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
26 to 50 of 74 Research Studies DisplayedBassett SM, Cohn M, Cotten P
Feasibility and acceptability of an online positive affect intervention for those living with comorbid HIV depression.
Positive affect has unique beneficial effects on psychological and physical health, independent of the effects of negative affect. Interventions that explicitly target positive affect show promise for improving health outcomes in a number of chronic illnesses. In this article, the investigators present pilot data on the acceptability and feasibility of an online intervention to increase positive affect in those living with comorbid human immunodeficiency virus (HIV) and depression.
AHRQ-funded; HS000084.
Citation: Bassett SM, Cohn M, Cotten P .
Feasibility and acceptability of an online positive affect intervention for those living with comorbid HIV depression.
AIDS Behav 2019 Mar;23(3):753-64. doi: 10.1007/s10461-019-02412-z..
Keywords: Human Immunodeficiency Virus (HIV), Depression, Behavioral Health, Chronic Conditions, Telehealth, Health Information Technology (HIT), Outcomes
Lipira L, Nevin PE, Frey S
The positive living program: development and pilot evaluation of a multimedia behavioral intervention to address HIV-related stigma and depression among African-immigrant people living with HIV in a large, Northwestern U.S. metropolitan area.
The purpose of thisstudy was to implement the first three steps (information gathering, preliminary design, preliminary testing) in the development of a culturally-adapted multimedia behavioral intervention to reduce HIV-related stigma among African-immigrant PLWH. The investigators concluded that input from key stakeholders and observed decreases in depressive symptoms post-intervention indicated that a multimedia behavioral intervention such as The Positive Living Program could be an effective way to address poor psychosocial outcomes associated with HIV-related stigma among African-immigrant PLWH.
AHRQ-funded; HS013853.
Citation: Lipira L, Nevin PE, Frey S .
The positive living program: development and pilot evaluation of a multimedia behavioral intervention to address HIV-related stigma and depression among African-immigrant people living with HIV in a large, Northwestern U.S. metropolitan area.
J Assoc Nurses AIDS Care 2019 Mar-Apr;30(2):224-31. doi: 10.1097/jnc.0000000000000037..
Keywords: Human Immunodeficiency Virus (HIV), Social Stigma, Depression, Behavioral Health, Racial and Ethnic Minorities
Gowey MA, Khodneva Y, Tison SE
Depressive symptoms, perceived stress, and metabolic health: the REGARDS study.
The purpose of this study was to describe the relationship between metabolic health parameters and depressive symptoms and perceived stress, and determine whether the co-occurrence of these two psychological stressors had an additive influence on metabolic dysregulation in adults at different levels of body mass index (BMI) without diabetes. The investigators found that elevated depressive symptoms in conjunction with high levels of perceived stress were more strongly associated with several parameters of metabolic health than only one of these psychological constructs in a large, diverse cohort of adults.
AHRQ-funded; HS023009; HS013852.
Citation: Gowey MA, Khodneva Y, Tison SE .
Depressive symptoms, perceived stress, and metabolic health: the REGARDS study.
Int J Obes 2019 Mar;43(3):615-32. doi: 10.1038/s41366-018-0270-3..
Keywords: Depression, Behavioral Health, Obesity, Stress
Antle BF, Owen JJ, Eells TD
Dissemination of computer-assisted cognitive-behavior therapy for depression in primary care.
Computer-assisted cognitive-behavior therapy (CCBT) for depression in primary care was evaluated in a trial with 240 patients randomly assigned to CCBT or treatment as usual (TAU). The study, described in this paper, disseminated a therapy method found to be effective in psychiatric settings into primary care - a setting in which there have been significant problems in the delivery of adequate, evidence-based treatment for depression.
AHRQ-funded; HS024047.
Citation: Antle BF, Owen JJ, Eells TD .
Dissemination of computer-assisted cognitive-behavior therapy for depression in primary care.
Contemp Clin Trials 2019 Mar;78:46-52. doi: 10.1016/j.cct.2018.11.001..
Keywords: Behavioral Health, Depression, Primary Care, Treatments
Adams LB, Gottfredson N, Lightfoot AF
Factor analysis of the CES-D 12 among a community sample of black men.
The Center for Epidemiologic Studies Depression (CES-D) scale is one of the most widely used measures for assessing depression in population-based research. This study assessed the dimensional structure of the CES-D 12-item scale using exploratory and confirmatory factor analysis in a community-based sample of Black men. Findings suggested that the "effort" item from the CES-D 12 should be interpreted with caution among Black men.
AHRQ-funded; HS000032.
Citation: Adams LB, Gottfredson N, Lightfoot AF .
Factor analysis of the CES-D 12 among a community sample of black men.
Am J Mens Health 2019 Mar-Apr;13(2):1557988319834105. doi: 10.1177/1557988319834105..
Keywords: Depression, Diagnostic Safety and Quality, Men's Health, Behavioral Health, Racial and Ethnic Minorities
Kilbourne AM, Prenovost KM, Liebrecht C
Randomized controlled trial of a collaborative care intervention for mood disorders by a national commercial health plan.
This study investigated the outcomes of a collaborative care intervention for patients with mood disorders. The randomized controlled trial was conducted with Aetna insurance enrollees who were recently hospitalized for unipolar major depression or bipolar disorder. An evidence-based chronic care model (CCM) program was developed that included 10 sessions of a Life Goals self-management program and brief contacts were also made by a care manager. Outcomes measured were changes over 12 months in depression symptoms and mental health-related quality of life through two different short questionnaires. Clinical outcomes improved for patients receiving CCM although there was substantial attrition in the program.
AHRQ-funded; HS021425.
Citation: Kilbourne AM, Prenovost KM, Liebrecht C .
Randomized controlled trial of a collaborative care intervention for mood disorders by a national commercial health plan.
Psychiatr Serv 2019 Mar;70(3):219-24. doi: 10.1176/appi.ps.201800336..
Keywords: Depression, Behavioral Health, Health Insurance, Care Management, Teams, Healthcare Delivery
Iyer AS, Holm KE, Bhatt SP
Symptoms of anxiety and depression and use of anxiolytic-hypnotics and antidepressants in current and former smokers with and without COPD - a cross sectional analysis of the COPDGene cohort.
This study compared the frequency of anxiety/depressive symptoms of current and former smokers with and without COPD and their use of anxiolytic-hypnotics/antidepressants. A cohort of 5331 current/former smokers were surveyed. About 25% of smokers with and without COPD had anxiety/depressive symptoms. Unmedicated smokers tended to be African American, male, have no health insurance, have severe-very severe COPD and higher respiratory symptoms/exacerbation history.
AHRQ-funded; HS023009; HS013852.
Citation: Iyer AS, Holm KE, Bhatt SP .
Symptoms of anxiety and depression and use of anxiolytic-hypnotics and antidepressants in current and former smokers with and without COPD - a cross sectional analysis of the COPDGene cohort.
J Psychosom Res 2019 Mar;118:18-26. doi: 10.1016/j.jpsychores.2019.01.002..
Keywords: Anxiety, Medication, Respiratory Conditions, Depression, Behavioral Health, Anxiety, Tobacco Use
O'Connor E, Senger CA, Henninger ML
Interventions to prevent perinatal depression: evidence report and systematic review for the US Preventive Services Task Force.
This evidence review, funded by the U.S. Preventive Services Task Force examined if interventions to prevent perinatal depression was effective. A large number of studies were identified, and 50 were included in the review. There was an absolute difference in the risk of perinatal depression from 1.3% reduction in the control group to 31.8% greater reduction in the intervention group. Most of the studies were limited to women at increased risk for perinatal depression. Counseling interventions seemed to be the most effective.
AHRQ-funded; 290201500017I.
Citation: O'Connor E, Senger CA, Henninger ML .
Interventions to prevent perinatal depression: evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2019 Feb 12;321(6):588-601. doi: 10.1001/jama.2018.20865.
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Keywords: Depression, Evidence-Based Practice, Pregnancy, U.S. Preventive Services Task Force (USPSTF), Women, Behavioral Health, Maternal Care
Parthipan A, Banerjee I, Humphreys K
Predicting inadequate postoperative pain management in depressed patients: a machine learning approach.
Researchers employed a machine-learning approach to identify patients who were prescribed a combination of selective serotonin reuptake inhibitors (SSRIs) and prodrug opioids in order to examine the effect of this combination on postoperative pain control. They identified patients who received surgery over a 9-year period by using EHR data from an academic medical center, then developed and validated natural language processing (NLP) algorithms to extract depression-related information from both structured and unstructured data elements. The machine-learning algorithm accurately predicted the increase or decrease of the discharge, 3-week, and 8-week follow-up pain scores when compared to the pre-operative pain score; pre-operative pain, surgery type, and opioid tolerance were the strongest predictors of postoperative pain control. The researchers conclude that their study results provide the first direct clinical evidence that the known ability of SSRIs to inhibit prodrug opioid effectiveness is associated with worse pain control among depressed patients. They suggest that prescribers might choose direct acting opioids such as oxycodone or morphine for depressed patients on SSRIs instead of prodrug opioids.
AHRQ-funded; HS024096.
Citation: Parthipan A, Banerjee I, Humphreys K .
Predicting inadequate postoperative pain management in depressed patients: a machine learning approach.
PLoS One 2019 Feb 6;14(2):e0210575. doi: 10.1371/journal.pone.0210575..
Keywords: Care Management, Depression, Medication, Opioids, Pain, Surgery
Wilkinson ST, Sanacora G
A new generation of antidepressants: an update on the pharmaceutical pipeline for novel and rapid-acting therapeutics in mood disorders based on glutamate/GABA neurotransmitter systems.
This article reviews the developmental progress of compounds, including glutamate-targeting drugs, that act on amino acid neurotransmitter systems as well as their purported mechanisms of action. Evidence suggests that these systems have a central role in the pathophysiology of mood disorders. The results of this review include information on new glutamatergic/GABAergic compounds in development that show promise and may be available as approved clinical treatments in the near future. The authors also express cautious optimism regarding improvements in the antidepressant research pipeline.
AHRQ-funded; HS023000.
Citation: Wilkinson ST, Sanacora G .
A new generation of antidepressants: an update on the pharmaceutical pipeline for novel and rapid-acting therapeutics in mood disorders based on glutamate/GABA neurotransmitter systems.
Drug Discov Today 2019 Feb;24(2):606-15. doi: 10.1016/j.drudis.2018.11.007..
Keywords: Medication, Depression, Behavioral Health
Mathew SJ, Wilkinson ST, Altinay M
ELEctroconvulsive therapy (ECT) vs. Ketamine in patients with treatment-resistant depression: The ELEKT-D study protocol.
This article discusses the protocol that will be used for an ongoing study to compare electroconvulsive therapy (ECT) vs. ketamine for patients with treatment-resistant major depressive disorder (MDD). The study is being called ELEKT-D. Patients will be randomized between thrice-weekly ECT treatments or intravenous ketamine given twice weekly for 3-5 weeks. The objective of the study is to determine if ketamine will retain 90% of the ECT treatment effect. Additional outcomes to be measured include remission rates, depression severity, cognitive functioning, quality of live, adverse events, and tolerability.
AHRQ-funded; HS023000.
Citation: Mathew SJ, Wilkinson ST, Altinay M .
ELEctroconvulsive therapy (ECT) vs. Ketamine in patients with treatment-resistant depression: The ELEKT-D study protocol.
Contemp Clin Trials 2019 Feb;77:19-26. doi: 10.1016/j.cct.2018.12.009..
Keywords: Depression, Behavioral Health, Medication, Comparative Effectiveness, Patient-Centered Outcomes Research, Evidence-Based Practice
Albrecht JS, Barbour L, Abariga SA
Risk of depression after traumatic brain injury in a large national sample.
The goal of this study was to estimate the risk of depression post-traumatic brain injury (TBI) among adults 18 years of age and older and to identify risk factors associated with developing depression post-TBI. Claims data for privately insured and Medicare Advantage enrollees was used. Results showed that history of neuropsychiatric disturbances pre-TBI was the strongest predictor of depression post-TBI. The risk of depression increases substantially post-TBI. Groups at increased risk include those with a history of neuropsychiatric disturbances, older adults, and men. This study highlights the importance of long-term monitoring for depression post-TBI.
AHRQ-funded; HS024560.
Citation: Albrecht JS, Barbour L, Abariga SA .
Risk of depression after traumatic brain injury in a large national sample.
J Neurotrauma 2019 Jan 15;36(2):300-07. doi: 10.1089/neu.2017.5608..
Keywords: Depression, Behavioral Health, Brain Injury, Trauma, Risk
Payan DD, Derose KP, Fulcar MA
"It was as though my spirit left, like they killed me": the disruptive impact of an HIV-positive diagnosis among women in the Dominican Republic.
An HIV diagnosis may be associated with severe emotional and psychological distress, which can contribute to delays in care or poor self-management. In this study, the investigators conducted in-depth interviews with 30 women living with HIV in the Dominican Republic to explore the emotional, psychological, and psychosocial impacts of an HIV diagnosis on women in low-resource settings.
AHRQ-funded; HS000046.
Citation: Payan DD, Derose KP, Fulcar MA .
"It was as though my spirit left, like they killed me": the disruptive impact of an HIV-positive diagnosis among women in the Dominican Republic.
J Int Assoc Provid AIDS Care 2019 Jan-Dec;18. doi: 10.1177/2325958219849042..
Keywords: Human Immunodeficiency Virus (HIV), Diagnostic Safety and Quality, Women, Social Stigma, Depression, Behavioral Health
Ishihara M, Harel D, Levis B
Shortening self-report mental health symptom measures through optimal test assembly methods: development and validation of the Patient Health Questionnaire-Depression-4.
Researchers developed and validated a short form of the Patient Health Questionnaire-9 (PHQ-9) which assesses depression symptoms. This form was tested on 7,850 English-speaking patients enrolled in 20 diagnostic accuracy studies. The questions were optimized using Optimal test assembly (OTA) methods. Questionnaires from one to eight items were tried, with four questions found to be the optimal number with minimal loss of information compared to a full-length PHQ-9.
AHRQ-funded; HS018246.
Citation: Ishihara M, Harel D, Levis B .
Shortening self-report mental health symptom measures through optimal test assembly methods: development and validation of the Patient Health Questionnaire-Depression-4.
Depress Anxiety 2019 Jan;36(1):82-92. doi: 10.1002/da.22841..
Keywords: Depression, Diagnostic Safety and Quality, Behavioral Health
Graham AK, Minc A, Staab E
Validation of the computerized adaptive test for mental health in primary care.
This study compared the use of a computerized assessment tool with paper questionnaires to diagnose major depressive disorder (MDD) and general anxiety disorder (GAD). It was found that the majority of patients in the study preferred the computerized adaptive testing tool. Diagnostic accuracy of the tool was similar or higher than many of the traditional screening methods.
AHRQ-funded; HS000078.
Citation: Graham AK, Minc A, Staab E .
Validation of the computerized adaptive test for mental health in primary care.
Ann Fam Med 2019 Jan;17(1):23-30. doi: 10.1370/afm.2316..
Keywords: Anxiety, Depression, Diagnostic Safety and Quality, Behavioral Health, Primary Care, Screening
Cherrington AL, Khodneva Y, Richman JS
Impact of peer support on acute care visits and hospitalizations for individuals with diabetes and depressive symptoms: a cluster-randomized controlled trial.
This study examined the impact of peer support on the number of acute care visits and hospitalizations for individuals with diabetes with and without depressive symptoms. This randomized controlled trial was conducted from 2010-2012. One year of peer support was given to intervention participants, and the usual care to control participants. A Patient Health Questionnaire (PHQ-8) was given to participants to assess depression symptoms at the beginning of the trial, at 6 months and then at 12 months. There was a lower rate of acute care visits and hospitalizations in those patients with depressive symptoms in the intervention group, but it made no difference for individuals without depressive symptoms.
AHRQ-funded; HS013852.
Citation: Cherrington AL, Khodneva Y, Richman JS .
Impact of peer support on acute care visits and hospitalizations for individuals with diabetes and depressive symptoms: a cluster-randomized controlled trial.
Diabetes Care 2018 Dec;41(12):2463-70. doi: 10.2337/dc18-0550..
Keywords: Ambulatory Care and Surgery, Chronic Conditions, Depression, Diabetes, Hospitalization, Behavioral Health, Patient Self-Management
Wilkinson ST, Kiselycznyk C, Banasr M
Serum and plasma brain-derived neurotrophic factor and response in a randomized controlled trial of riluzole for treatment resistant depression.
In this paper, the authors report serum brain-derived neurotrophic factor (BDNF) and plasma BDNF levels from a randomized controlled, adjunctive, sequential parallel comparison design trial of riluzole in major depressive disorder. The investigators noted that preliminary evidence suggested that lower baseline BDNF may be associated with better clinical response to riluzole.
AHRQ-funded; HS023000.
Citation: Wilkinson ST, Kiselycznyk C, Banasr M .
Serum and plasma brain-derived neurotrophic factor and response in a randomized controlled trial of riluzole for treatment resistant depression.
J Affect Disord 2018 Dec 1;241:514-18. doi: 10.1016/j.jad.2018.08.075..
Keywords: Comparative Effectiveness, Depression, Medication, Patient-Centered Outcomes Research
Chudy-Onwugaje K, Abutaleb A, Buchwald A
Age modifies the association between depressive symptoms and adherence to self-testing with telemedicine in patients with inflammatory bowel disease.
This study researched the association between age and increased depressive symptoms and adherence to self-testing with telemedicine in patients with inflammatory bowel disease (IBD). It was found that patients 40 and older had worse adherence than patients younger than 40 with depressive symptoms.
AHRQ-funded; HS018975.
Citation: Chudy-Onwugaje K, Abutaleb A, Buchwald A .
Age modifies the association between depressive symptoms and adherence to self-testing with telemedicine in patients with inflammatory bowel disease.
Inflamm Bowel Dis 2018 Nov 29;24(12):2648-54. doi: 10.1093/ibd/izy194..
Keywords: Chronic Conditions, Depression, Digestive Disease and Health, Patient Adherence/Compliance, Patient Self-Management, Telehealth
Francis BA, Beaumont J, Mass MB
Depressive symptom prevalence after intracerebral hemorrhage: a multi-center study.
In this multi-center study, the investigators examined depressive symptom prevalence after intracerebral hemorrhage. The investigators concluded that depressive symptoms in patients with intracerebral hemorrhage (ICH) are more common than medication treatment or a coded diagnosis in a multi-center cohort, and are a potential opportunity for additional treatment to improve outcomes. There are currently no AHA/ASA treatment guidelines for depression screening of patients with ICH.
AHRQ-funded; HS023437; HS000078.
Citation: Francis BA, Beaumont J, Mass MB .
Depressive symptom prevalence after intracerebral hemorrhage: a multi-center study.
J Patient Rep Outcomes 2018 Nov 23;2(1):55. doi: 10.1186/s41687-018-0083-0..
Keywords: Depression, Patient-Centered Outcomes Research, Quality of Life
Moise N, Falzon L, Obi M
Interventions to increase depression treatment initiation in primary care patients: a systematic review.
Researchers investigated interventions for increasing depression treatment initiation in primary care settings. They found that collaborative/integrated care, preference treatment matching, and case management strategies had the best evidence for improving depression treatment initiation, but none of the strategies had high strength of evidence. While primary care settings can consider using some of these strategies when referring depressed patients to treatment, their review highlights the need for further rigorous research in this area.
AHRQ-funded; HS025198.
Citation: Moise N, Falzon L, Obi M .
Interventions to increase depression treatment initiation in primary care patients: a systematic review.
J Gen Intern Med 2018 Nov;33(11):1978-89. doi: 10.1007/s11606-018-4554-z..
Keywords: Patient-Centered Healthcare, Depression, Primary Care, Behavioral Health, Patient and Family Engagement
Burnett-Zeigler IE, Waldron EM, Hong S
Accessibility and feasibility of using technology to support mindfulness practice, reduce stress and promote long term mental health.
In this study the investigators evaluated the feasibility of using an activity monitor to support mindfulness practice, reduce self-reported stress and physiological indicators of stress. They found that there were no significant changes in self-reported stress, depression, post-traumatic stress and mindfulness from baseline to eight-weeks; pulse pressure and standard deviation of pulse pressure increased over time; and those who were high on the non-judge mindfulness subscale had a lower standard deviation pulse pressure and spent less time stressed.
AHRQ-funded; HS023011.
Citation: Burnett-Zeigler IE, Waldron EM, Hong S .
Accessibility and feasibility of using technology to support mindfulness practice, reduce stress and promote long term mental health.
Complement Ther Clin Pract 2018 Nov;33:93-99. doi: 10.1016/j.ctcp.2018.09.001..
Keywords: Depression, Health Information Technology (HIT), Behavioral Health, Patient-Centered Outcomes Research, Stress
Fry CE, Sommers BD
Effect of Medicaid expansion on health insurance coverage and access to care among adults with depression.
This quasi-experimental study sought to determine the relationship between Medicaid expansion and various health and financial outcomes among low-income adults with depression. The investigators found that Medicaid expansion was associated with a significant reduction in the proportion of adults with depression who lacked health insurance. Medicaid expansion was also associated with significant reductions in delaying care and medications because of cost.
AHRQ-funded; HS021291.
Citation: Fry CE, Sommers BD .
Effect of Medicaid expansion on health insurance coverage and access to care among adults with depression.
Psychiatr Serv 2018 Nov;69(11):1146-52. doi: 10.1176/appi.ps.201800181..
Keywords: Access to Care, Depression, Health Insurance, Medicaid, Behavioral Health
Lapham GT, Lee AK, Caldeiro RM
Prevalence of behavioral health conditions across frequency of cannabis use among adult primary care patients in Washington state.
This population-based study of primary care patients reports on the prevalence of common behavioral health conditions across cannabis use frequency. The investigators concluded that their study found a strong association between the frequency of cannabis use and tobacco use, depression symptoms, and other drug use, and as well as diagnosed mental health and substance use disorders.
AHRQ-funded; HS023173.
Citation: Lapham GT, Lee AK, Caldeiro RM .
Prevalence of behavioral health conditions across frequency of cannabis use among adult primary care patients in Washington state.
J Gen Intern Med 2018 Nov;33(11):1833-35. doi: 10.1007/s11606-018-4558-8..
Keywords: Behavioral Health, Depression, Primary Care, Substance Abuse, Tobacco Use
Lifland B, Wright DR, Mangione-Smith R
The impact of an adolescent depressive disorders clinical pathway on healthcare utilization.
The purpose of this study was to examine the association between level of adherence to an adolescent depressive disorders inpatient clinical pathway with psychiatric patients’ length of stay (LOS), cost, and readmissions. Patients in the high-adherence category were found to have significantly longer LOS and higher costs when compared to those in the low-adherence category. The authors conclude that understanding which of the care processes within the pathway are most cost-effective for improving patient-centered outcomes requires further investigation.
AHRQ-funded; HS024299.
Citation: Lifland B, Wright DR, Mangione-Smith R .
The impact of an adolescent depressive disorders clinical pathway on healthcare utilization.
Adm Policy Ment Health 2018 Nov;45(6):979-87. doi: 10.1007/s10488-018-0878-6..
Keywords: Care Management, Children/Adolescents, Depression, Healthcare Costs, Healthcare Utilization, Hospital Readmissions, Hospitalization, Inpatient Care, Behavioral Health, Outcomes, Patient-Centered Outcomes Research
Moise N, Shah RN, Essock S
Sustainability of collaborative care management for depression in primary care settings with academic affiliations across New York State.
This study examined sustainability of collaborative care management for depression in primary care settings with academic affiliations across New York State. The investigators used descriptive statistics to assess implementation metrics in sustaining vs. opt-out clinics and trends in implementation fidelity 1 and 2 years into the sustainability phase among sustaining clinics.
AHRQ-funded; HS025198
Citation: Moise N, Shah RN, Essock S .
Sustainability of collaborative care management for depression in primary care settings with academic affiliations across New York State.
Implement Sci 2018 Oct 12;13(1):128. doi: 10.1186/s13012-018-0818-6..
Keywords: Care Coordination, Depression, Behavioral Health, Primary Care