National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
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- Back Health and Pain (2)
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- Patient and Family Engagement (1)
- Patient Experience (1)
- Practice Patterns (1)
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- Racial and Ethnic Minorities (3)
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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 14 of 14 Research Studies DisplayedBajaj JS, Duarte-Rojo A, Xie JJ
Minimal hepatic encephalopathy and mild cognitive impairment worsen quality of life in elderly patients with cirrhosis.
Researchers investigated the performance of elderly patients with cirrhosis on tests for minimal hepatic encephalopathy (MHE) and predementia mild cognitive impairment (MCI) and their effects on quality of life (QOL). They found that, in a multicenter study of elderly patients with cirrhosis and controls, the presence of MHE, regardless of MCI, was associated with poor cognition and QOL. They created adjusted norms that defined the high sensitivity of EncephalApp for the detection of MHE in older individuals and validated it in a separate cohort.
AHRQ-funded; HS025412.
Citation: Bajaj JS, Duarte-Rojo A, Xie JJ .
Minimal hepatic encephalopathy and mild cognitive impairment worsen quality of life in elderly patients with cirrhosis.
Clin Gastroenterol Hepatol 2020 Dec;18(13):3008-16.e2. doi: 10.1016/j.cgh.2020.03.033..
Keywords: Elderly, Chronic Conditions, Quality of Life, Dementia, Neurological Disorders
Romman AN, Hsu CM, Chou LN
Opioid prescribing to Medicare Part D enrollees, 2013-2017: shifting responsibility to pain management providers.
This study looked at trends in opioid prescribing frequency to Medicare Part D enrollees from 2013 to 2017 by medical specialty and provider type. The authors analyzed opioid claims and prescribing trends for specialties accounting for ≥1% of all opioid claims. Pain management specialists increased Medicare Part D opioid claims by 27.3% to 1,140 mean claims per provider in 2017. Physical medicine and rehabilitation providers increased claims by 16.9% to 511 mean claims per provider in 2017. All other medical specialties decreased opioid claims during this period, with emergency medicine decreasing the most (-19.9%) and orthopedic surgery (-16%) dropping opioid claims the most of all the other specialties. Overall physician decrease was -5.2%. However opioid claims among dentists (+5.6%) and nonphysician providers (+10.2%) increased during this period.
AHRQ-funded; HS020642.
Citation: Romman AN, Hsu CM, Chou LN .
Opioid prescribing to Medicare Part D enrollees, 2013-2017: shifting responsibility to pain management providers.
Pain Med 2020 Nov 7;21(7):1400-07. doi: 10.1093/pm/pnz344..
Keywords: Elderly, Opioids, Medication, Medicare, Pain, Chronic Conditions, Practice Patterns
Odlum M, Moise N, Kronish IM
Trends in poor health indicators among Black and Hispanic middle-aged and older adults in the United States, 1999-2018.
This study used records extracted from the Behavioral Risk Factor Surveillance System to determine which health indicators have improved or became worse among Black and Hispanic middle-aged (45 and older) adults compared to Whites from 1999 to 2018. This data is required by the Minority Health and Health Disparities Research and Education Act of 2000. A sample included of 4,856,326 participants, of them 60.9% women, mean age 60.4. During the last 20 years, Black adults showed an overall decrease showing improvement in uninsured status and physical inactivity while showing an overall increase in hypertension, diabetes, asthma, and stroke, and also the same increases and decreases in the Black-White gap. Hispanic adults showed improvement in physical inactivity and perceived poor health, while they showed overall deterioration in hypertension and diabetes. The Hispanic-White gap improved in coronary heart disease, stroke, kidney disease, asthma, arthritis, depression and physical inactivity while it increased for diabetes, hypertension, and uninsured status.
AHRQ-funded; HS025198.
Citation: Odlum M, Moise N, Kronish IM .
Trends in poor health indicators among Black and Hispanic middle-aged and older adults in the United States, 1999-2018.
JAMA Netw Open 2020 Nov 2;3(11):e2025134. doi: 10.1001/jamanetworkopen.2020.25134..
Keywords: Elderly, Racial and Ethnic Minorities, Disparities, Health Status, Health Insurance, Diabetes, Blood Pressure, Chronic Conditions
Dos Santos Marques IC, Theiss LM, Baker SJ
Low health literacy exists in the inflammatory bowel disease (IBD) population and is disproportionately prevalent in older African Americans.
This study assessed the prevalence of low health literacy rates among adult patients with inflammatory bowel disease (IBD) in a diverse population and identified risk factors for low health literacy. IBD patients at a single institution from November 2017 to May 2018 were assessed for health literacy using the Newest Vital Sign (NWS). Secondary outcomes were length-of-stay (LOS) and 30-day readmissions after surgery. There were 175 patients surveyed who were 59% female, 23% African Americans, 91% with Crohn’s disease, and mean age was 46. Overall the low health literacy rate was 24%, with African Americans having a higher prevalence (47.5%) versus 17.0% for white IBD patients. Low health literacy was associated with older age and African American race. There were no significant differences between LOS and readmissions rates by health literacy levels.
AHRQ-funded; HS023009.
Citation: Dos Santos Marques IC, Theiss LM, Baker SJ .
Low health literacy exists in the inflammatory bowel disease (IBD) population and is disproportionately prevalent in older African Americans.
Crohns Colitis 360 2020 Oct;2(4). doi: 10.1093/crocol/otaa076..
Keywords: Elderly, Health Literacy, Digestive Disease and Health, Racial and Ethnic Minorities, Chronic Conditions
Nayfe R, Chansard M, Hynan LS
Comparison of patient-reported outcomes measurement information system and legacy instruments in multiple domains among older veterans with chronic back pain.
This study evaluated construct (convergent and discriminant) validity and time to complete NIH's Patient Reported Outcomes Measurement Information System (PROMIS) as compared to legacy instruments. Results showed that, given time efficiency of using PROMIS, along with strong construct validity, PROMIS instruments are a practical choice for measuring multidimensional patient-reported outcomes in older Veterans with chronic low back pain for both research and clinical purposes.
AHRQ-funded; HS022418.
Citation: Nayfe R, Chansard M, Hynan LS .
Comparison of patient-reported outcomes measurement information system and legacy instruments in multiple domains among older veterans with chronic back pain.
BMC Musculoskelet Disord 2020 Sep 8;21(1):598. doi: 10.1186/s12891-020-03587-6..
Keywords: Elderly, Back Health and Pain, Pain, Chronic Conditions, Patient-Centered Outcomes Research, Research Methodologies
Iyer AS, Goodrich CA, Dransfield MT
End-of-life spending and healthcare utilization among older adults with chronic obstructive pulmonary disease.
This study examined end-of-life spending and healthcare utilization among Medicare beneficiaries aged 65 years or older with chronic obstructive pulmonary disease (COPD) who died during the period 2013-2014. Data on 146,240 decedents with COPD was investigated from 306 hospital referral regions (HRRs). The overall spending during the last 2 years of life varied significantly nationwide. Inpatient care accounted for 40.2% of spending, with 82% of decedents admitted to the hospital for 13.7±3.1 days and 55%±11% admitted to an intensive care unit for 3-7 days. Skilled nursing facilities accounted for 11.6% of spending and were utilized by 31-45% of decedents for 14-23 days. Hospitals were utilized by 39-56% of decedents and accounted for 10.3% of spending.
AHRQ-funded; HS023009.
Citation: Iyer AS, Goodrich CA, Dransfield MT .
End-of-life spending and healthcare utilization among older adults with chronic obstructive pulmonary disease.
Am J Med 2020 Jul;133(7):817-24.e1. doi: 10.1016/j.amjmed.2019.11.024..
Keywords: Elderly, Healthcare Utilization, Respiratory Conditions, Chronic Conditions, Healthcare Costs, Palliative Care
Nahm ES, Son H, Yoon JM
Older adults' use of patient portals: experiences, challenges, and suggestions shared through discussion board forums.
The goal of this study was to explore older adults' experiences with using patient portals (PPs), perceived impact of PPs on their health, and suggestions for improvement through analysis of discussion posts. The research team had previously developed an older-adult-friendly Theory-based PP eLearning Program (T-PeP), and tested its impact on older adults with chronic conditions. Findings from 10 major themes explained older adults' experiences with PPs and offered suggestions for vendors and healthcare organizations.
AHRQ-funded; HS024739.
Citation: Nahm ES, Son H, Yoon JM .
Older adults' use of patient portals: experiences, challenges, and suggestions shared through discussion board forums.
Geriatr Nurs 2020 Jul-Aug;41(4):387-93. doi: 10.1016/j.gerinurse.2019.12.001..
Keywords: Elderly, Health Information Technology (HIT), Chronic Conditions, Care Management, Patient and Family Engagement, Education: Patient and Caregiver
Singh M, Duarte AG, Hsu ES
Trends and factors associated with nebulized therapy prescription in older adults with chronic obstructive pulmonary disease from 2008 to 2015.
Medical management of patients with chronic obstructive pulmonary disease (COPD) includes nebulized therapy as an option for inhalational drug delivery. A broad variety of short- and long-acting bronchodilators and inhaled corticosteroids in the nebulized form are available. Despite this, limited information exists on the pattern and predictors of nebulized prescription. In this retrospective cross-sectional study, the investigators examined the trend and factors associated with prescription of nebulized therapy among Medicare beneficiaries with COPD.
AHRQ-funded; HS020642.
Citation: Singh M, Duarte AG, Hsu ES .
Trends and factors associated with nebulized therapy prescription in older adults with chronic obstructive pulmonary disease from 2008 to 2015.
J Aerosol Med Pulm Drug Deliv 2020 Jun;33(3):161-69. doi: 10.1089/jamp.2019.1582..
Keywords: Elderly, Respiratory Conditions, Chronic Conditions, Medication
Rundell SD, Resnik L, Heagerty PJ
Comparing the performance of comorbidity indices in predicting functional status, health-related quality of life, and total health care use in older adults with back pain.
The purpose of this prospective cohort study was to determine how well the functional comorbidity index (FCI) predicted outcomes in older adults with back pain compared to Quan's modification of the Charlson comorbidity index (Quan-Charlson comorbidity index) and the Elixhauser comorbidity index. The investigators concluded that all indices performed similarly in predicting outcomes. The authors indicated that there is still a need to develop better function-based risk-adjustment models that improve prediction of functional outcomes versus standard comorbidity indices.
AHRQ-funded; HS019222; HS022972.
Citation: Rundell SD, Resnik L, Heagerty PJ .
Comparing the performance of comorbidity indices in predicting functional status, health-related quality of life, and total health care use in older adults with back pain.
J Orthop Sports Phys Ther 2020 Mar;50(3):143-48. doi: 10.2519/jospt.2020.8764..
Keywords: Elderly, Back Health and Pain, Pain, Chronic Conditions, Quality of Life, Healthcare Utilization, Health Status
Naylor MD, Hirschman KB, Toles MP
Adaptations of the evidence-based Transitional Care Model in the U.S.
The goal of this study was to describe and classify common local adaptations of the evidence-based intervention Transitional Care Model (TCM); this model is comprised of 10 components that have been proven in multiple clinical trials to improve care and outcomes for chronically ill older adults who are transitioning home from hospitals. 582 U.S.-based transitional care clinicians in health systems and community-based organizations were asked to complete a survey, then researchers interviewed a subset of survey respondents regarding implementation of TCM in their distinct organizations. The results suggest hypotheses that can be used to guide rigorous examination of the association between adaptations of TCM components and desired outcomes, and reinforce a need for investment in adaptation science.
AHRQ-funded; HS022406.
Citation: Naylor MD, Hirschman KB, Toles MP .
Adaptations of the evidence-based Transitional Care Model in the U.S.
Soc Sci Med 2018 Sep;213:28-36. doi: 10.1016/j.socscimed.2018.07.023..
Keywords: Elderly, Chronic Conditions, Evidence-Based Practice, Transitions of Care
Iyer AS, Benzo RP, Bakitas MA
Easing the tension between palliative care and intensive care in chronic obstructive pulmonary disease.
This editorial discusses palliative care and intensive care in chronic obstructive pulmonary disease and comments on an article by Shen, et al., published, in 2018, in the Journal of Palliative Care, entitled “Life-sustaining procedures, palliative care consultation, and do-not resuscitate status in dying patients with COPD in US hospitals: 2010-2014.”
AHRQ-funded; HS023009.
Citation: Iyer AS, Benzo RP, Bakitas MA .
Easing the tension between palliative care and intensive care in chronic obstructive pulmonary disease.
J Palliat Care 2018 Jul;33(3):123-24. doi: 10.1177/0825859718782505..
Keywords: Chronic Conditions, Respiratory Conditions, Critical Care, Elderly, Palliative Care, Quality of Care
Collins DM, Downer B, Kumar A
Impact of multiple chronic conditions on activity limitations among older Mexican-American care recipients.
The authors examined the impact of multiple chronic conditions on basic activities of daily living (ADL) and instrumental activities of daily living (IADL) limitations. They found that care recipients with three or more chronic conditions had higher odds of having mobility limitations, self-care limitations, more than three ADL limitations, and more than three IADL limitations.
AHRQ-funded; HS022134.
Citation: Collins DM, Downer B, Kumar A .
Impact of multiple chronic conditions on activity limitations among older Mexican-American care recipients.
Prev Chronic Dis 2018 May 3;15:E51. doi: 10.5888/pcd15.170358.
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Keywords: Chronic Conditions, Elderly, Lifestyle Changes, Racial and Ethnic Minorities
DuGoff EH
Continuity of care in older adults with multiple chronic conditions: how well do administrative measures correspond with patient experiences?
The objective of this study was to assess the concordance of administrative continuity indices and patient reports of continuity among older adults with multiple chronic conditions (MCCs). The investigators concluded that among older adults with two or more conditions, the Usual Provider of Care Index was not associated with any patient experience measure; Continuity of Care Index was associated with informational and management continuity items.
AHRQ-funded; HS000029.
Citation: DuGoff EH .
Continuity of care in older adults with multiple chronic conditions: how well do administrative measures correspond with patient experiences?
J Healthc Qual 2018 May/Jun;40(3):120-28. doi: 10.1097/jhq.0000000000000051..
Keywords: Patient Experience, Chronic Conditions, Elderly
Maciejewski ML, Hammill BG, Voils CI
Prescriber continuity and medication availability in older adults with cardiometabolic conditions.
Researchers examined whether the number of prescribers of essential medications was associated with the availability of medications, a surrogate for adherence, to manage diabetes, hypertension or dyslipidemia. They found that the number of prescribers was not significantly associated with availability of oral diabetes agents but having more prescribers is associated with increased medication availability in older Medicare beneficiaries with dyslipidemia or hypertension.
AHRQ-funded; HS023085.
Citation: Maciejewski ML, Hammill BG, Voils CI .
Prescriber continuity and medication availability in older adults with cardiometabolic conditions.
SAGE Open Med 2018 Feb 6;6:2050312118757388. doi: 10.1177/2050312118757388.
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Keywords: Chronic Conditions, Elderly, Medicare, Medication, Patient Adherence/Compliance