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
51 to 71 of 71 Research Studies DisplayedShortell 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
Bowen ME, Xuan L, Lingvay I
Performance of a random glucose case-finding strategy to detect undiagnosed diabetes.
This study describes a case-finding approach using non-diagnostic random glucose values to identify individuals in need of diabetes testing and compares its performance to current screening guidelines. Using random glucose >/=100 mg/dL to identify individuals in need of diabetes, it determined that screening is highly sensitive and specific, performing better than current screening guidelines. Case-finding strategies informed by random glucose data may improve diabetes detection.
AHRQ-funded; HS022418.
Citation: Bowen ME, Xuan L, Lingvay I .
Performance of a random glucose case-finding strategy to detect undiagnosed diabetes.
Am J Prev Med 2017 Jun;52(6):710-16. doi: 10.1016/j.amepre.2017.01.023.
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Keywords: Diabetes, Diagnostic Safety and Quality, Risk, Screening
Waldfogel JM, Nesbit SA, Dy SM
Pharmacotherapy for diabetic peripheral neuropathy pain and quality of life: a systematic review.
This review systematically assessed the effect of pharmacologic treatments of diabetic peripheral neuropathy (DPN) on pain and quality of life. It concluded that for reducing pain, duloxetine and venlafaxine, pregabalin and oxcarbazepine, tricyclic antidepressants, atypical opioids, and botulinum toxin were more effective than placebo. However, quality of life was poorly reported, studies were short-term, drugs had substantial dropout rates, and opioids have significant risks.
AHRQ-funded; 2902015000061.
Citation: Waldfogel JM, Nesbit SA, Dy SM .
Pharmacotherapy for diabetic peripheral neuropathy pain and quality of life: a systematic review.
Neurology 2017 May 16;88(20):1958-67. doi: 10.1212/wnl.0000000000003882.
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Keywords: Diabetes, Chronic Conditions, Medication, Quality of Life, Patient-Centered Outcomes Research
Shah NR, Cheezum MK, Veeranna V
Ranolazine in symptomatic diabetic patients without obstructive coronary artery disease: impact on microvascular and diastolic function.
The primary aim of this study was to determine whether ranolazine would quantitatively improve exercise-stimulated myocardial blood flow and cardiac function in symptomatic diabetic patients without obstructive coronary artery disease. The investigators found that in symptomatic diabetic patients without obstructive coronary artery disease, ranolazine did not change exercise-stimulated myocardial blood flow or CFR but did modestly improve diastolic function.
AHRQ-funded; HS022998.
Citation: Shah NR, Cheezum MK, Veeranna V .
Ranolazine in symptomatic diabetic patients without obstructive coronary artery disease: impact on microvascular and diastolic function.
J Am Heart Assoc 2017 May 4;6(5). doi: 10.1161/jaha.116.005027..
Keywords: Cardiovascular Conditions, Diabetes, Medication, Patient-Centered Outcomes Research
Carlson AE, Aronson BD, Unzen M
Apathy and type 2 diabetes among American Indians: exploring the protective effects of traditional cultural involvement.
In this study researchers examined relationships between traditional cultural factors, apathy, and health-related outcomes among a sample of American Indian adults with type 2 diabetes. Their model revealed significant direct effects from cultural participation to apathy, and apathy to both health-related outcomes. Cultural participation had a negative indirect effect through apathy on high blood sugar and positive indirect effects on health-related quality of life.
AHRQ-funded; HS024180.
Citation: Carlson AE, Aronson BD, Unzen M .
Apathy and type 2 diabetes among American Indians: exploring the protective effects of traditional cultural involvement.
J Health Care Poor Underserved 2017;28(2):770-83. doi: 10.1353/hpu.2017.0073.
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Keywords: Cultural Competence, Diabetes, Racial and Ethnic Minorities, Patient-Centered Outcomes Research, Racial and Ethnic Minorities
Gabriel MH, Powers C, Encinosa W
AHRQ Author: Encinosa W
E-prescribing and adverse drug events: an observational study of the Medicare part D population with diabetes.
The researchers examined the impact of e-prescribing on emergency visits or hospitalizations for diabetes-related adverse drug events (ADEs) including hypoglycemia. They concluded that at the e-prescribing threshold of 75 percent and above, there were significant reductions in ADE risk.
AHRQ-authored.
Citation: Gabriel MH, Powers C, Encinosa W .
E-prescribing and adverse drug events: an observational study of the Medicare part D population with diabetes.
Med Care 2017 May;55(5):456-62. doi: 10.1097/mlr.0000000000000684.
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Keywords: Adverse Drug Events (ADE), Electronic Prescribing (E-Prescribing), Diabetes, Medicare, Medication
Karter AJ, Lipska KJ, O'Connor PJ
High rates of severe hypoglycemia among African American patients with diabetes: the Surveillance, Prevention, and Management of Diabetes Mellitus (SUPREME-DM) network.
This seven-year surveillance study (2005-2011) evaluated race/ethnic differences in the trends in rates of severe hypoglycemia (SH) in a population of insured, at-risk adults with diabetes. Annual SH rates ranged from 1.8 percent to 2.1 percent during this 7-year observation period. African Americans had consistently higher SH rates compared with Whites, while Latinos and Asians had consistently lower rates compared with Whites in each of the 7 years.
AHRQ-funded; HS019859.
Citation: Karter AJ, Lipska KJ, O'Connor PJ .
High rates of severe hypoglycemia among African American patients with diabetes: the Surveillance, Prevention, and Management of Diabetes Mellitus (SUPREME-DM) network.
J Diabetes Complications 2017 May;31(5):869-73. doi: 10.1016/j.jdiacomp.2017.02.009.
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Keywords: Chronic Conditions, Diabetes, Healthcare Delivery, Health Status, Racial and Ethnic Minorities
Goins RT, Noonan C, Gonzales K
Association of depressive symptomology and psychological trauma with diabetes control among older American Indian women: does social support matter?
Among older American Indian women with type 2 diabetes (T2DM), the researchers examined the association between mental health and T2DM control and if social support modifies the association. They found that there was not a significant association between depressive symptomatology and higher HbA1c although increased depressive symptomatology was associated with higher HbA1c values among participants with low social support.
AHRQ-funded; HS000078.
Citation: Goins RT, Noonan C, Gonzales K .
Association of depressive symptomology and psychological trauma with diabetes control among older American Indian women: does social support matter?
J Diabetes Complications 2017 Apr;31(4):669-74. doi: 10.1016/j.jdiacomp.2017.01.004.
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Keywords: Diabetes, Elderly, Behavioral Health, Racial and Ethnic Minorities, Trauma
Palta P, Huang ES, Kalyani RR
Hemoglobin A1c and mortality in older adults with and without diabetes: Results from the National Health and Nutrition Examination Surveys (1988-2011).
In this paper, the investigators sought to estimate the risk of mortality by HbA1c levels among older adults with and without diabetes. They concluded that an HbA1c >8.0% was associated with increased risk of all-cause and cause-specific mortality in older adults with diabetes. The investigators suggest that their results support the idea that better glycemic control is important for reducing mortality; however, they also indicate that there is a need for individualized glycemic targets for older adults with diabetes depending on their demographics, duration of diabetes, and existing comorbidities.
AHRQ-funded; HS018542.
Citation: Palta P, Huang ES, Kalyani RR .
Hemoglobin A1c and mortality in older adults with and without diabetes: Results from the National Health and Nutrition Examination Surveys (1988-2011).
Diabetes Care 2017 Apr;40(4):453-60. doi: 10.2337/dci16-0042.
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Keywords: Cancer, Cardiovascular Conditions, Diabetes, Elderly, Mortality, Risk
Gunter KE, Nocon RS, Gao Y
Medical home characteristics and quality of diabetes care in safety net clinics.
The researchers examined associations between patient-centered medical home (PCMH) characteristics and quality of diabetes care in 15 safety net clinics in five states. They found that PCMH characteristics had mixed, inconsistent associations with the quality of diabetes care. The PCMH model may require refinement in design and implementation to improve diabetes care among vulnerable populations.
AHRQ-funded; HS000084.
Citation: Gunter KE, Nocon RS, Gao Y .
Medical home characteristics and quality of diabetes care in safety net clinics.
J Community Health 2017 Apr;42(2):303-11. doi: 10.1007/s10900-016-0256-9.
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Keywords: Diabetes, Patient-Centered Healthcare, Quality of Care, Chronic Conditions
Maciejewski ML, Hammill BG, Bayliss EA
Prescriber continuity and disease control of older adults.
The objective of this study was to examine whether glycemic control or lipid control was associated with the number of prescribers of cardiometabolic medications. It concluded that multiple prescribers were associated with worse disease control, possibly because patients with more severe diabetes or dyslipidemia have multiple prescribers or because care fragmentation is associated with worse disease control.
AHRQ-funded; HS023085.
Citation: Maciejewski ML, Hammill BG, Bayliss EA .
Prescriber continuity and disease control of older adults.
Med Care 2017 Apr;55(4):405-10. doi: 10.1097/mlr.0000000000000658.
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Keywords: Elderly, Medication, Diabetes, Patient Adherence/Compliance, Healthcare Delivery
Tung EL, Baig AA, Huang ES
Racial and ethnic disparities in diabetes screening between asian americans and other adults: BRFSS 2012-2014.
The researchers assessed racial and ethnic disparities in diabetes screening between Asian Americans and other adults. They found that Asian Americans were the least likely racial and ethnic group to receive recommended diabetes screening. Overall, Asian Americans had 34 percent lower adjusted odds of receiving recommended diabetes screening compared to non-Hispanic whites.
AHRQ-funded; HS000078.
Citation: Tung EL, Baig AA, Huang ES .
Racial and ethnic disparities in diabetes screening between asian americans and other adults: BRFSS 2012-2014.
J Gen Intern Med 2017 Apr;32(4):423-29. doi: 10.1007/s11606-016-3913-x.
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Keywords: Racial and Ethnic Minorities, Diabetes, Screening, Disparities, Prevention
Brennan MB, Hess TM, Bartle B
Diabetic foot ulcer severity predicts mortality among veterans with type 2 diabetes.
Diabetic foot ulcers are associated with an increased risk of death. This study evaluated whether ulcer severity at presentation predicts mortality. It concluded that initial diabetic foot ulcer severity is a more significant predictor of subsequent mortality than coronary artery disease, peripheral arterial disease, or stroke.
AHRQ-funded; HS018542.
Citation: Brennan MB, Hess TM, Bartle B .
Diabetic foot ulcer severity predicts mortality among veterans with type 2 diabetes.
J Diabetes Complications. 2017 Mar;31(3):556-561. doi: 10.1016/j.jdiacomp.2016.11.020..
Keywords: Diabetes, Mortality, Chronic Conditions, Pressure Ulcers
Flory J
Will cardiovascular outcomes data on newer diabetes drugs bury the older agents?
This paper comments on the variety of drug treatment options for patients with type 2 diabetes. The authors assert that the FDA has an opportunity to champion public health because the agency exerts great influence on how type 2 diabetes drugs are studied. The authors also suggest that the FDA’s influence and regulatory powers should be used to improve the health of patients with diabetes who now face many uninformed choices between newer and older drugs.
AHRQ-funded; HS023898.
Citation: Flory J .
Will cardiovascular outcomes data on newer diabetes drugs bury the older agents?
JAMA Intern Med 2017 Mar;177(3):301-02. doi: 10.1001/jamainternmed.2016.8284..
Keywords: Cardiovascular Conditions, Diabetes, Medication
Huguet N, Angier H, Marino M
Protocol for the analysis of a natural experiment on the impact of the Affordable Care Act on diabetes care in community health centers.
It is hypothesized that Affordable Care Act (ACA) Medicaid expansions could substantially improve access to health insurance and healthcare services for patients at risk for diabetes mellitus (DM), with pre-DM, or already diagnosed with DM. Data collection will include information on changes in health insurance, service receipt, and health outcomes, spanning 9 years (pre- and post-expansion), comparing states that expanded Medicaid, and those that did not.
AHRQ-funded; HS024270.
Citation: Huguet N, Angier H, Marino M .
Protocol for the analysis of a natural experiment on the impact of the Affordable Care Act on diabetes care in community health centers.
Implement Sci 2017 Feb 10;12(1):14. doi: 10.1186/s13012-017-0543-6.
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Keywords: Diabetes, Policy, Access to Care, Health Insurance
Makam AN, Nguyen OK
An evidence-based medicine approach to antihyperglycemic therapy in diabetes mellitus to overcome overtreatment.
This article discusses the importance of (1) using absolute rather than relative estimates of benefits to inform treatment decisions; (2) considering the time horizon to benefit of treatments; (3) balancing potential harms and benefits; and (4) using shared decision making by physicians to incorporate the patient's values and preferences into treatment decisions.
AHRQ-funded; HS022418.
Citation: Makam AN, Nguyen OK .
An evidence-based medicine approach to antihyperglycemic therapy in diabetes mellitus to overcome overtreatment.
Circulation 2017 Jan 10;135(2):180-95. doi: 10.1161/circulationaha.116.022622.
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Keywords: Shared Decision Making, Diabetes, Evidence-Based Practice, Patient and Family Engagement, Patient-Centered Outcomes Research
Sarkar U, Lyles C, Steinman M
Changes in medication use after dementia diagnosis in an observational cohort of individuals with diabetes mellitus.
The researchers assessed changes in medication use after a diagnosis of dementia in individuals with type 2 diabetes mellitus. After adjustment, the number of chronic medications and the subset of cardiovascular medications declined after a dementia diagnosis in the overall cohort and in age-, sex-, and time-matched reference individuals, but the decline was significantly greater in the group with dementia.
AHRQ-funded; HS023558.
Citation: Sarkar U, Lyles C, Steinman M .
Changes in medication use after dementia diagnosis in an observational cohort of individuals with diabetes mellitus.
J Am Geriatr Soc 2017 Jan;65(1):77-82. doi: 10.1111/jgs.14429.
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Keywords: Medication, Diabetes, Dementia, Elderly, Healthcare Utilization
Saeed MJ, Olsen MA, Powderly WG
Diabetes mellitus is associated with higher risk of developing decompensated cirrhosis in chronic hepatitis C patients.
This study investigated the association of diabetes with risk of decompensated cirrhosis in patients with chronic hepatitis C (CHC). In a privately insured US population with CHC, the rates of decompensated cirrhosis per 1000 person-years were: 185.5 for persons with baseline cirrhosis and diabetes, 119.8 for persons with cirrhosis and no diabetes, 35.3 for persons with no cirrhosis and diabetes, and 17.1 for persons with no cirrhosis and no diabetes.
AHRQ-funded; HS019455.
Citation: Saeed MJ, Olsen MA, Powderly WG .
Diabetes mellitus is associated with higher risk of developing decompensated cirrhosis in chronic hepatitis C patients.
J Clin Gastroenterol 2017 Jan;51(1):70-76. doi: 10.1097/mcg.0000000000000566.
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Keywords: Chronic Conditions, Diabetes, Hepatitis, Risk
Flory JH, Roy J, Gagne JJ
Missing laboratory results data in electronic health databases: implications for monitoring diabetes risk.
Researchers assessed the value of lab results added to diagnosis codes and dispensing claims to identify incident diabetes. Inclusion of lab results increased the number of diabetes outcomes identified by 21 percent. In settings where capture of lab results was relatively complete, the absence of lab results was associated with implausibly low rates of the outcome.
AHRQ-funded; HS023898.
Citation: Flory JH, Roy J, Gagne JJ .
Missing laboratory results data in electronic health databases: implications for monitoring diabetes risk.
J Comp Eff Res 2017 Jan;6(1):25-32. doi: 10.2217/cer-2016-0033.
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Keywords: Diabetes, Diagnostic Safety and Quality, Electronic Health Records (EHRs)
Leung MY, Carlsson NP, Colditz GA
The burden of obesity on diabetes in the United States: Medical Expenditure Panel Survey, 2008 to 2012.
The researchers analyzed the risk of developing diabetes and the annual cost of diabetes for a US general population. Their results suggested that the annual health care expenditure differentials between those with and without diabetes of age 50 years were the highest for individuals with class II ($12,907) and class III ($9,703) obesity.
AHRQ-funded; HS022330.
Citation: Leung MY, Carlsson NP, Colditz GA .
The burden of obesity on diabetes in the United States: Medical Expenditure Panel Survey, 2008 to 2012.
Value Health 2017 Jan;20(1):77-84. doi: 10.1016/j.jval.2016.08.735.
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Keywords: Medical Expenditure Panel Survey (MEPS), Obesity, Diabetes, Healthcare Costs, Risk
Sohn MW, Epstein N, Huang ES
Visit-to-visit systolic blood pressure variability and microvascular complications among patients with diabetes.
This study examined the relationship between systolic blood pressure (SBP) variability and the risk of microvascular complications in a non-elderly diabetic population. Compared to individuals with the least SBP variability (Quartile 1), those with most variability (Quartile 4) had 81 percent and 19 percent higher incidence of nephropathy, retinopathy, neuropathy, and any complication, respectively, after adjusting for mean SBP, demographic and clinical factors.
AHRQ-funded; HS018542.
Citation: Sohn MW, Epstein N, Huang ES .
Visit-to-visit systolic blood pressure variability and microvascular complications among patients with diabetes.
J Diabetes Complications 2017 Jan;31(1):195-201. doi: 10.1016/j.jdiacomp.2016.09.003.
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Keywords: Blood Pressure, Diabetes, Risk, Chronic Conditions