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Topics
- Ambulatory Care and Surgery (1)
- Arthritis (1)
- (-) Asthma (22)
- Care Coordination (1)
- Caregiving (1)
- Children/Adolescents (12)
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- Clinician-Patient Communication (2)
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- Comparative Effectiveness (1)
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- Medication (4)
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- Obesity: Weight Management (1)
- Outcomes (1)
- Patient-Centered Outcomes Research (8)
- Patient Adherence/Compliance (2)
- Pregnancy (1)
- Primary Care (2)
- Quality Improvement (1)
- Quality of Life (1)
- Racial and Ethnic Minorities (2)
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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 22 of 22 Research Studies DisplayedParikh K, Paul J, Foushee N
Barriers and facilitators to asthma care after hospitalization as reported by caregivers, health providers, and school nurses.
This study focused on developing a comprehensive understanding of asthma care after hospitalization of children as reported by caregivers, health providers, and school nurses. The children had a median age of 7 years, mean hospital length of stay of 1.9 days, and 56% had a previous hospitalization in the last 12 months. Family caregivers and health professionals were given individual interviews while focus groups were conducted with school nurses. There were different health beliefs about asthma knowledge between caregivers and health professionals. School nurses highlighted specific barriers that focused on medication use in schools.
AHRQ-funded; HS024554.
Citation: Parikh K, Paul J, Foushee N .
Barriers and facilitators to asthma care after hospitalization as reported by caregivers, health providers, and school nurses.
Hosp Pediatr 2018 Nov;8(11):706-17. doi: 10.1542/hpeds.2017-0182..
Keywords: Asthma, Hospitalization, Children/Adolescents, Caregiving, Patient Adherence/Compliance, Education
Luthe SK, Hirayama A, Goto T
Association between obesity and acute severity among patients hospitalized for asthma exacerbation.
This study examined the association between obesity and exacerbation of asthma symptoms in hospitalized adults (age 18-54 years). This retrospective cohort study used data from 8 diverse US states from 2010-2013. Among 72,086 patients hospitalized for asthma exacerbation, 24% were considered obese. Obesity was associated with a higher use of mechanical ventilation as well as a longer hospital stay. These findings were consistent among all ages, sex, and race/ethnicity.
AHRQ-funded; HS023305.
Citation: Luthe SK, Hirayama A, Goto T .
Association between obesity and acute severity among patients hospitalized for asthma exacerbation.
J Allergy Clin Immunol Pract 2018 Nov - Dec;6(6):1936-41.e4. doi: 10.1016/j.jaip.2018.02.001..
Keywords: Asthma, Hospitalization, Obesity, Respiratory Conditions
Kuzniewicz MW, Niki H, Walsh EM
Hyperbilirubinemia, phototherapy, and childhood asthma.
The purpose of this retrospective cohort study was to quantify the associations of both hyperbilirubinemia and phototherapy with childhood asthma with total serum bilirubin (TSB) levels. Infants born after at least 35 weeks’ gestation within the Kaiser Permanente Northern California health system between 2010 and 2014 made up the study population. Cox models were used to estimate hazard ratios for a diagnosis of asthma. The researchers conclude that moderate levels of hyperbilirubinemia are associated with increased risk of asthma, but this association was not seen at higher levels. No dose-response relationship was observed.
AHRQ-funded; HS020618.
Citation: Kuzniewicz MW, Niki H, Walsh EM .
Hyperbilirubinemia, phototherapy, and childhood asthma.
Pediatrics 2018 Oct;142(4). doi: 10.1542/peds.2018-0662..
Keywords: Asthma, Children/Adolescents, Treatments
Washington DM, Curtis LM, Waite K
Sociodemographic factors mediate race and ethnicity-associated childhood asthma health disparities: a longitudinal analysis.
This study characterized the longitudinal effects associated with being African-American/Black or Hispanic/Latino on a range of asthma outcomes, and the extent to which sociodemographic factors, caregiver health literacy, education level, and asthma knowledge mediated these associations. The investigators concluded that African-American race and Hispanic/Latino ethnicity are significantly associated with worse asthma compared to Whites in longitudinal analyses.
AHRQ-funded; HS022242.
Citation: Washington DM, Curtis LM, Waite K .
Sociodemographic factors mediate race and ethnicity-associated childhood asthma health disparities: a longitudinal analysis.
J Racial Ethn Health Disparities 2018 Oct;5(5):928-38. doi: 10.1007/s40615-017-0441-2..
Keywords: Asthma, Children/Adolescents, Disparities, Racial and Ethnic Minorities, Social Determinants of Health
Liu TL, Taylor YJ, Mahabaleshwarkar R
Shared decision making and time to exacerbation in children with asthma.
This study examined the use of shared decision making (SDM) to delay exacerbation in children with asthma. A prospective cohort of children at five primary care practices in Charlotte, North Carolina that serve vulnerable population was studied between 2011 and 2013. The cohort included 746 children, with 60.5% male and 54.2% African American with a mean age of 8.6 years. The final analysis included 100 matched pairs of children for use of SDM and normal care. There was a marginally significant difference in the time of exacerbation between the two groups.
AHRQ-funded; HS019946.
Citation: Liu TL, Taylor YJ, Mahabaleshwarkar R .
Shared decision making and time to exacerbation in children with asthma.
J Asthma 2018 Sep;55(9):949-55. doi: 10.1080/02770903.2017.1378357..
Keywords: Children/Adolescents, Decision Making, Asthma, Respiratory Conditions, Chronic Conditions, Primary Care
Lin SY, Azar A, Suarez-Cuervo C
Role of sublingual immunotherapy in the treatment of asthma: an updated systematic review.
This systematic review analyzed a number of studies on sublingual immunotherapy treatment (SLIT) for asthma caused by allergies. Fourteen randomized control trials (RCTs) studies were identified to analyze effective for allergies of house mites, birch, and grasses. However, a total of 20 RCTs and 10 observational studies were identified and used in this review. The review showed moderate-to-high strength evidence that SLIT is effective in improving allergic asthma symptoms. It also reduced long-term medication use and improved FEV1.
AHRQ-funded; 290201500006I.
Citation: Lin SY, Azar A, Suarez-Cuervo C .
Role of sublingual immunotherapy in the treatment of asthma: an updated systematic review.
Int Forum Allergy Rhinol 2018 Sep;8(9):982-92. doi: 10.1002/alr.22152..
Keywords: Asthma, Evidence-Based Practice, Patient-Centered Outcomes Research, Treatments
Turi KN, Gebretsadik T, Lee RL
Seasonal patterns of asthma medication fills among diverse populations of the United States.
Nonadherence to controller and overuse of reliever asthma medications are associated with exacerbations. In this study, the investigators aimed to determine patterns of seasonal asthma medication use and to identify time period(s) during which interventions to improve medication adherence could reduce asthma morbidity. The investigators concluded that a seasonal pattern of asthma medication fill rates likely represented a reactive response to a loss of disease control and increased symptoms.
AHRQ-funded; HS019669; HS022093.
Citation: Turi KN, Gebretsadik T, Lee RL .
Seasonal patterns of asthma medication fills among diverse populations of the United States.
J Asthma 2018 Jul;55(7):764-70. doi: 10.1080/02770903.2017.1362426..
Keywords: Asthma, Chronic Conditions, Medication, Patient Adherence/Compliance
Taylor YJ, Tapp H, Shade LE
Impact of shared decision making on asthma quality of life and asthma control among children.
This study evaluated the impact of shared decision making (SDM) on quality of life and symptom control in children with asthma. The investigators found that implementation of SDM within clinical practices using a standardized toolkit was associated with improved asthma quality of life and asthma control for low-income children with asthma when compared to usual care with decision support.
AHRQ-funded; HS019946.
Citation: Taylor YJ, Tapp H, Shade LE .
Impact of shared decision making on asthma quality of life and asthma control among children.
J Asthma 2018 Jun;55(6):675-83. doi: 10.1080/02770903.2017.1362423..
Keywords: Children/Adolescents, Asthma, Respiratory Conditions, Chronic Conditions, Decision Making, Quality of Life
Kaiser SV, Rodean J, Bekmezian A
Effectiveness of pediatric asthma pathways for hospitalized children: a multicenter, national analysis.
The purpose of this retrospective, multicenter cohort study was to determine if clinical pathways affect care and outcomes for children hospitalized with asthma, using an administrative database, the Pediatric Health Information System. The investigators found that clinical pathways can decrease length of stay, costs, and unnecessary antibiotic use without increasing rates of readmissions, leading to higher value care.
AHRQ-funded; HS024554.
Citation: Kaiser SV, Rodean J, Bekmezian A .
Effectiveness of pediatric asthma pathways for hospitalized children: a multicenter, national analysis.
J Pediatr 2018 Jun;197:165-71.e2. doi: 10.1016/j.jpeds.2018.01.084..
Keywords: Asthma, Children/Adolescents, Evidence-Based Practice, Hospitalization, Patient-Centered Outcomes Research, Children/Adolescents
Parikh K, Keller S, Ralston S
Inpatient quality improvement interventions for asthma: a meta-analysis.
This article reviewed interventional studies of inpatient-initiated asthma quality improvement (QI) to synthesize its impact on health care utilization. Thirty articles were included; 12 provided data on health care reutilization outcomes. The selected studies were categorized by intervention type and outcome. Risk ratios for readmissions were examined and a subanalyis of multimodal interventions conducted; the latter suggested lower readmission rates. A subanalysis of education and discharge planning interventions did not show an effect. The authors did not identify any inpatient strategies that impacted health care reutilization within 30 days of index hospitalization, but note that multimodal interventions demonstrated impact over the longer interval.
AHRQ-funded; HS024554.
Citation: Parikh K, Keller S, Ralston S .
Inpatient quality improvement interventions for asthma: a meta-analysis.
Pediatrics 2018 May;141(5). doi: 10.1542/peds.2017-3334.
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Keywords: Asthma, Children/Adolescents, Hospitalization, Inpatient Care, Quality Improvement
Brunwasser SM, Gebretsadik T, Gold DR
A new model of wheezing severity in young children using the validated ISAAC wheezing module: a latent variable approach with validation in independent cohorts.
The authors of this paper developed an easily applicable continuous latent variable model of pediatric wheezing severity based on items from the well-validated International Study of Asthma and Allergies in Children (ISAAC) Wheezing Module. Their model prospectively associates with asthma morbidity, as demonstrated in two ECHO birth cohort studies, and provides a more statistically powerful method of testing etiologic hypotheses of childhood wheezing illness and asthma.
AHRQ-funded; HS022990.
Citation: Brunwasser SM, Gebretsadik T, Gold DR .
A new model of wheezing severity in young children using the validated ISAAC wheezing module: a latent variable approach with validation in independent cohorts.
PLoS One 2018 Apr 17;13(4):e0194739. doi: 10.1371/journal.pone.0194739..
Keywords: Asthma, Children/Adolescents, Diagnostic Safety and Quality, Patient-Centered Outcomes Research
Sobieraj DM, Weeda ER, Nguyen E
Association of inhaled corticosteroids and long-acting beta-agonists as controller and quick relief therapy with exacerbations and symptom control in persistent asthma: a systematic review and meta-analysis.
The authors conducted a systematic review and meta-analysis of the effects of single maintenance and reliever therapy (SMART) in patients with persistent asthma. They found that in patients with persistent asthma, the use of single maintenance and reliever therapy compared with inhaled corticosteroids as the controller therapy (with or without a long-acting beta-agonist) and short-acting beta-agonists as the relief therapy was associated with a lower risk of asthma exacerbations.
AHRQ-funded; 290201500012I.
Citation: Sobieraj DM, Weeda ER, Nguyen E .
Association of inhaled corticosteroids and long-acting beta-agonists as controller and quick relief therapy with exacerbations and symptom control in persistent asthma: a systematic review and meta-analysis.
JAMA 2018 Apr 10;319(14):1485-96. doi: 10.1001/jama.2018.2769.
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Keywords: Asthma, Comparative Effectiveness, Medication, Patient-Centered Outcomes Research, Respiratory Conditions
Sobieraj DM, Baker WL, Nguyen E
Association of inhaled corticosteroids and long-acting muscarinic antagonists with asthma control in patients with uncontrolled, persistent asthma: a systematic review and meta-analysis.
The authors conducted a systematic review and meta-analysis of the effects associated with long-acting muscarinic antagonists (LAMAs) vs placebo or vs other controllers as an add-on therapy to inhaled corticosteroids. They concluded that use of LAMA compared with placebo as add-on therapy to inhaled corticosteroids was associated with a lower risk of asthma exacerbations.
AHRQ-funded; 290201500012I.
Citation: Sobieraj DM, Baker WL, Nguyen E .
Association of inhaled corticosteroids and long-acting muscarinic antagonists with asthma control in patients with uncontrolled, persistent asthma: a systematic review and meta-analysis.
JAMA 2018 Apr 10;319(14):1473-84. doi: 10.1001/jama.2018.2757.
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Keywords: Asthma, Evidence-Based Practice, Medication, Patient-Centered Outcomes Research, Respiratory Conditions
Parikh K, Hall M, Kenyon CC
Impact of discharge components on readmission rates for children hospitalized with asthma.
This study described hospital-based asthma-specific discharge components at children's hospitals and determine the association of these discharge components with pediatric asthma readmission rates. No individual or combination discharge components were associated with lower 30-day adjusted readmission rates. The only single-component significantly associated with a lower rate of readmission at 3 months was having comprehensive content of education.
AHRQ-funded; HS024554.
Citation: Parikh K, Hall M, Kenyon CC .
Impact of discharge components on readmission rates for children hospitalized with asthma.
J Pediatr. 2018 Apr;195:175-181.e2. doi: 10.1016/j.jpeds.2017.11.062..
Keywords: Asthma, Children/Adolescents, Hospital Discharge, Hospital Readmissions, Patient-Centered Outcomes Research
Trivedi M, Fung V, Kharbanda EO
Racial disparities in family-provider interactions for pediatric asthma care.
The purpose of this study was to investigate differences in family-provider interactions for pediatric asthma, based on race/ethnicity and using parent surveys of asthmatic children within the Population-Based Effectiveness in Asthma and Lung Diseases Network. 647 parents provided survey response data and self-reported race/ethnicity of the child. The outcomes studied were responses to questions about family-provider interactions in the previous 12 months including number of visits with asthma provider, number of times provider reviewed asthma medications with patient/family, review of written asthma treatment plans, and preferences about asthma care decisionmaking. The study concludes that black children with asthma have fewer visits with their providers than white children and are less likely to have a written asthma treatment plan. The authors suggest that asthma providers could focus on improving these specific family-provider interactions.
AHRQ-funded; HS019669.
Citation: Trivedi M, Fung V, Kharbanda EO .
Racial disparities in family-provider interactions for pediatric asthma care.
J Asthma 2018 Apr;55(4):424-29. doi: 10.1080/02770903.2017.1337790..
Keywords: Asthma, Children/Adolescents, Clinician-Patient Communication, Disparities, Racial and Ethnic Minorities
Alexander GL, Olden HA, Troy T
Overweight adolescents and asthma: revealing motivations and challenges with adolescent-provider communication.
This mixed-methods study assessed teens' awareness of the link between weight and asthma management, and perspectives on how medical providers might open a discussion about managing weight. The investigators found that most teens responded favorably to initiating weight loss if it impacted asthma management, valued their provider addressing weight and family participation in weight management efforts.
AHRQ-funded; HS022417.
Citation: Alexander GL, Olden HA, Troy T .
Overweight adolescents and asthma: revealing motivations and challenges with adolescent-provider communication.
J Asthma 2018 Mar;55(3):266-74. doi: 10.1080/02770903.2017.1323921..
Keywords: Asthma, Children/Adolescents, Clinician-Patient Communication, Communication, Obesity, Obesity: Weight Management
Yawn BP, Wollan PC, Rank MA
Use of asthma APGAR tools in primary care practices: a cluster-randomized controlled trial.
The purpose of this study was to assess patient and practice outcomes after introducing the Asthma APGAR (Activities, Persistent, triGGers, Asthma medications, Response to therapy) tools into primary care practices. It concluded that introduction of the Asthma APGAR tools improves rates of asthma control; reduces asthma-related ED, urgent care, and hospital visits; and increases practices' adherence to asthma management guidelines.
AHRQ-funded; HS022126.
Citation: Yawn BP, Wollan PC, Rank MA .
Use of asthma APGAR tools in primary care practices: a cluster-randomized controlled trial.
Ann Fam Med 2018 Mar;16(2):100-10. doi: 10.1370/afm.2179.
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Keywords: Asthma, Patient-Centered Outcomes Research, Primary Care, Medical Expenditure Panel Survey (MEPS), Tools & Toolkits
Cardet JC, Louisias M, King TS
Income is an independent risk factor for worse asthma outcomes.
The authors investigated whether low income, low education, and high perceived stress were independent risk factors for treatment failure and asthma exacerbations in the context of a randomized controlled trial. They found that participants with lower income were more likely to experience adverse asthma outcomes independent of education, perceived stress, race, and medication adherence.
AHRQ-funded; HS022986.
Citation: Cardet JC, Louisias M, King TS .
Income is an independent risk factor for worse asthma outcomes.
J Allergy Clin Immunol 2018 Feb;141(2):754-60.e3. doi: 10.1016/j.jaci.2017.04.036..
Keywords: Asthma, Chronic Conditions, Low-Income, Outcomes, Patient-Centered Outcomes Research, Risk, Social Determinants of Health
Kaiser SV, Rodean J, Bekmezian A
Rising utilization of inpatient pediatric asthma pathways.
The objectives of this study were to: 1) Describe inpatient pediatric asthma pathway design and implementation across a large hospital network and (2) Compare characteristics of hospitals with and without pathways. The investigators concluded that from 2005-2015, there was a dramatic rise in implementation of inpatient pediatric asthma pathways. They found variation in many aspects of pathway design and implementation.
AHRQ-funded; HS024554; HS024592.
Citation: Kaiser SV, Rodean J, Bekmezian A .
Rising utilization of inpatient pediatric asthma pathways.
J Asthma 2018 Feb;55(2):196-207. doi: 10.1080/02770903.2017.1316392..
Keywords: Asthma, Care Coordination, Children/Adolescents, Inpatient Care
Wang Z, Pianosi PT, Keogh KA
The diagnostic accuracy of fractional exhaled nitric oxide testing in asthma: a systematic review and meta-analyses.
This study evaluated the diagnostic accuracy of fractional exhaled nitric oxide (FeNO) measurement in individuals with suspected asthma. It concluded that fractional exhaled nitric oxide measurement has moderate accuracy to diagnose asthma in individuals aged 5 years and older. Test performance may be modestly better in corticosteroid-naive asthmatics, children, and nonsmokers than in the general population with suspected asthma.
AHRQ-funded; 290201500013I.
Citation: Wang Z, Pianosi PT, Keogh KA .
The diagnostic accuracy of fractional exhaled nitric oxide testing in asthma: a systematic review and meta-analyses.
Mayo Clin Proc 2018 Feb;93(2):191-98. doi: 10.1016/j.mayocp.2017.11.012.
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Keywords: Asthma, Diagnostic Safety and Quality
Stone C, Gebretsadik T, Lee RL
Trends in health care utilization for asthma exacerbations among diverse populations with asthma in the United States.
This article discusses trends in asthma hospitalization and outpatient visit rates from 2004 to 2010. The rates for all populations included in this study went down during the time period, in particular the population from the Tennessee Medicaid program (49%). Other populations used in the study included subjects 4 to 50 years enrolled in the US Department of Defense Military Health System (MHS), and 3 large integrated health delivery systems (IHCDS) of the Population Based Effectiveness in Asthma and Lung Diseases (PEAL) Network. The 3 PEAL health plans included Harvard Pilgrim Health Care, Kaiser Permanente Georgia, and Kaiser Permanent Northern California. A total of 473,524 subjects in those 3 study populations were identified. These downward trends are encouraging but need to continue, particularly in diverse populations.
AHRQ-funded; HS019669; HS022093.
Citation: Stone C, Gebretsadik T, Lee RL .
Trends in health care utilization for asthma exacerbations among diverse populations with asthma in the United States.
J Allergy Clin Immunol Pract 2018 Jan - Feb;6(1):295-97.e5. doi: 10.1016/j.jaip.2017.07.038..
Keywords: Asthma, Healthcare Utilization, Hospitalization, Healthcare Delivery, Chronic Conditions, Ambulatory Care and Surgery
Palmsten K, Hulugalle A, Bandoli G
Agreement between maternal report and medical records during pregnancy: medications for rheumatoid arthritis and asthma.
This study examined the agreement between maternal report and medical records during pregnancy for rheumatoid arthritis and asthma-related medications. The investigators concluded that agreement was higher for medications typically used continuously than sporadically. Information on medication use from medical records alone may not be adequate when studying the impact of intermittently used medications during pregnancy on perinatal outcomes.
AHRQ-funded; HS018474.
Citation: Palmsten K, Hulugalle A, Bandoli G .
Agreement between maternal report and medical records during pregnancy: medications for rheumatoid arthritis and asthma.
Paediatr Perinat Epidemiol 2018 Jan;32(1):68-77. doi: 10.1111/ppe.12415..
Keywords: Asthma, Medication, Pregnancy, Arthritis