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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 152 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
Raval AD, Mattes MD, Madhavan S
Association between metformin use and cancer stage at diagnosis among elderly Medicare beneficiaries with preexisting Type 2 diabetes mellitus and incident prostate cancer.
The researchers examined the association between metformin use and cancer stage at diagnosis among elderly men with preexisting diabetes mellitus and incident prostate cancer. They found a significantly lower percentage of metformin users were diagnosed with advanced prostate cancer as compared to nonusers (4.7 percent versus 6.7 percent.
AHRQ-funded; HS018622.
Citation: Raval AD, Mattes MD, Madhavan S .
Association between metformin use and cancer stage at diagnosis among elderly Medicare beneficiaries with preexisting Type 2 diabetes mellitus and incident prostate cancer.
J Diabetes Res 2016;2016:2656814. doi: 10.1155/2016/2656814.
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Keywords: Cancer: Prostate Cancer, Medication, Elderly, Diabetes, Medicare
Raval AD, Madhavan S, Mattes MD
Association between types of chronic conditions and cancer stage at diagnosis among elderly Medicare beneficiaries with prostate cancer.
The current retrospective observational study was conducted to examine the association between types of chronic conditions and cancer stage at diagnosis among elderly Medicare beneficiaries with prostate cancer. It found that those with none of the 3 types of chronic conditions (cardiometabolic, mental health, and respiratory) were 44 percent more likely to be diagnosed with advanced prostate cancer compared to men with all 3 types of chronic conditions.
AHRQ-funded; HS018622.
Citation: Raval AD, Madhavan S, Mattes MD .
Association between types of chronic conditions and cancer stage at diagnosis among elderly Medicare beneficiaries with prostate cancer.
Popul Health Manag 2016 Dec;19(6):445-53. doi: 10.1089/pop.2015.0141.
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Keywords: Cancer, Cancer: Prostate Cancer, Elderly, Medicare
Gaugler JE, Reese M, Tanler R
Care to Plan: an online tool that offers tailored support to dementia caregivers.
This study developed and tested the feasibility of "Care to Plan" (CtP), an online resource for dementia caregivers (e.g., relatives or unpaid nonrelatives) that generates tailored support recommendations. It concluded that, based on the integrated qualitative and quantitative data, CtP was simple and easy to understand. The streamlined visual layout facilitated utility and the individualized recommendations could meet the needs of users.
AHRQ-funded; HS20948; HS22445.
Citation: Gaugler JE, Reese M, Tanler R .
Care to Plan: an online tool that offers tailored support to dementia caregivers.
Gerontologist 2016 Dec;56(6):1161-74. doi: 10.1093/geront/gnv150.
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Keywords: Caregiving, Dementia, Elderly, Web-Based, Tools & Toolkits
Kenzik KM, Kent EE, Martin MY
Chronic condition clusters and functional impairment in older cancer survivors: a population-based study.
The purpose of this study was to identify chronic condition clusters at pre- and post-cancer diagnosis, evaluate predictors of developing clusters post-cancer, and examine the impact on functional impairment among older cancer survivors. It found that distinct condition clusters of two or more chronic conditions are prevalent among older cancer survivors. Cluster prevalence increases from pre- to post-cancer diagnosis.
AHRQ-funded; HS023009; HS013852.
Citation: Kenzik KM, Kent EE, Martin MY .
Chronic condition clusters and functional impairment in older cancer survivors: a population-based study.
J Cancer Surviv 2016 Dec;10(6):1096-103. doi: 10.1007/s11764-016-0553-4.
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Keywords: Chronic Conditions, Cancer, Elderly, Research Methodologies, Health Status
Wang SY, Aldridge MD, Canavan M
Continuous home care reduces hospice disenrollment and hospitalization after hospice enrollment.
The purpose of this paper is to identify hospice and patient characteristics associated with the use of continuous home care (CHC) and to examine the associations between CHC utilization and hospice disenrollment or hospitalization after hospice enrollment. The researchers found that patients who were white, had cancer, and had more comorbidities were more likely to use CHC and that patients who used CHC were less likely to have hospice disenrollment and less likely to be hospitalized after hospice enrollment.
AHRQ-funded; HS023900.
Citation: Wang SY, Aldridge MD, Canavan M .
Continuous home care reduces hospice disenrollment and hospitalization after hospice enrollment.
J Pain Symptom Manage 2016 Dec;52(6):813-21. doi: 10.1016/j.jpainsymman.2016.05.031.
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Keywords: Elderly, Home Healthcare, Hospitalization, Palliative Care
Naples JG, Kotlarczyk MP, Perera S
Non-tricyclic and non-selective serotonin reuptake inhibitor antidepressants and recurrent falls in frail older women.
This study determined the risk of recurrent falls associated with antidepressants other than tricyclics (TCAs) and selective serotonin reuptake inhibitors (SSRIs) among frail older women. At least 15 percent of women experienced recurrent falls between 0-6 and 6-12 months. At baseline and 6 months, 18.2 percent and 6.9 percent had a non-TCA/non-SSRI antidepressant, respectively. It concluded that non-TCA/non-SSRI antidepressant exposure significantly increased the risk of recurrent falls.
AHRQ-funded; HS023779.
Citation: Naples JG, Kotlarczyk MP, Perera S .
Non-tricyclic and non-selective serotonin reuptake inhibitor antidepressants and recurrent falls in frail older women.
Am J Geriatr Psychiatry 2016 Dec;24(12):1221-27. doi: 10.1016/j.jagp.2016.08.008.
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Keywords: Medication, Elderly, Falls, Patient Safety
Coyle CE, Putman M, Kramer J
The role of aging and disability resource centers in serving adults aging with intellectual disabilities and their families: findings from seven states.
The purpose of this project was to assess the activities of aging and disability resource centers (ADRCs) as they seek to serve older adults with intellectual disabilities and their family caregivers. Results of this qualitative analysis indicate that ADRCs are not focusing explicitly on adults aging with intellectual and developmental disabilities and their family caregivers.
AHRQ-funded; HS017589.
Citation: Coyle CE, Putman M, Kramer J .
The role of aging and disability resource centers in serving adults aging with intellectual disabilities and their families: findings from seven states.
J Aging Soc Policy 2016;28(1):1-14. doi: 10.1080/08959420.2015.1096142.
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Keywords: Caregiving, Disabilities, Elderly, Long-Term Care
Jayadevappa R, Chhatre S
Association between age, substance use, and outcomes in Medicare enrollees with prostate cancer.
The authors analyzed the association between age, substance use, and outcomes in fee-for-service Medicare enrollees with advanced prostate cancer. As they found age-specific results, they recommend an integrated and multidisciplinary approach to screen, refer, and treat substance use in patients with prostate cancer to improve outcomes and reduce costs.
AHRQ-funded; HS024106.
Citation: Jayadevappa R, Chhatre S .
Association between age, substance use, and outcomes in Medicare enrollees with prostate cancer.
J Geriatr Oncol 2016 Nov;7(6):444-52. doi: 10.1016/j.jgo.2016.06.007.
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Keywords: Elderly, Medicare, Outcomes, Cancer: Prostate Cancer, Substance Abuse
Zullo AR, Dore DD, Gutman R
National glucose-lowering treatment complexity is greater in nursing home residents than community-dwelling adults.
This letter describes common glucose-lowering medication usage patterns for a national cross-section of U.S. adults aged 65 and older residing in nursing home (NH) and community settings from 2007 to 2010. The study results suggest that continued efforts are warranted to improve glucose-lowering medication management and simplify treatment regimens in the NH; that the relative importance of CER questions regarding specific glucose-lowering treatments may differ according to the care setting; and that CER studies of glucose-lowering treatments in older adults must address the combination use of medications, especially in NH residents.
AHRQ-funded; HS022998.
Citation: Zullo AR, Dore DD, Gutman R .
National glucose-lowering treatment complexity is greater in nursing home residents than community-dwelling adults.
J Am Geriatr Soc 2016 Nov;64(11):e233-e35. doi: 10.1111/jgs.14485.
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Keywords: Care Management, Chronic Conditions, Diabetes, Elderly, Medication, Nursing Homes
Carballo NJ, Alessi CA, Martin JL
Perceived effectiveness, self-efficacy, and social support for oral appliance therapy among older veterans with obstructive sleep apnea.
Adherence to oral appliance therapy may be influenced by patients' perceived effectiveness of the therapy, self-efficacy, and availability of social support. The researchers examined these perceptions among older adults with obstructive sleep apnea who were prescribed oral appliance therapy. They concluded that only about one third of older adults perceived it as an effective treatment, were confident about oral appliance use, and/or believed that they would receive needed support.
AHRQ-funded; HS024379.
Citation: Carballo NJ, Alessi CA, Martin JL .
Perceived effectiveness, self-efficacy, and social support for oral appliance therapy among older veterans with obstructive sleep apnea.
Clin Ther 2016 Nov;38(11):2407-15. doi: 10.1016/j.clinthera.2016.09.008.
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Keywords: Elderly, Patient Adherence/Compliance, Sleep Problems, Patient Self-Management
Naples JG, Gellad WF, Hanlon JT
The role of opioid analgesics in geriatric pain management.
This article reviews the epidemiology of opioid use and their effectiveness for chronic noncancer pain (CNCP) in older adults and summarizes important age-related changes in opioid pharmacokinetics and pharmacodynamics that increase the risks of adverse effects in the elderly. Finally, to assist clinicians with selecting appropriate therapy, the article concludes with an evidence-based approach to optimize opioid prescribing in older adults with CNCP.
AHRQ-funded; HS023779.
Citation: Naples JG, Gellad WF, Hanlon JT .
The role of opioid analgesics in geriatric pain management.
Clin Geriatr Med 2016 Nov;32(4):725-35. doi: 10.1016/j.cger.2016.06.006.
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Keywords: Chronic Conditions, Elderly, Medication, Opioids, Pain, Patient Safety
Harrison KL, Adrion ER, Ritchie CS
Low completion and disparities in advance care planning activities among older Medicare beneficiaries.
The researchers investigated the strength and magnitude of the relationship between sociodemographic and health characteristics of older adults and engagement in advance care planning (ACP)using logistic regression analysis and predicted probabilities. Their findings suggest that, in 2012, more than a quarter of older Medicare beneficiaries had not engaged in ACP. Those who were Latino, African American, poorly educated, or low income were at highest risk.
AHRQ-funded; HS000053.
Citation: Harrison KL, Adrion ER, Ritchie CS .
Low completion and disparities in advance care planning activities among older Medicare beneficiaries.
JAMA Intern Med 2016 Oct 31;176(12):1872-75. doi: 10.1001/jamainternmed.2016.6751.
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Keywords: Elderly, Medicare, Disparities, Social Determinants of Health
Thompson MP, Kaplan CM, Cao Y
Reliability of 30-day readmission measures used in the hospital readmission reduction program.
The researchers assessed the reliability of risk-standardized readmission rates (RSRRs) for medical conditions and surgical procedures used in the Hospital Readmission Reduction Program (HRRP). They found that approximately 25 percent of payments for excess readmissions were tied to unreliable RSRRs. Unreliable measures blur the connection between hospital performance and incentives, and threaten the success of the HRRP.
AHRQ-funded; HS023783.
Citation: Thompson MP, Kaplan CM, Cao Y .
Reliability of 30-day readmission measures used in the hospital readmission reduction program.
Health Serv Res 2016 Oct 21;51(6):2095-114. doi: 10.1111/1475-6773.12587.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Hospital Readmissions, Hospitals, Elderly, Quality Measures
Reid MC, Eccleston C, Pillemer K
Management of chronic pain in older adults.
This review summarized recent evidence on the assessment and management of pain in older patients. Evidence is taken from systematic reviews, meta-analyses, individual trials, and clinical guidelines. Based on their review, the authors argue that all older adults with chronic pain should undergo a comprehensive geriatric pain assessment and that a comprehensive assessment can guide selection of treatments most likely to benefit the patient and identify targets for intervention besides pain relief.
AHRQ-funded; HS020648.
Citation: Reid MC, Eccleston C, Pillemer K .
Management of chronic pain in older adults.
BMJ 2015;350:h532. doi: 10.1136/bmj.h532..
Keywords: Care Management, Chronic Conditions, Elderly, Comparative Effectiveness, Evidence-Based Practice, Pain
Berridge C
Breathing room in monitored space: the impact of passive monitoring technology on privacy in independent living.
The author examines articulations of the relationship between privacy and passive monitoring by users and former users of a sensor-based remote monitoring system. This research identifies where boundary intrusion can occur in the use of passive monitoring and how changes to technology design and practice could create opportunities for residents to manage their own boundaries according to their privacy needs.
AHRQ-funded; HS000011.
Citation: Berridge C .
Breathing room in monitored space: the impact of passive monitoring technology on privacy in independent living.
Gerontologist 2016 Oct;56(5):807-16. doi: 10.1093/geront/gnv034.
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Keywords: Care Management, Elderly, Health Information Technology (HIT)
Raji MY, Chen NW, Raji M
Factors associated with seeking physician care by Medicare beneficiaries who receive all their primary care from nurse practitioners.
The authors sought to examine rate and correlates of switching from exclusive nurse practitioner (NP) primary care to receiving some or all primary care from physicians. The study group consisted of Medicare beneficiaries with diabetes, congrestive heart failure, or chronic obstructive pulmonary disease. The researchers found that about half of Medicare patients under exclusive NP primary care switched to physicians for some or all primary care over a 3-year period.
AHRQ-funded; HS022134; HS020642.
Citation: Raji MY, Chen NW, Raji M .
Factors associated with seeking physician care by Medicare beneficiaries who receive all their primary care from nurse practitioners.
J Prim Care Community Health 2016 Oct;7(4):249-57. doi: 10.1177/2150131916659674.
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Keywords: Elderly, Medicare, Primary Care, Practice Patterns
Masterson Creber RM, Hickey KT, Maurer MS
Gerontechnologies for older patients with heart failure: what is the role of smartphones, tablets, and remote monitoring devices in improving symptom monitoring and self-care management?
The authors discussed the role of gerontechnologies, specifically the use of mobile applications available on smartphones and tablets as well as remote monitoring systems, for outpatient disease management among older adults with heart failure.
AHRQ-funded; HS021816.
Citation: Masterson Creber RM, Hickey KT, Maurer MS .
Gerontechnologies for older patients with heart failure: what is the role of smartphones, tablets, and remote monitoring devices in improving symptom monitoring and self-care management?
Curr Cardiovasc Risk Rep 2016 Oct;10(10). doi: 10.1007/s12170-016-0511-8.
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Keywords: Elderly, Telehealth, Health Information Technology (HIT), Heart Disease and Health, Cardiovascular Conditions, Patient Self-Management
Huo J, Lairson DR, Du XL
Hospital case volume is associated with improved survival for patients with metastatic melanoma.
This study investigated the influence of hospital case volume on malignant melanoma survival and treatment utilization. The researchers discovered that for patients diagnosed with metastatic melanoma, being treated in a high-volume hospital was associated with an improvement in survival and lower utilization of chemotherapy, immunotherapy, surgery, and radiation therapy.
AHRQ-funded; HS018956.
Citation: Huo J, Lairson DR, Du XL .
Hospital case volume is associated with improved survival for patients with metastatic melanoma.
Am J Clin Oncol 2016 Oct;39(5):491-6. doi: 10.1097/coc.0000000000000074.
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Keywords: Elderly, Hospitals, Mortality, Patient-Centered Outcomes Research, Cancer: Skin Cancer
Barile JP, Horner-Johnson W, Krahn G
Measurement characteristics for two health-related quality of life measures in older adults: the SF-36 and the CDC Healthy Days items.
This study assessed the extent to which the SF-36 and the Centers for Disease Control and Prevention (CDC) Healthy Days items measure the same aspects of health. It found that the CDC Healthy Days items measure similar domains as the SF-36 but appear to assess health-related quality of life without regard to limitations in functioning.
AHRQ-funded; HS022981.
Citation: Barile JP, Horner-Johnson W, Krahn G .
Measurement characteristics for two health-related quality of life measures in older adults: the SF-36 and the CDC Healthy Days items.
Disabil Health J 2016 Oct;9(4):567-74. doi: 10.1016/j.dhjo.2016.04.008.
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Keywords: Disabilities, Elderly, Health Status, Quality of Life
Doll JA, Hellkamp AS, Goyal A
Treatment, outcomes, and adherence to medication regimens among dual Medicare-Medicaid-eligible adults with myocardial infarction.
The purpose of the study was to examine the association of dual-eligible status with clinical outcomes and adherence to medication regimens among older adults after MI. The investigators found that compared with Medicare-only patients, older adults with dual Medicare-Medicaid eligibility presenting with MI had superior rates of medication adherence but higher rates of postdischarge readmission and adverse cardiovascular outcomes.
AHRQ-funded; HS021092.
Citation: Doll JA, Hellkamp AS, Goyal A .
Treatment, outcomes, and adherence to medication regimens among dual Medicare-Medicaid-eligible adults with myocardial infarction.
JAMA Cardiol 2016 Oct 1;1(7):787-94. doi: 10.1001/jamacardio.2016.2724..
Keywords: Elderly, Medicaid, Medicare, Medication, Heart Disease and Health, Outcomes, Patient Adherence/Compliance
Albrecht JS, Park Y, Hur P
Adherence to maintenance medications among older adults with chronic obstructive pulmonary disease. the role of depression.
The objective of this study was to assess the impact of depression on COPD maintenance medication adherence among of Medicare beneficiaries newly diagnosed with COPD. Average monthly adherence to COPD maintenance medications was low, peaking at 57 percent in the month after first fill and decreasing to 35 percent within 6 months. In the adjusted regression model, depression was associated with decreased adherence to COPD maintenance medications.
AHRQ-funded; HS024560.
Citation: Albrecht JS, Park Y, Hur P .
Adherence to maintenance medications among older adults with chronic obstructive pulmonary disease. the role of depression.
Ann Am Thorac Soc 2016 Sep;13(9):1497-504. doi: 10.1513/AnnalsATS.201602-136OC.
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Keywords: Respiratory Conditions, Elderly, Medication, Patient Adherence/Compliance, Depression
Valley TS, Sjoding MW, Goldberger ZD
ICU use and quality of care for patients with myocardial infarction and heart failure.
This study evaluated the relationship between a hospital's ICU or coronary care unit (CCU) admission rate and quality of care provided to patients with acute myocardial infarction (AMI) or heart failure (HF). It found that hospitals with the highest rates of ICU admission for patients with either of these conditions delivered lower quality of care and had higher 30-day mortality.
AHRQ-funded; HS020672.
Citation: Valley TS, Sjoding MW, Goldberger ZD .
ICU use and quality of care for patients with myocardial infarction and heart failure.
Chest 2016 Sep;150(3):524-32. doi: 10.1016/j.chest.2016.05.034.
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Keywords: Intensive Care Unit (ICU), Heart Disease and Health, Quality of Care, Elderly
Dimou FM, Adhikari D, Mehta HB
Incidence of hepaticojejunostomy stricture after hepaticojejunostomy.
The authors aimed to determine the timing, incidence, and management of stricture after biliary-enteric anastomosis. They found that younger age was associated with a decreased likelihood of stricture formation and that the presence of an endostent predicted stricture formation. They concluded that biliary-enteric anastomotic strictures occur with significant frequency after a biliary-enteric anastomosis, and that while many patients are managed nonoperatively, stricture diagnosis remains burdensome.
AHRQ-funded; HS022134.
Citation: Dimou FM, Adhikari D, Mehta HB .
Incidence of hepaticojejunostomy stricture after hepaticojejunostomy.
Surgery 2016 Sep;160(3):691-8. doi: 10.1016/j.surg.2016.05.021.
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Keywords: Surgery, Adverse Events, Digestive Disease and Health, Elderly, Patient-Centered Outcomes Research
Berry SD, Lee Y, Zullo AR
Incidence of hip fracture in U.S. nursing homes.
The researchers described the incidence rate (IR) of hip fracture according to age, sex, and race in a nationwide sample of long-stay nursing home residents. They found that the mean age was 84 years, 74.5% were women, 83.9% were white, and 12.0% were black. The overall IR of hip fracture was 2.3/100 person years, which was similar in men and women across age groups. The IR of hip fracture was highest in Native Americans aged 85 years or older, in whites, and during the first 100 days of institutionalization, while the.IRs of hip fracture were lowest in blacks.
AHRQ-funded; HS022998.
Citation: Berry SD, Lee Y, Zullo AR .
Incidence of hip fracture in U.S. nursing homes.
J Gerontol A Biol Sci Med Sci 2016 Sep;71(9):1230-4. doi: 10.1093/gerona/glw034.
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Keywords: Elderly, Injuries and Wounds, Long-Term Care, Nursing Homes, Racial and Ethnic Minorities