus erythematosus, inflammatory bowel disease, and rheumatoid arthritis are AI diseases associated with a higher risk of HZ compared to that in older adults for whom vaccination is currently recommended, suggesting that individuals with these conditions who are as young as age 40 years could potentially benefit from the HZ vaccine.
AHRQ-funded; HS021694; HS018517.
Citation: Yun H, Yang S, Chen L .
Risk of herpes zoster in autoimmune and inflammatory diseases: implications for vaccination.
Arthritis Rheumatol 2016 Sep;68(9):2328-37. doi: 10.1002/art.39670.
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Keywords: Infectious Diseases, Prevention, Arthritis, Risk, Sexual Health, Vaccination
Sieberts SK, Zhu F, Garcia-Garcia J
Crowdsourced assessment of common genetic contribution to predicting anti-TNF treatment response in rheumatoid arthritis.
A rigorous community-based assessment of the utility of SNP data for predicting anti-TNF treatment efficacy in RA patients was performed in the context of an open challenge framework which enabled the comparative evaluation of predictions developed by 73 research groups using the most comprehensive available data and covering a wide range of state-of-the-art modelling methodologies.
AHRQ-funded; HS018517.
Citation: Sieberts SK, Zhu F, Garcia-Garcia J .
Crowdsourced assessment of common genetic contribution to predicting anti-TNF treatment response in rheumatoid arthritis.
Nat Commun 2016 Aug 23;7:12460. doi: 10.1038/ncomms12460..
Keywords: Genetics, Arthritis
Fitzgerald GK, Fritz JM, Childs JD
Exercise, manual therapy, and use of booster sessions in physical therapy for knee osteoarthritis: a multi-center, factorial randomized clinical trial.
The purposes of this paper are to determine if (1) treatment effects differ between participants receiving manual therapy (MT) with exercise compared to subjects who don't, and if (2) treatment effects are better sustained when participants receive booster sessions compared to those who don't over a one year period in subjects with knee osteoarthritis. The researchers found that MT or use of boosters with exercise did not result in additive improvement in the primary outcome at 1 year. Also, secondary outcomes suggest MT may have some short term benefit, and booster sessions may improve responder status and knee pain at 1 year.
AHRQ-funded; HS019624.
Citation: Fitzgerald GK, Fritz JM, Childs JD .
Exercise, manual therapy, and use of booster sessions in physical therapy for knee osteoarthritis: a multi-center, factorial randomized clinical trial.
Osteoarthritis Cartilage 2016 Aug;24(8):1340-9. doi: 10.1016/j.joca.2016.03.001.
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Keywords: Arthritis, Comparative Effectiveness, Patient-Centered Outcomes Research, Treatments
Park JK, Yang JA, Ahn EY
Survival rates of cancer patients with and without rheumatic disease: a retrospective cohort analysis.
The researchers compared the outcomes of gastric, colon, lung, and breast cancer patients with and without rheumatic diseases. They found that rheumatoid arthritis and dermatomyositis/polymyositis seemed to be associated with a higher mortality in patients with lung or breast cancers, whereas systemic sclerosis seemed to be associated with decreased mortality in patients with lung cancer.
AHRQ-funded; HS018517.
Citation: Park JK, Yang JA, Ahn EY .
Survival rates of cancer patients with and without rheumatic disease: a retrospective cohort analysis.
BMC Cancer 2016 Jul 4;16:381. doi: 10.1186/s12885-016-2444-5.
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Keywords: Cancer, Mortality, Arthritis, Skin Conditions
Curtis JR, Bharat A, Chen L
Agreement between rheumatologist and patient-reported adherence to methotrexate in a US rheumatoid arthritis registry.
To determine the extent to which methotrexate (MTX) adherence is overestimated by rheumatologists, the researchers deployed an Internet survey to patients with rheumatoid arthritis (RA) participating in a US registry. They found that MTX use was misclassified for 13-20 percent of patients, mainly because of 1 or more missed doses rather than overt discontinuation. Clinicians should be aware of suboptimal adherence when assessing MTX response.
AHRQ-funded; HS018517.
Citation: Curtis JR, Bharat A, Chen L .
Agreement between rheumatologist and patient-reported adherence to methotrexate in a US rheumatoid arthritis registry.
J Rheumatol 2016 Jun;43(6):1027-9. doi: 10.3899/jrheum.151136.
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Keywords: Arthritis, Patient Adherence/Compliance, Medication, Registries
Pappas DA, John A, Curtis JR
Dosing of intravenous tocilizumab in a real-world setting of rheumatoid arthritis: analyses from the corrona registry.
The objective of this analysis was to describe patterns of early intravenous tocilizumab (TCZ) dose escalation in a real-world setting using data from the Corrona registry. It determined that of the 213 patients who were eligible for analysis, 86 (40.4 percent) remained on their initial dose of TCZ 4 mg/kg and 110 (51.6 percent) were escalated to TCZ 8 mg/kg by or at 3 months.
AHRQ-funded; HS018517.
Citation: Pappas DA, John A, Curtis JR .
Dosing of intravenous tocilizumab in a real-world setting of rheumatoid arthritis: analyses from the corrona registry.
Rheumatol Ther 2016 Jun;3(1):103-15. doi: 10.1007/s40744-016-0028-0.
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Keywords: Arthritis, Medication, Registries
Pellegrini CA, Song J, Chang RW
Change in physical activity and sedentary time associated with 2-year weight loss in obese adults with osteoarthritis.
The investigators examined if changes in moderate-to-vigorous physical activity (MVPA), light activity, and sedentary behavior are related to weight change over a 2-year period in obese adults with elevated risk for knee osteoarthritis. They found that small increases in MVPA and decreases in sedentary time over 2 years were associated with weight loss among adults with obesity and with or at elevated risk for knee osteoarthritis.
AHRQ-funded; HS023011.
Citation: Pellegrini CA, Song J, Chang RW .
Change in physical activity and sedentary time associated with 2-year weight loss in obese adults with osteoarthritis.
J Phys Act Health 2016 May;13(5):461-6. doi: 10.1123/jpah.2015-0404.
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Keywords: Lifestyle Changes, Obesity, Arthritis, Obesity: Weight Management
Charles-Schoeman C, Wang X, Lee YY
Association of triple therapy with improvement in cholesterol profiles over two-year followup in the treatment of early aggressive rheumatoid arthritis trial.
The researchers evaluated long-term changes in cholesterol levels in patients with early rheumatoid arthritis (RA) who were randomized to begin treatment with methotrexate (MTX) monotherapy, MTX plus etanercept, or triple therapy (MTX plus sulfasalazine plus hydroxychloroquine) . Triple therapy was strongly associated with higher levels of HDL cholesterol, lower levels of LDL cholesterol, and higher ratios of total cholesterol.
AHRQ-funded; HS018517.
Citation: Charles-Schoeman C, Wang X, Lee YY .
Association of triple therapy with improvement in cholesterol profiles over two-year followup in the treatment of early aggressive rheumatoid arthritis trial.
Arthritis Rheumatol 2016 Mar;68(3):577-86. doi: 10.1002/art.39502.
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Keywords: Arthritis, Heart Disease and Health, Medication
Scott FI, Mamtani R, Brensinger CM
Risk of nonmelanoma skin cancer associated with the use of immunosuppressant and biologic agents in patients with a history of autoimmune disease and nonmelanoma skin cancer.
The study objective was to determine the relative hazard of a second nonmelanoma skin cancer (NMSC) in patients with rheumatoid arthritis and inflammatory bowel disease who use methotrexate, anti-tumor necrosis factor (anti-TNF) therapy, or thiopurines after an initial NMSC. It concluded that methotrexate use is associated with an increased risk of a second NMSC.
AHRQ-funded; HS018517.
Citation: Scott FI, Mamtani R, Brensinger CM .
Risk of nonmelanoma skin cancer associated with the use of immunosuppressant and biologic agents in patients with a history of autoimmune disease and nonmelanoma skin cancer.
JAMA Dermatol 2016 Feb;152(2):164-72. doi: 10.1001/jamadermatol.2015.3029.
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Keywords: Cancer, Arthritis, Risk, Comparative Effectiveness, Treatments
Navarro-Millan I, Yang S, DuVall SL
Association of hyperlipidaemia, inflammation and serological status and coronary heart disease among patients with rheumatoid arthritis: data from the National Veterans Health Administration.
The researchers studied the association of serum lipids, inflammation, and seropositivity on coronary heart disease (CHD) and stroke in patients with rheumatoid arthritis. They found that in the study population of predominantly male veterans, higher levels of erythrocyte sedimentation rate and C-reactive protein were associated with increased risk of heart attack and stroke, and higher levels of HDL-C were inversely associated with heart attack and stroke.
AHRQ-funded; HS018517
Citation: Navarro-Millan I, Yang S, DuVall SL .
Association of hyperlipidaemia, inflammation and serological status and coronary heart disease among patients with rheumatoid arthritis: data from the National Veterans Health Administration.
Ann Rheum Dis. 2016 Feb;75(2):341-7. doi: 10.1136/annrheumdis-2013-204987..
Keywords: Stroke, Cardiovascular Conditions, Arthritis
Mandl LA, Zhu R, Huang WT
Short-term total hip arthroplasty outcomes in patients with psoriatic arthritis or psoriatic skin disease compared to patients with osteoarthritis.
This study was undertaken to assess whether patients with psoriatic arthritis (PsA) or those with cutaneous psoriasis (PsC) without evidence of inflammatory joint disease are at an increased risk for worse outcomes after total hip arthroplasty (THA) as compared to patients with osteoarthritis (OA). It concluded that neither PsA nor PsC are risk factors for poor outcomes after THA.
AHRQ-funded; HS016075.
Citation: Mandl LA, Zhu R, Huang WT .
Short-term total hip arthroplasty outcomes in patients with psoriatic arthritis or psoriatic skin disease compared to patients with osteoarthritis.
Arthritis Rheumatol 2016 Feb;68(2):410-7. doi: 10.1002/art.39431.
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Keywords: Arthritis, Surgery, Registries, Patient-Centered Outcomes Research
Yun H, Xie F, Delzell E
Comparative risk of hospitalized infection associated with biologic agents in rheumatoid arthritis patients enrolled in Medicare.
The aim of this study was to determine whether the associated risk of hospitalized infections differed between specific biologic agents used to treat rheumatoid arthritis (RA). It concluded that RA patients with prior exposure to a biologic agent, exposure to etanercept, infliximab, or rituximab was associated with a greater 1-year risk of hospitalized infection compared with the risk associated with exposure to abatacept.
AHRQ-funded; HS021694; HS018517.
Citation: Yun H, Xie F, Delzell E .
Comparative risk of hospitalized infection associated with biologic agents in rheumatoid arthritis patients enrolled in Medicare.
Arthritis Rheumatol 2016 Jan;68(1):56-66. doi: 10.1002/art.39399..
Keywords: Comparative Effectiveness, Healthcare-Associated Infections (HAIs), Arthritis, Hospitalization, Risk
Chimenti PC, Drinkwater CJ, Li W
Factors associated with early improvement in low back pain after total hip arthroplasty: A multi-center prospective cohort analyses.
This study identified factors associated with an improvement in low back pain (LBP) at six-month follow-up after total hip arthroplasty (THA). It found that among patients reporting severe or moderate LBP preoperatively, 56 percent improved 6 months after surgery. Patients without improvement were more likely to be on Medicare, have a high school education or less, have household income less than $45,000 and have one or more comorbid conditions.
AHRQ-funded; HS018910.
Citation: Chimenti PC, Drinkwater CJ, Li W .
Factors associated with early improvement in low back pain after total hip arthroplasty: A multi-center prospective cohort analyses.
J Arthroplasty 2016 Jan;31(1):176-9. doi: 10.1016/j.arth.2015.07.028.
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Keywords: Back Health and Pain, Arthritis, Surgery, Patient-Centered Outcomes Research, Registries
Goodman SM, Johnson B, Zhang M
Patients with rheumatoid arthritis have similar excellent outcomes after total knee replacement compared with patients with osteoarthritis.
The purpose of this study is to assess pain, function, and quality of life 2 years after total knee replacement (TKR) in contemporary patients with rheumatoid arthritis (RA) compared with patients with osteoarthritis (OA). It concluded that patients with RA undergoing primary TKR have excellent 2-year outcomes, comparable with OA, in spite of worse preoperative pain and function.
AHRQ-funded; HS016075.
Citation: Goodman SM, Johnson B, Zhang M .
Patients with rheumatoid arthritis have similar excellent outcomes after total knee replacement compared with patients with osteoarthritis.
J Rheumatol 2016 Jan;43(1):46-53. doi: 10.3899/jrheum.150525..
Keywords: Quality of Life, Treatments, Risk, Arthritis
Singh JA, Lewallen DG
Increasing obesity and comorbidity in patients undergoing primary total hip arthroplasty in the U.S.: a 13-year study of time trends.
The researchers examined the time-trends in key demographic and clinical characteristics of patients undergoing primary total hip arthroplasty (THA). They found that obesity, medical and psychological comorbidity increased and the underlying diagnosis of RA/inflammatory arthritis decreased rapidly in primary THA patients over 13-years.
AHRQ-funded; HS021110.
Citation: Singh JA, Lewallen DG .
Increasing obesity and comorbidity in patients undergoing primary total hip arthroplasty in the U.S.: a 13-year study of time trends.
BMC Musculoskelet Disord 2014 Dec 17;15:441. doi: 10.1186/1471-2474-15-441..
Keywords: Surgery, Obesity, Risk, Registries, Arthritis