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AHRQ Research Studies Date
Topics
- Access to Care (1)
- Asthma (2)
- Blood Pressure (1)
- Care Coordination (2)
- Care Management (3)
- Children/Adolescents (3)
- (-) Chronic Conditions (15)
- Clinical Decision Support (CDS) (1)
- COVID-19 (1)
- Diabetes (5)
- Education: Patient and Caregiver (1)
- Electronic Health Records (EHRs) (3)
- Evidence-Based Practice (2)
- Healthcare Delivery (2)
- Health Information Exchange (HIE) (1)
- (-) Health Information Technology (HIT) (15)
- Implementation (1)
- Kidney Disease and Health (1)
- Lifestyle Changes (1)
- Medication (1)
- Obesity (1)
- Obesity: Weight Management (1)
- Opioids (1)
- Outcomes (1)
- Pain (2)
- Patient-Centered Healthcare (1)
- Patient-Centered Outcomes Research (1)
- Patient Adherence/Compliance (1)
- Patient and Family Engagement (1)
- Patient Experience (1)
- Patient Self-Management (4)
- Primary Care (1)
- Respiratory Conditions (2)
- Rural Health (1)
- Shared Decision Making (1)
- Sickle Cell Disease (1)
- Teams (1)
- Telehealth (5)
- Vulnerable Populations (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 15 of 15 Research Studies DisplayedKilgallon JL, Gannon M, Burns Z
Multicomponent intervention to improve blood pressure management in chronic kidney disease: a protocol for a pragmatic clinical trial.
This study’s objective is to develop an intervention for the primary care management of uncontrolled hypertension (HTN) in chronic kidney disease (CKD) utilizing user-centered design principles and behavioral economic principles, test the effectiveness of that intervention, and collect implementation data that will facilitate the application of the intervention in other practice settings. One hundred and eighty-four eligible clinical physicians from 15 practices of The Brigham and Women's Practice -Based Research Network are enrolled in the study. The researchers will use the Reach Effectiveness Adoption Implementation Maintenance framework to assess the intervention’s effectiveness in impacting a change in mean systolic blood pressure between baseline and 6 months.
AHRQ-funded; 233201500020I; HS026506; HS028127.
Citation: Kilgallon JL, Gannon M, Burns Z .
Multicomponent intervention to improve blood pressure management in chronic kidney disease: a protocol for a pragmatic clinical trial.
BMJ Open 2021 Dec 22;11(12):e054065. doi: 10.1136/bmjopen-2021-054065..
Keywords: Blood Pressure, Kidney Disease and Health, Chronic Conditions, Clinical Decision Support (CDS), Health Information Technology (HIT)
Schirle L, Jeffery A, Yaqoob A
Two data-driven approaches to identifying the spectrum of problematic opioid use: a pilot study within a chronic pain cohort.
Although electronic health records (EHR) have significant potential for the study of opioid use disorders (OUD), detecting OUD in clinical data is challenging. Models using EHR data to predict OUD often rely on case/control classifications focused on extreme opioid use. IN this study, the investigators discussed two data-driven approaches to identifying the spectrum of problematic opioid use. The investigators concluded that risk scores comprising comorbidities and text offer differing but synergistic insights into characterizing problematic opioid use.
AHRQ-funded; HS026395.
Citation: Schirle L, Jeffery A, Yaqoob A .
Two data-driven approaches to identifying the spectrum of problematic opioid use: a pilot study within a chronic pain cohort.
Int J Med Inform 2021 Dec;156:104621. doi: 10.1016/j.ijmedinf.2021.104621..
Keywords: Opioids, Pain, Chronic Conditions, Medication, Health Information Technology (HIT)
McKernan LC, Crofford LJ, Kim A
Electronic delivery of pain education for chronic overlapping pain conditions: a prospective cohort study.
This study’s objective was to examine the impact of educational materials for chronic overlapping pain conditions (COPCs), the feasibility of delivery materials online, and to explore its impact on self-reported self-management applications at 3-month follow-up. This prospective cohort study used individuals from a university-wide active research repository with ≥1 coded diagnostic COPC by ICD-9/10 in the medical record. The authors assessed content awareness after the participants read educational materials pre- and post-exposure to education. A total of 216 individuals were enrolled, with 181 completing both timepoints. Knowledge and understanding of COPCs increased significantly after education and were retained at three months. There was no significant change to symptoms or self-management applications over the three-month period.
AHRQ-funded; HS022990.
Citation: McKernan LC, Crofford LJ, Kim A .
Electronic delivery of pain education for chronic overlapping pain conditions: a prospective cohort study.
Pain Med 2021 Oct 8;22(10):2252-62. doi: 10.1093/pm/pnab018..
Keywords: Education: Patient and Caregiver, Pain, Health Information Technology (HIT), Chronic Conditions
Fuji KT, Abbott AA, Galt KA
A mixed-methods evaluation of standalone personal health record use by patients with type 2 diabetes.
The purpose of this study was to compare use of a standalone personal health records (PHRs) by patients with Type 2 diabetes to usual care through assessment of self-care behaviors, and short-term impact on social cognitive outcomes and hemoglobin A1c (HbA1c). Five themes emerged from the qualitative analysis describing participants' experiences with the PHR and identifying reasons for lack of engagement. Study findings revealed low PHR uptake and minimal impact on study outcomes, including lack of communication and information-sharing between patients and providers.
AHRQ-funded; HS018625.
Citation: Fuji KT, Abbott AA, Galt KA .
A mixed-methods evaluation of standalone personal health record use by patients with type 2 diabetes.
Perspect Health Inf Manag 2021 Fall;18(4):1e..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Diabetes, Patient Self-Management, Chronic Conditions, Patient and Family Engagement
Samal L, Fu HN, Camara DS
AHRQ Author: Camara DS, Wang J, Bierman AS
Health information technology to improve care for people with multiple chronic conditions.
The objective of this study was to review evidence regarding the use of Health Information Technology (health IT) interventions aimed at improving care for people living with multiple chronic conditions (PLWMCC) in order to identify critical knowledge gaps. The investigators concluded that the body of literature included in this review provides critical information on the state of the science as well as the many gaps that need to be filled for digital health to fulfill its promise in supporting care delivery that meets the needs of PLWMCC.
AHRQ-authored; AHRQ-funded; HS026849; 290201600001B.
Citation: Samal L, Fu HN, Camara DS .
Health information technology to improve care for people with multiple chronic conditions.
Health Serv Res 2021 Oct;56(Suppl 1):1006-36. doi: 10.1111/1475-6773.13860..
Keywords: Chronic Conditions, Health Information Technology (HIT), Evidence-Based Practice, Shared Decision Making, Healthcare Delivery
Misra-Hebert AD, Hu B, Pantalone KM
Primary care health care use for patients with type 2 diabetes during the COVID-19 pandemic.
This study sought to examine factors associated with total and virtual primary care use for patients with type 2 diabetes (T2D) during the COVID-19 pandemic. This study used electronic medical records in the Cleveland Clinic Health System comparing prepandemic use from August 2019 to March 2020 (baseline period 0) to two pandemic periods: March to June 2020 (period 1) when in-person visits were converted to virtual; and July to November 2020 when in-person visits resumed (period 2). Demographic characteristics were obtained including age, sex, race, insurance type, median income estimated by zip code and baseline HbA1C. The study included 76,015 patients with T2D who completed a primary care visit in baseline period 0. Cohort median age was 66.2 years, 50.7% women, 21.7% Black, 71.0% White and 7.4 Other. Insurance distribution was 43.2% private, 46.5% Medicare, and 9.5% Medicaid. Median income was estimated at $59,000 and baseline HbA1C was ≤ 7% for 59.6% of patients. There were higher odds of Black patients, those with uncontrolled T2D, and those with Medicare and Medicare using virtual visits during the 2 postpandemic periods suggesting that virtual visits may be a preference for those groups. Older and male patients had lower odds of visit completion.
AHRQ-funded; HS024128.
Citation: Misra-Hebert AD, Hu B, Pantalone KM .
Primary care health care use for patients with type 2 diabetes during the COVID-19 pandemic.
Diabetes Care 2021 Sep;44(9):e173-e74. doi: 10.2337/dc21-0853..
Keywords: COVID-19, Diabetes, Primary Care, Telehealth, Health Information Technology (HIT), Healthcare Delivery, Access to Care, Chronic Conditions
Joseph CLM, Alexander GL, Lu M
Pilot study of a brief provider and EMR-based intervention for overweight teens with asthma.
The authors piloted an electronic medical record-based tailored discussion guide (TDG) and a brief provider training to address weight management in overweight teens with asthma. They observed modest improvements in patient-reported asthma outcomes and health behaviors. They found strong evidence that the TDG supports provider discussion of weight and asthma to create a more patient-centered conversation from the perspective of participating teens. They recommended addressing challenges to recruitment and clinic adaptation prior to advancing to a full-scale trial.
AHRQ-funded; HS022417.
Citation: Joseph CLM, Alexander GL, Lu M .
Pilot study of a brief provider and EMR-based intervention for overweight teens with asthma.
Pilot Feasibility Stud 2021 Aug 30;7(1):167. doi: 10.1186/s40814-021-00848-6..
Keywords: Children/Adolescents, Obesity: Weight Management, Obesity, Asthma, Chronic Conditions, Respiratory Conditions, Electronic Health Records (EHRs), Health Information Technology (HIT)
Jacob SA, Carroll AE, Bennett WE
A feasibility study of telemedicine for paediatric sickle cell patients living in a rural medically underserved area.
The purpose of this cross-sectional, observational study was to determine the feasibility of using telemedicine for the provision of subspecialty pediatric (0-21 years old) Sickle Cell Disease care in a rural medically underserved area. METHODS: This was a cross-sectional, observational, feasibility study. The study found that 10 SCD patients initiated telemedicine visits during the study period. Approximately 60% of the eligible participants did not attend more than 50% of scheduled visits prior to beginning telemedicine visits or were lost to follow-up. After initiation of telemedicine, all Hb SS patients were started and/or maintained on hydroxyurea. Nine out of 10 patients who participated during this timeframe had a 100% follow-up rate. All the participants rated the comfort and ease of using the telehealth system as good or excellent, and all participants would take part in a telemedicine visit again.
AHRQ-funded; HS026390.
Citation: Jacob SA, Carroll AE, Bennett WE .
A feasibility study of telemedicine for paediatric sickle cell patients living in a rural medically underserved area.
J Telemed Telecare 2021 Aug;27(7):431-35. doi: 10.1177/1357633x19883558..
Keywords: Children/Adolescents, Telehealth, Sickle Cell Disease, Rural Health, Chronic Conditions, Vulnerable Populations, Health Information Technology (HIT)
Cemballi AG, Karter AJ, Schillinger D
Descriptive examination of secure messaging in a longitudinal cohort of diabetes patients in the ECLIPPSE study.
This longitudinal study looked at trends in secure messaging (SM) use in health care system patient portals using a diverse cohort of diabetes patients enrolled in the ECLIPPSE study from 2006 to 2015. The authors found a 10-fold increase in overall messaging volume during that time period. A majority of patients were using SM by 2015, including those with lower income or with self-reported limited health literacy. At the beginning of the survey period more physicians than nurses were using SM, but that changed over time as well.
AHRQ-funded; HS026383.
Citation: Cemballi AG, Karter AJ, Schillinger D .
Descriptive examination of secure messaging in a longitudinal cohort of diabetes patients in the ECLIPPSE study.
J Am Med Inform Assoc 2021 Jun 12;28(6):1252-58. doi: 10.1093/jamia/ocaa281..
Keywords: Diabetes, Chronic Conditions, Electronic Health Records (EHRs), Health Information Technology (HIT)
Doshi H, Hsia B, Shahani J
Impact of technology-based interventions on patient-reported outcomes in asthma: a systematic review.
This systematic review’s goal was to identify which technology-based interventions (TBIs) for asthma management have been formally evaluated using patient-reported outcomes (PROs). The authors aimed to: 1) identify the TBIs that have been evaluated in clinical trials using PROs; 2) identify the most commonly used PROs in these trials; and 3) determine the impact of TBIs on PROs in the management of chronic asthma. PubMed and Clinicaltrials.gov databases were searched for English-language studies published between January 2000 and February 2020. The final analysis included 14 clinical trials with 1 to 3 arms. Five different TBI types were identified, most commonly involving multimedia education. Four different categories of PROs were identified. At least 1 PRO domain with positive outcomes were reported by patients in 12 of 14 studies.
AHRQ-funded; R18 HS025645.
Citation: Doshi H, Hsia B, Shahani J .
Impact of technology-based interventions on patient-reported outcomes in asthma: a systematic review.
J Allergy Clin Immunol Pract 2021 Jun;9(6):2336-41. doi: 10.1016/j.jaip.2021.01.027..
Keywords: Asthma, Respiratory Conditions, Chronic Conditions, Telehealth, Health Information Technology (HIT)
Aiyegbusi OL, Nair D, Peipert JD
A narrative review of current evidence supporting the implementation of electronic patient-reported outcome measures in the management of chronic diseases.
This review discusses and summarizes evidence of the impact of electronic patient-reported outcomes measures (ePROMs) on clinical parameters and outcomes relevant to chronic diseases. Various studies have demonstrated the feasibility of ePROMs in routine clinical practice with patients increasing expressing a preference for an electronic mode of administration. These ePROMs could have significant impacts on outcomes valued by patients, healthcare providers, and researchers. Recently published literature.
AHRQ-funded; HS026395.
Citation: Aiyegbusi OL, Nair D, Peipert JD .
A narrative review of current evidence supporting the implementation of electronic patient-reported outcome measures in the management of chronic diseases.
Ther Adv Chronic Dis 2021 May 24;12:20406223211015958. doi: 10.1177/20406223211015958..
Keywords: Chronic Conditions, Patient Experience, Health Information Technology (HIT), Outcomes, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Evidence-Based Practice
Oikonomidi T, Ravaud P, James A
AHRQ Author: Montori V
An international, mixed-methods study of the perceived intrusiveness of remote digital diabetes monitoring.
This paper describes an international online vignette-based survey to assess the relationship between remote digital monitoring (RDM) modalities for diabetes and intrusiveness in patients’ lives. The survey was conducted from February-June 2019 in 30 countries with 1010 participants. A total of 2680 vignette-assessments were completed with 52% on type 1 diabetes. Increased intrusiveness was associated with food monitoring compared with glucose- and PA-monitoring alone and permanent monitoring with real-time physician-generated feedback compared with monitoring for a week with feedback. Public-sector data handling was associated with decreased intrusiveness as compared with the private sector.
AHRQ-authored.
Citation: Oikonomidi T, Ravaud P, James A .
An international, mixed-methods study of the perceived intrusiveness of remote digital diabetes monitoring.
Mayo Clin Proc 2021 May;96(5):1236-47. doi: 10.1016/j.mayocp.2020.07.040..
Keywords: Telehealth, Health Information Technology (HIT), Diabetes, Chronic Conditions, Lifestyle Changes, Patient Self-Management
Ozkaynak M, Valdez R, Hannah K
Understanding gaps between daily living and clinical settings in chronic disease management: qualitative study.
This study’s objective was to characterize gaps from the patient’s perspective between health-related activities across home-based and clinical settings in the management of chronic conditions. Patients were recruited from an anticoagulation clinic of an urban, western mountain system and primary interviews were conducted with 39 patients and 4 providers. The causes of gaps included clinician recommendations not fitting into patients’ daily routines; recommendations not fitting into a patients’ living contexts; and no information transfer across settings. Consequences of these gaps included increased cognitive and physical workload on the patient, poor patient satisfaction, and compromised adherence to the therapy plan.
AHRQ-funded; HS024092.
Citation: Ozkaynak M, Valdez R, Hannah K .
Understanding gaps between daily living and clinical settings in chronic disease management: qualitative study.
J Med Internet Res 2021 Feb 25;23(2):e17590. doi: 10.2196/17590..
Keywords: Chronic Conditions, Care Management, Care Coordination, Patient Self-Management, Health Information Technology (HIT)
Wang G, Wignall J, Kinard D
An implementation model for managing cloud-based longitudinal care plans for children with medical complexity.
In this study, the investigators aimed to iteratively refine an implementation model for managing cloud-based longitudinal care plans (LCPs) for children with medical complexity (CMC). They conducted iterative 1-on-1 design sessions with CMC caregivers (ie, parents/legal guardians) and providers between August 2017 and March 2019. The investigators concluded that utilizing the management strategies, described in the article, when implementing cloud-based LCPs had the potential to improve team-based care across settings.
AHRQ-funded; HS024299.
Citation: Wang G, Wignall J, Kinard D .
An implementation model for managing cloud-based longitudinal care plans for children with medical complexity.
J Am Med Inform Assoc 2021 Jan 15;28(1):23-32. doi: 10.1093/jamia/ocaa207..
Keywords: Children/Adolescents, Implementation, Chronic Conditions, Care Management, Care Coordination, Health Information Exchange (HIE), Health Information Technology (HIT), Teams
Oikonomidi T, Ravaud P, Cosson E
AHRQ Author: Montori V
Evaluation of patient willingness to adopt remote digital monitoring for diabetes management.
Investigators sought to identify the minimum effectiveness patients report they require to adopt 36 different remote digital monitoring (RDM) scenarios. Adults with type 1 or type 2 diabetes living in 30 countries assessed three randomly selected scenarios from a total of 36 that described different combinations of digital monitoring tools. The investigators found that patients required greater health benefits to adopt more intrusive RDM modalities, food monitoring, and real-time feedback by a health care professional. They recommended that patient monitoring devices be designed to be minimally intrusive.
AHRQ-authored.
Citation: Oikonomidi T, Ravaud P, Cosson E .
Evaluation of patient willingness to adopt remote digital monitoring for diabetes management.
JAMA Netw Open 2021 Jan;4(1):e2033115. doi: 10.1001/jamanetworkopen.2020.33115..
Keywords: Telehealth, Health Information Technology (HIT), Diabetes, Chronic Conditions, Care Management, Patient Self-Management, Patient Adherence/Compliance