National Healthcare Quality and Disparities Report
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Topics
- Behavioral Health (1)
- Blood Pressure (1)
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- Clinical Decision Support (CDS) (1)
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- Skin Conditions (1)
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- (-) Tobacco Use (10)
- Tobacco Use: Smoking Cessation (5)
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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 10 of 10 Research Studies DisplayedRoberts MM, Marino M, Wells R
Differences in use of clinical decision support tools and implementation of aspirin, blood pressure control, cholesterol management, and smoking cessation quality metrics in small practices by race and sex.
The objective of this cross-sectional study was to evaluate the association between population-based clinical decision support (CDS) tools and racial and sex disparities in the aspirin use, blood pressure control, cholesterol management, and smoking cessation (ABCS) care quality metrics among smaller primary care practices. Researchers used practice-level data from the EvidenceNOW initiative, from practices that submitted both survey data and electronic health record (EHR)-derived ABCS data stratified by race and sex. Their findings suggested that practices using CDS tools had small disparities but were not statistically significant; however, CDS tools were not associated with reductions in disparities. They concluded that more research was needed on effective practice-level interventions to mitigate disparities.
AHRQ-funded; HS023940.
Citation: Roberts MM, Marino M, Wells R .
Differences in use of clinical decision support tools and implementation of aspirin, blood pressure control, cholesterol management, and smoking cessation quality metrics in small practices by race and sex.
JAMA Netw Open 2023 Aug; 6(8):e2326905. doi: 10.1001/jamanetworkopen.2023.26905..
Keywords: Clinical Decision Support (CDS), Health Information Technology (HIT), Cardiovascular Conditions, Tobacco Use, Tobacco Use: Smoking Cessation, Primary Care, Evidence-Based Practice, Prevention
Kowitt SD, Goldstein AO, Cykert S
A heart healthy intervention improved tobacco screening rates and cessation support in primary care practices.
This study investigated the outcomes of an evidence-based cardiovascular disease risk reduction tool called Heart Health Now to improve rates for tobacco cessation screening and counseling in small primary care practices in North Carolina. This tool was developed as part of AHRQ’s EvidenceNow initiative. This stepped wedge, stratified, cluster randomized trial looked at 28 practices that were staffed by 10 or fewer clinicians and had an electronic health record. Heart Health Now consisted of education tools, onsite practice facilitation for a year, and a practice-specific cardiovascular population management dashboard that included monthly, measure-specific run charts to help guide quality improvement. The practices included in their analyses consisted of 78,120 patients, and 17,687 smokers. From pre- to post-intervention, screening rates significantly increased from 82.7 to 96.2%. Cessation support rates also significantly increased from 44.3% to 50.1%. Some of the practices associated with improvement included being in an academic health center or faculty, having more clinicians, and having a lower percentage of White patients.
AHRQ-funded; HS023912.
Citation: Kowitt SD, Goldstein AO, Cykert S .
A heart healthy intervention improved tobacco screening rates and cessation support in primary care practices.
J Prev 2022 Jun;43(3):375-86. doi: 10.1007/s10935-022-00672-5..
Keywords: Tobacco Use, Tobacco Use: Smoking Cessation, Screening, Primary Care, Evidence-Based Practice, Heart Disease and Health, Cardiovascular Conditions
Cohen DJ, Sweeney SM, Miller WL
Improving smoking and blood pressure outcomes: the interplay between operational changes and local context.
This study identified conditions and operational changes linked to improvements in smoking and blood pressure (BP) outcomes in primary care using samples and interviews from a subset of 104 practices participating in EvidenceNOW, a multisite cardiovascular disease prevention initiative. The authors calculated Clinical Quality Measure improvements, with targets of 10-point or greater absolute improvements in the proportion of patients with smoking screening, and if relevant, counseling and the proportion of hypertensive patients with adequately controlled BP. Primary care staff were surveyed and interviewed. In clinician-owned practices, implementing a workflow to routinely screen and counsel patients on smoking cessation resources, or implementing a documentation change or a referral to a resource alone led to an improvement of at least 10 points in the smoking outcome. These improvements did not occur though in health- or hospital system-owned practices or in Federally Qualified Health Centers. BP outcome improved by at least 10 points among solo practices after medical assistants learned how to take an accurate BP. Among larger, clinician-owned practices, BP outcomes improvement took place when staff took a second BP measurement after the first measurement was elevated and when staff learned where to document this information in the electronic health record. For larger and health- and hospital system-owned practices, 50 or more hours of facilitation was needed to improve BP outcomes.
AHRQ-funded; HS023940.
Citation: Cohen DJ, Sweeney SM, Miller WL .
Improving smoking and blood pressure outcomes: the interplay between operational changes and local context.
Ann Fam Med 2021 May-Jun;19(3):240-48. doi: 10.1370/afm.2668..
Keywords: Blood Pressure, Tobacco Use, Primary Care, Quality Improvement, Cardiovascular Conditions, Quality of Care, Evidence-Based Practice, Patient-Centered Outcomes Research, Prevention, Outcomes
Lewis JA, Senft N, Chen H
Evidence-based smoking cessation treatment: a comparison by healthcare system.
The authors surveyed general medicine providers and specialists in a large academic health center (AHC) and its affiliated Veterans Health Administration (VHA) in the Mid-South in 2017 to determine the cross-sectional association of healthcare system in which the provider practiced (AHC versus VHA) with self-reported provision of evidence-based smoking cessation treatment at least once in the past 12 months. They found that VHA healthcare providers were significantly more likely to provide evidence-based smoking cessation treatment compared to AHC healthcare providers.
AHRQ-funded; HS026122.
Citation: Lewis JA, Senft N, Chen H .
Evidence-based smoking cessation treatment: a comparison by healthcare system.
BMC Health Serv Res 2021 Jan 7;21(1):33. doi: 10.1186/s12913-020-06016-5..
Keywords: Health Systems, Tobacco Use: Smoking Cessation, Tobacco Use, Evidence-Based Practice, Substance Abuse
Chu KH, Matheny SJ, Escobar-Viera CG
Smartphone health apps for tobacco cessation: a systematic review.
The objective of this systematic review was to identify and evaluate the types of studies that use smartphone apps for interventions in tobacco cessation. Findings showed that the majority of studies identified that use tobacco cessation apps as an intervention delivery modality were mostly at the pilot/feasibility stage. The growing field has resulted in studies that varied in methodologies, study design, and inclusion criteria. Recommendations included more consistency in intervention components and larger randomized controlled trials for tobacco cessation smartphone apps.
AHRQ-funded; HS022989.
Citation: Chu KH, Matheny SJ, Escobar-Viera CG .
Smartphone health apps for tobacco cessation: a systematic review.
Addict Behav 2021 Jan;112:106616. doi: 10.1016/j.addbeh.2020.106616..
Keywords: Health Information Technology (HIT), Tobacco Use: Smoking Cessation, Tobacco Use, Evidence-Based Practice
Selph S, Patnode C, Bailey SR
Primary care-relevant interventions for tobacco and nicotine use prevention and cessation in children and adolescents: updated evidence report and systematic review for the US Preventive Services Task Force.
Interventions to discourage the use of tobacco products (including electronic nicotine delivery systems or e-cigarettes) among children and adolescents may help decrease tobacco-related illness and injury. The objective of this study was to update the 2013 review on primary care-relevant interventions for tobacco use prevention and cessation in children and adolescents to inform the US Preventive Services Task Force.
AHRQ-funded; 290201500009I.
Citation: Selph S, Patnode C, Bailey SR .
Primary care-relevant interventions for tobacco and nicotine use prevention and cessation in children and adolescents: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2020 Apr 28;323(16):1599-608. doi: 10.1001/jama.2020.3332..
Keywords: U.S. Preventive Services Task Force (USPSTF), Children/Adolescents, Tobacco Use, Tobacco Use: Smoking Cessation, Prevention, Primary Care, Evidence-Based Practice, Guidelines
Cartmell KB, Dooley M, Mueller M
Effect of an evidence-based inpatient tobacco dependence treatment service on 30-, 90-, and 180-day hospital readmission rates.
This study explored the effect of an inpatient tobacco dependence treatment services (TDTS) on 30-, 90-, and 180-day hospital readmissions. The investigators suggest that findings from their study, which are supported by prior studies, provide evidence that delivery of TDTS is a strategy that may help to reduce hospital readmissions.
AHRQ-funded; HS023863.
Citation: Cartmell KB, Dooley M, Mueller M .
Effect of an evidence-based inpatient tobacco dependence treatment service on 30-, 90-, and 180-day hospital readmission rates.
Med Care 2018 Apr;56(4):358-63. doi: 10.1097/mlr.0000000000000884..
Keywords: Evidence-Based Practice, Hospital Readmissions, Substance Abuse, Tobacco Use
Kantor R, Kim A, Thyssen JP
Association of atopic dermatitis with smoking: a systematic review and meta-analysis.
The authors examined the association between atopic dermatitis (AD) and exposure to tobacco smoke. They found that a diagnosis of AD was associated with higher odds of active smoking and exposure to passive smoke but not to maternal smoking during pregnancy, and concluded that active and passive tobacco smoke exposure are associated with increased AD prevalence.
AHRQ-funded; HS023011.
Citation: Kantor R, Kim A, Thyssen JP .
Association of atopic dermatitis with smoking: a systematic review and meta-analysis.
J Am Acad Dermatol 2016 Dec;75(6):1119-25.e1. doi: 10.1016/j.jaad.2016.07.017.
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Keywords: Skin Conditions, Tobacco Use, Risk, Evidence-Based Practice
Patnode CD, Henderson JT, Thompson JH
Behavioral counseling and pharmacotherapy interventions for tobacco cessation in adults, including pregnant women: a review of reviews for the U.S. Preventive Services Task Force.
The researchers reviewed the effectiveness and safety of pharmacotherapy and behavioral interventions for tobacco cessation. They concluded that behavioral and pharmacotherapy interventions improve rates of smoking cessation among the general adult population, alone or in combination. Data on the effectiveness and safety of electronic nicotine delivery systems are limited.
AHRQ-funded; 290201200015I.
Citation: Patnode CD, Henderson JT, Thompson JH .
Behavioral counseling and pharmacotherapy interventions for tobacco cessation in adults, including pregnant women: a review of reviews for the U.S. Preventive Services Task Force.
Ann Intern Med 2015 Oct 20;163(8):608-21. doi: 10.7326/m15-0171..
Keywords: Behavioral Health, Evidence-Based Practice, Medication, Pregnancy, Prevention, Tobacco Use, U.S. Preventive Services Task Force (USPSTF), Women
Leeman J, Myers AE, Ribisl KM
Disseminating policy and environmental change interventions: insights from obesity prevention and tobacco control.
This paper describes the approach that two projects developed to disseminate policy and environmental change interventions. The Center for Training and Research Translation (Center TRT) disseminates evidence-based interventions (EBIs) to promote physical activity and healthy eating. Counter Tobacco disseminates EBIs to counter tobacco product sales and marketing in the retail environment.
AHRQ-funded; HS019468.
Citation: Leeman J, Myers AE, Ribisl KM .
Disseminating policy and environmental change interventions: insights from obesity prevention and tobacco control.
Int J Behav Med 2015 Jun;22(3):301-11. doi: 10.1007/s12529-014-9427-1..
Keywords: Communication, Evidence-Based Practice, Obesity, Policy, Prevention, Public Health, Tobacco Use, Implementation