National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (1)
- Ambulatory Care and Surgery (1)
- Behavioral Health (1)
- Blood Pressure (1)
- Brain Injury (1)
- Cancer (4)
- Cancer: Lung Cancer (1)
- Cancer: Prostate Cancer (1)
- (-) Care Management (21)
- Chronic Conditions (4)
- Diabetes (2)
- Diagnostic Safety and Quality (1)
- Elderly (6)
- Electronic Health Records (EHRs) (1)
- Emergency Department (1)
- Healthcare Delivery (2)
- Healthcare Utilization (1)
- Health Information Technology (HIT) (2)
- Health Services Research (HSR) (1)
- Heart Disease and Health (1)
- Home Healthcare (1)
- Hospital Readmissions (1)
- Hospitals (1)
- Human Immunodeficiency Virus (HIV) (1)
- Inpatient Care (1)
- Kidney Disease and Health (1)
- Long-Term Care (2)
- Medicaid (1)
- Medicare (1)
- Medication (4)
- Men's Health (1)
- Nursing Homes (2)
- Opioids (3)
- Orthopedics (1)
- Outcomes (1)
- Pain (3)
- Palliative Care (2)
- Patient-Centered Healthcare (3)
- Patient-Centered Outcomes Research (2)
- Patient Adherence/Compliance (2)
- Patient Safety (1)
- Practice Patterns (3)
- Provider: Health Personnel (1)
- Quality of Care (1)
- Racial and Ethnic Minorities (1)
- Stroke (1)
- Surgery (4)
- Transitions of Care (2)
- Urban Health (1)
- Urinary Tract Infection (UTI) (1)
- Young Adults (1)
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 21 of 21 Research Studies DisplayedBowen ME, Rumana U, Kilgore EA
A user-centered glucose-insulin data display for the inpatient setting.
Researchers sought to develop a set of user-centered displays of capillary glucose data and insulin dose to improve inpatient management of insulin-dependent diabetes. Their proposed conceptual data display prototype is designed to simplify the presentation and visualization of key information needed for treatment decisions. The goal is also to enhance clinician's ability to identify opportunities to optimize insulin dosing and decrease end users' cognitive load and error rates.
AHRQ-funded; HS022895.
Citation: Bowen ME, Rumana U, Kilgore EA .
A user-centered glucose-insulin data display for the inpatient setting.
Stud Health Technol Inform 2017;245:684-88.
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Keywords: Care Management, Diabetes, Health Information Technology (HIT), Inpatient Care, Patient Safety
Khandelwal N, Curtis JR, Freedman VA
How often is end-of-life care in the United States inconsistent with patients' goals of care?
The purpose of this study was to document the proportion of bereaved respondents who reported care inconsistent with patients' wishes and characterize the predictors of end-of-life care associated with inconsistent care. The study found that one in eight respondents stated care in the last months of life was inconsistent with patients' wishes; such care was associated with worse ratings of care, pain management, and communication with clinicians.
AHRQ-funded; HS022982.
Citation: Khandelwal N, Curtis JR, Freedman VA .
How often is end-of-life care in the United States inconsistent with patients' goals of care?
J Palliat Med 2017 Dec;20(12):1400-04. doi: 10.1089/jpm.2017.0065..
Keywords: Care Management, Healthcare Delivery, Elderly, Palliative Care, Patient-Centered Healthcare, Quality of Care
Gooding HC, Brown CA, Wisk LE
Investing in our future: the importance of ambulatory visits to achieving blood pressure control in young adults.
In this commentary, the authors discuss an article written by King, et al. and published in 2017 in the Journal of Clinical Hypertension, entitled “The importance of frequent return visits and hypertension control among US young adults: a multidisciplinary group practice observational study.”
AHRQ-funded; K12 HS022986.
Citation: Gooding HC, Brown CA, Wisk LE .
Investing in our future: the importance of ambulatory visits to achieving blood pressure control in young adults.
J Clin Hypertens 2017 Dec;19(12):1298-300. doi: 10.1111/jch.13100..
Keywords: Ambulatory Care and Surgery, Care Management, Blood Pressure, Young Adults
Werner NE, Malkana S, Gurses AP
Toward a process-level view of distributed healthcare tasks: medication management as a case study.
Researchers aimed to highlight the importance of using a process-level view in analyzing distributed healthcare tasks through a case study analysis of medication management (MM). Their findings identified key cross-system characteristics not observable at the task-level: (1) identification of emergent properties (e.g., role ambiguity, loosely-coupled teams performing MM) and associated barriers; and (2) examination of barrier propagation across system boundaries.
AHRQ-funded; HS022916.
Citation: Werner NE, Malkana S, Gurses AP .
Toward a process-level view of distributed healthcare tasks: medication management as a case study.
Appl Ergon 2017 Nov;65:255-68. doi: 10.1016/j.apergo.2017.06.020.
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Keywords: Care Management, Elderly, Home Healthcare, Medication, Transitions of Care
Tedesco D, Gori D, Desai KR
Drug-free interventions to reduce pain or opioid consumption after total knee arthroplasty: a systematic review and meta-analysis.
The authors systematically reviewed and meta-analyzed evidence of nonpharmacological interventions for postoperative pain management after total knee arthroplasty. The most commonly performed interventions included in the review were continuous passive motion, preoperative exercise, cryotherapy, electrotherapy, and acupuncture. In the meta-analysis, electrotherapy and acupuncture after total knee arthroplasty were associated with reduced and delayed opioid consumption.
AHRQ-funded; HS024096.
Citation: Tedesco D, Gori D, Desai KR .
Drug-free interventions to reduce pain or opioid consumption after total knee arthroplasty: a systematic review and meta-analysis.
JAMA Surg 2017 Oct 18;152(10):e172872. doi: 10.1001/jamasurg.2017.2872.
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Keywords: Care Management, Medication, Opioids, Orthopedics, Pain, Surgery
Balaban RB, Zhang F, Vialle-Valentin CE
Impact of a patient navigator program on hospital-based and outpatient utilization over 180 days in a safety-net health system.
The objective of this study was to determine the effect of a care transition program using patient navigators (PNs) on health service utilization among high-risk safety-net patients over a 180-day period. The investigators concluded that a PN program serving high-risk safety-net patients differentially impacted patients based on age, and among younger patients, outcomes varied over time. The investigators suggest that their findings highlight the importance for future research to evaluate care transition programs among different subpopulations and over longer time peri
AHRQ-funded; HS020628.
Citation: Balaban RB, Zhang F, Vialle-Valentin CE .
Impact of a patient navigator program on hospital-based and outpatient utilization over 180 days in a safety-net health system.
J Gen Intern Med 2017 Sep;32(9):981-89. doi: 10.1007/s11606-017-4074-2..
Keywords: Care Management, Healthcare Delivery, Healthcare Utilization, Hospital Readmissions, Patient-Centered Healthcare, Transitions of Care
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
Sangha RS, Naidech AM, Corado C
Challenges in the medical management of symptomatic intracranial stenosis in an urban setting.
The researchers hypothesized that recurrent stroke risk among patients treated with aggressive medical management (AMM) is similar to that found in the medical arm of the SAMMPRIS trial (Stenting and Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis). However, results indicated that recurrent stroke risk within 30 days in patients with symptomatic intracranial atherosclerotic disease was higher than that observed in the medical arm of SAMMPRIS even in the subgroup receiving AMM.
AHRQ-funded; HS023437.
Citation: Sangha RS, Naidech AM, Corado C .
Challenges in the medical management of symptomatic intracranial stenosis in an urban setting.
Stroke 2017 Aug;48(8):2158-63. doi: 10.1161/strokeaha.116.016254.
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Keywords: Brain Injury, Urban Health, Stroke, Patient-Centered Outcomes Research, Care Management
Haymart MR, Esfandiari NH, Stang MT
Controversies in the management of low-risk differentiated thyroid cancer.
This article addresses the controversy that exists over optimal management of low-risk differentiated thyroid cancer. It discusses the fact that lack of physician consensus results in wide variation in patient care, with some patients at risk for over- or under-treatment and highlights the need to design and implement studies to address current knowledge gaps.
AHRQ-funded; HS024512.
Citation: Haymart MR, Esfandiari NH, Stang MT .
Controversies in the management of low-risk differentiated thyroid cancer.
Endocr Rev 2017 Aug 1;38(4):351-78. doi: 10.1210/er.2017-00067..
Keywords: Cancer, Care Management, Health Services Research (HSR)
Olesiuk WJ, Farley JF, Domino ME
Do medical homes offer improved diabetes care for Medicaid enrollees with co-occurring schizophrenia?
The purpose of this study was to determine whether Medicaid recipients with co-occurring diabetes and schizophrenia that are medical-home-enrolled are more likely to receive guideline-concordant diabetes care than those who are not medical-home-enrolled, controlling for confounders. The study concluded that medical-home enrollment is generally associated with greater likelihood of receiving guideline-concordant diabetes care for Medicaid enrollees with diabetes and schizophrenia.
AHRQ-funded; HS023099; HS019659; HS000032.
Citation: Olesiuk WJ, Farley JF, Domino ME .
Do medical homes offer improved diabetes care for Medicaid enrollees with co-occurring schizophrenia?
J Health Care Poor Underserved 2017;28(3):1030-41. doi: 10.1353/hpu.2017.0094..
Keywords: Care Management, Diabetes, Medicaid, Behavioral Health, Patient-Centered Healthcare
Crnich CJ, Jump RL, Nace DA
Improving management of urinary tract infections in older adults: a paradigm shift or therapeutic nihilism?
The authors address the various arguments and solutions advanced in a commentary, published in the Journal of the American Geriatrics Society, which addresses over diagnosis and overtreatment of UTI in older adults and offer several alternative solutions for this challenging clinical problem.
AHRQ-funded; HS022465.
Citation: Crnich CJ, Jump RL, Nace DA .
Improving management of urinary tract infections in older adults: a paradigm shift or therapeutic nihilism?
J Am Geriatr Soc 2017 Aug;65(8):1661-63. doi: 10.1111/jgs.14961..
Keywords: Elderly, Care Management, Urinary Tract Infection (UTI)
Smith AB, Basch E
Role of patient-reported outcomes in postsurgical monitoring in oncology.
This article describes the benefits of electronic patient-reported outcomes (ePROs) in postsurgical symptom monitoring for surgical oncology patients; ePROs can identify at-risk patients, provide closer monitoring, and provide a mechanism to identify and treat complications before they worsen. The article also summarizes the literature of ePRO use in surgical oncology.
AHRQ-funded; HS024134.
Citation: Smith AB, Basch E .
Role of patient-reported outcomes in postsurgical monitoring in oncology.
J Oncol Pract 2017 Aug;13(8):535-38. doi: 10.1200/jop.2017.023838..
Keywords: Cancer, Care Management, Health Information Technology (HIT), Electronic Health Records (EHRs), Surgery, Outcomes
Schuler MS, Joyce NR, Huskamp HA
Medicare beneficiaries with advanced lung cancer experience diverse patterns of care from diagnosis to death.
Using Medicare claims data for patients diagnosed with extensive-stage small-cell lung cancer, the authors used latent class analysis to identify classes of people with different care patterns. The findings showed substantial heterogeneity in patterns of care for patients with advanced cancer, which should be accounted for in efforts to improve end-of-life care.
AHRQ-funded; HS022998.
Citation: Schuler MS, Joyce NR, Huskamp HA .
Medicare beneficiaries with advanced lung cancer experience diverse patterns of care from diagnosis to death.
Health Aff 2017 Jul;36(7):1193-200. doi: 10.1377/hlthaff.2017.0448..
Keywords: Cancer, Cancer: Lung Cancer, Care Management, Elderly, Medicare, Palliative Care
Finnegan MA, Shaffer R, Remington A
Emergency department visits following elective total hip and knee replacement surgery: identifying gaps in continuity of care.
The researchers sought to characterize 30-day ED visits following a major joint replacement surgical procedure. They concluded that ED visits following an elective major joint replacement surgical procedure were numerous and most commonly for pain-related diagnoses. Medicaid patients had almost double the risk of an ED or pain-related ED visit following a surgical procedure.
AHRQ-funded; HS024096.
Citation: Finnegan MA, Shaffer R, Remington A .
Emergency department visits following elective total hip and knee replacement surgery: identifying gaps in continuity of care.
J Bone Joint Surg Am 2017 Jun 21;99(12):1005-12. doi: 10.2106/jbjs.16.00692.
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Keywords: Care Management, Emergency Department, Surgery
Blecker S, Meisel T, Dickson VV
"We're almost guests in their clinical care": inpatient provider attitudes toward chronic disease management.
The purpose of this study was to explore inpatient provider attitudes about chronic disease management and, in particular, barriers and facilitators of chronic disease management in the hospital. It found that a strong relationship with the outpatient provider and involvement of specialists were facilitators of inpatient chronic disease management. Providers perceived benefits to in-hospital chronic disease management for both processes of care and clinical outcomes.
AHRQ-funded; HS023683.
Citation: Blecker S, Meisel T, Dickson VV .
"We're almost guests in their clinical care": inpatient provider attitudes toward chronic disease management.
J Hosp Med 2017 Mar;12(3):162-67. doi: 10.12788/jhm.2699.
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Keywords: Care Management, Chronic Conditions, Hospitals, Provider: Health Personnel
Eifler JB, Alvarez J, Koyama T
More judicious use of expectant management for localized prostate cancer during the last 2 decades.
Urologists have been criticized for overtreating men with low risk prostate cancer and for passively observing older men with higher risk disease. Proponents of active surveillance for low risk disease and critics of watchful waiting for higher risk disease have advocated for more judicious use of observation. In this study, the investigator compared 2 population based cohorts to determine how expectant management has evolved during the last 2 decades.
AHRQ-funded; HS019356; HS022640.
Citation: Eifler JB, Alvarez J, Koyama T .
More judicious use of expectant management for localized prostate cancer during the last 2 decades.
J Urol 2017 Mar;197(3 Pt 1):614-20. doi: 10.1016/j.juro.2016.10.067..
Keywords: Cancer, Cancer: Prostate Cancer, Care Management, Diagnostic Safety and Quality, Men's Health
Fain KM, Alexander GC, Dore DD
Frequency and predictors of analgesic prescribing in U.S. nursing home residents with persistent pain.
The purpose of this study was to quantify prescription analgesic use of elderly nursing home (NH) residents with persistent noncancer pain and to identify individual and facility traits associated with no treatment. The investigators concluded that through 2008, pain remained undertreated in NHs, especially in certain subpopulations, including cognitively impaired and older residents. The authors suggest that changes in pain management practice and policies may be necessary to target these vulnerable residents.
AHRQ-funded; HS022998.
Citation: Fain KM, Alexander GC, Dore DD .
Frequency and predictors of analgesic prescribing in U.S. nursing home residents with persistent pain.
J Am Geriatr Soc 2017 Feb;65(2):286-93. doi: 10.1111/jgs.14512..
Keywords: Care Management, Chronic Conditions, Elderly, Long-Term Care, Medication, Nursing Homes, Opioids, Pain, Practice Patterns
Fain KM, Castillo-Salgado C, Dore DD
Inappropriate fentanyl prescribing among nursing home residents in the United States.
In this cross-sectional study, the investigators quantified transdermal fentanyl prescribing in elderly nursing home residents without prior opioid use or persistent pain, and the association of individual and facility traits with opioid-naive prescribing. The investigators concluded that most nursing home residents initiating transdermal fentanyl did not have persistent pain and many were opioid-naive. They suggest that changes in prescribing practices may be necessary to ensure Food and Drug Administration warnings are followed, particularly for vulnerable subgroups, such as the cognitively impaired.
AHRQ-funded; HS018960.
Citation: Fain KM, Castillo-Salgado C, Dore DD .
Inappropriate fentanyl prescribing among nursing home residents in the United States.
J Am Med Dir Assoc 2017 Feb;18(2):138-44. doi: 10.1016/j.jamda.2016.08.015..
Keywords: Care Management, Chronic Conditions, Elderly, Long-Term Care, Medication, Nursing Homes, Opioids, Pain, Practice Patterns
Schneider JA, Kozloski M, Michaels S
Criminal justice involvement history is associated with better HIV care continuum metrics among a population-based sample of young black MSM.
This study examined how history of criminal justice involvement (CJI) is related to HIV care continuum metrics among young black MSM 16-29 years of age. It found that having one CJI experience and detention for only 1 day was associated with better retention in care compared with no or more frequent CJI. Those with a previous history of CJI were more successful in achieving most HIV care continuum metrics.
AHRQ-funded; HS000084.
Citation: Schneider JA, Kozloski M, Michaels S .
Criminal justice involvement history is associated with better HIV care continuum metrics among a population-based sample of young black MSM.
AIDS 2017 Jan 2;31(1):159-65. doi: 10.1097/qad.0000000000001269.
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Keywords: Care Management, Human Immunodeficiency Virus (HIV), Patient Adherence/Compliance, Racial and Ethnic Minorities
Cooper LB, Hammill BG, Peterson ED
Characterization of mineralocorticoid receptor antagonist therapy initiation in high-risk patients with heart failure.
Heart failure guidelines recommend routine monitoring of serum potassium, and renal function in patients treated with a mineralocorticoid receptor antagonist (MRA). This study found that patients initiated on MRA therapy as an outpatient had extremely poor rates of guideline indicated follow-up laboratory monitoring after drug initiation. In particular, patients with chronic kidney disease were at high risk for adverse events after MRA initiation.
AHRQ-funded; HS021092.
Citation: Cooper LB, Hammill BG, Peterson ED .
Characterization of mineralocorticoid receptor antagonist therapy initiation in high-risk patients with heart failure.
Circ Cardiovasc Qual Outcomes 2017 Jan;10(1):pii: e002946. doi: 10.1161/circoutcomes.116.002946.
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Keywords: Care Management, Heart Disease and Health, Kidney Disease and Health, Adverse Drug Events (ADE), Patient Adherence/Compliance
Lou I, Balentine C, Clarkson S
How long should we follow patients after apparently curative parathyroidectomy?
This study aimed to evaluate the risk of recurrent hyperparathyroidism in the 10 years after operation. It evaluated 196 patients with a 14.8 percent 10-year recurrence rate. It found that median time to recurrence was 6.3 years and 34.5 percent of all recurrences were identified more than 10 years after operation.
AHRQ-funded; HS023009.
Citation: Lou I, Balentine C, Clarkson S .
How long should we follow patients after apparently curative parathyroidectomy?
Surgery 2017 Jan;161(1):54-61. doi: 10.1016/j.surg.2016.05.049.
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Keywords: Care Management, Patient-Centered Outcomes Research, Surgery