National Healthcare Quality and Disparities Report
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Topics
- Caregiving (1)
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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 DisplayedMacDonald J, Doyle L, Moore
Sustainment of proactive physical therapy for individuals with early-stage Parkinson's disease: a quality improvement study over 4 years.
The purpose of this study is to describe the process of sustaining a proactive physical therapy (PAPT) program in practice for 4 years for patients with early-stage Parkinson’s disease. Sustainability was measured using RE-AIM, NHS Sustainability Model, and the Clinical Sustainability Assessment Tool. Reach increased from 28 to 110 total patients per year. The program sustained its effect to help participants increase or maintain self-reported exercise. Upon evaluation, PAPT users in year 3 had longer time since symptom onset and worse UPDRS motor scores compared to year 1 PAPT users.
AHRQ-funded; HS025077.
Citation: MacDonald J, Doyle L, Moore .
Sustainment of proactive physical therapy for individuals with early-stage Parkinson's disease: a quality improvement study over 4 years.
Implement Sci Commun 2021 Sep 27;2(1):111. doi: 10.1186/s43058-021-00205-x..
Keywords: Neurological Disorders, Quality Improvement, Quality of Care, Care Management
Shetty KD, Robbins M, Aragaki D
The quality of electrodiagnostic tests for carpal tunnel syndrome: Implications for surgery, outcomes, and expenditures.
The quality of electrodiagnostic tests may influence treatment decisions, particularly regarding surgery, affecting health outcomes and health-care expenditures. In this study, the investigators evaluated test quality among 338 adults with workers' compensation claims for carpal tunnel syndrome. The investigators found that in simulations, suboptimal quality tests rendered surgery inappropriate for 99 of 309 patients (+32 percentage points). They also found that test quality was not associated with overall health, actual receipt of surgery, or expenditures.
AHRQ-funded; HS018982.
Citation: Shetty KD, Robbins M, Aragaki D .
The quality of electrodiagnostic tests for carpal tunnel syndrome: Implications for surgery, outcomes, and expenditures.
Muscle Nerve 2020 Jul;62(1):60-69. doi: 10.1002/mus.26874..
Keywords: Diagnostic Safety and Quality, Neurological Disorders, Surgery, Quality Indicators (QIs), Quality Measures, Quality of Care
Crystal S, Jarrín OF, Rosenthal M
National partnership to improve dementia care in nursing homes campaign: state and facility strategies, impact, and antipsychotic reduction outcomes.
This study examines the success of the national partnership campaign to reduce prescription of antipsychotic medications to elderly nursing home residents with dementia. Antipsychotic medications have been shown to increase mortality. Use of these medications had increased 23.9% in dementia patients by 2011. The campaign reduced use by 40.1% to 14.3% by the second quarter of 2019. The campaign measured progress with public reporting of quality measures, increased regulatory scrutiny, and accompanying state and facility initiatives. Sedative-hypnotic medication use also decreased in tandem with antipsychotic reduction suggesting that the campaign increased attention to the use of other risky psychotropic medications.
AHRQ-funded; HS023464; HS022406; HS023258; HS021112.
Citation: Crystal S, Jarrín OF, Rosenthal M .
National partnership to improve dementia care in nursing homes campaign: state and facility strategies, impact, and antipsychotic reduction outcomes.
Innov Aging 2020 Jun 2;4(3):igaa018. doi: 10.1093/geroni/igaa018..
Keywords: Elderly, Nursing Homes, Long-Term Care, Dementia, Neurological Disorders, Quality Improvement, Quality of Care, Medication, Mortality
LaHue SC, Albers K, Goldman S
Cervical dystonia incidence and diagnostic delay in a multiethnic population.
This study examined rates of diagnostic delay of cervical dystonia (CD) and the population of CD patients. Cases were identified from electronic medical records and multistage screening of more than 3 million Kaiser Permanente Northern California members from 2003-2007. CD incidence is greater in women and increases with age. About half of CD patients had a diagnostic delay. They were first given diagnoses of essential tremor, cervical disc disease, neck sprain/strain, anxiety and depression. Adverse effects are associated with diagnostic delay.
AHRQ-funded; HS018413.
Citation: LaHue SC, Albers K, Goldman S .
Cervical dystonia incidence and diagnostic delay in a multiethnic population.
Mov Disord 2020 Mar;35(3):450-56. doi: 10.1002/mds.27927..
Keywords: Neurological Disorders, Diagnostic Safety and Quality, Patient Safety, Quality of Care
Simon KC, Yucus C, Castle J
Building of EMR tools to support quality and research in a memory disorders clinic.
This article describes the development of a customized EMR toolkit that standardizes patient data collection with hundreds of discrete fields, supports Best Practices for treating patients with memory disorders, and also supports practice-based research. The toolkit was successfully implemented to support Best Practices in the care of patients with memory disorders. Applications are also discussed. Data collection is ongoing, but the authors anticipate that the toolkit will generate data that allows for descriptive and hypothesis-driven research as well as quality improvement among patients seen in memory clinics.
AHRQ-funded; HS024057.
Citation: Simon KC, Yucus C, Castle J .
Building of EMR tools to support quality and research in a memory disorders clinic.
Front Neurol 2019 Mar 7;10:161. doi: 10.3389/fneur.2019.00161..
Keywords: Dementia, Electronic Health Records (EHRs), Health Information Technology (HIT), Neurological Disorders, Quality of Care, Quality Improvement, Tools & Toolkits
Gaugler JE, Zmora R, Mitchell LL
Six-month effectiveness of remote activity monitoring for persons living with dementia and their family caregivers: an experimental mixed methods study.
This paper describes a pilot study conducted to evaluate the effectiveness of remote activity monitoring (RAM) for persons living with Alzheimer’s disease or a related dementia (ADRD) and their family caregivers. An experimental mixed methods study of 132 persons living with ADRD was conducted for six months. There were mixed results as the early months spent calibrating and modifying the RAM system was challenging for families. For families who care for ADRD patients with less severe cognitive impairment and difficulty navigating around the most there was a statistically significant increase in competence and self-sufficiency. However, it may not be as effective for patients with more severe cognitive impairment.
AHRQ-funded; HS022836.
Citation: Gaugler JE, Zmora R, Mitchell LL .
Six-month effectiveness of remote activity monitoring for persons living with dementia and their family caregivers: an experimental mixed methods study.
Gerontologist 2019 Jan 9;59(1):78-89. doi: 10.1093/geront/gny078..
Keywords: Caregiving, Dementia, Elderly, Health Information Technology (HIT), Neurological Disorders, Quality of Care, Quality Improvement
Nuckols TK, Conlon C, Robbins M
Quality of care and patient-reported outcomes in carpal tunnel syndrome: a prospective observational study.
This prospective observational study examined the association of higher quality care for carpal tunnel syndrome (CTS) with better outcomes. Adults diagnosed with CTS from 30 occupational health centers were recruited and their physicians' adherence to recommended care processes evaluated. Among 343 individuals, receiving better was associated with greater improvements. CTS symptoms showed greater improvement when physicians assessed and managed patient activity, when patients underwent necessary surgery, and when employers adjusted job tasks. The researchers conclude that efforts should be made to ensure patients with CTS receive essential care processes, including activity assessment and management as well as necessary surgery.
AHRQ-funded; HS018982.
Citation: Nuckols TK, Conlon C, Robbins M .
Quality of care and patient-reported outcomes in carpal tunnel syndrome: a prospective observational study.
Muscle Nerve 2018 Jun;57(6):896-904. doi: 10.1002/mus.26041..
Keywords: Neurological Disorders, Outcomes, Patient Experience, Patient-Centered Outcomes Research, Quality of Care
Nuckols T, Conlon C, Robbins M
Quality of care for work-associated carpal tunnel syndrome.
This study evaluated the quality of care provided to individuals with workers' compensation claims related to carpal tunnel syndrome and identified patient characteristics associated with receiving better care. Overall, 81.6 percent of care adhered to recommended standards. Patients with classic/probable Katz diagrams, positive electrodiagnostic tests, and higher incomes received better care. However, age, sex, and race/ethnicity were not associated with quality.
AHRQ-funded; HS018982.
Citation: Nuckols T, Conlon C, Robbins M .
Quality of care for work-associated carpal tunnel syndrome.
J Occup Environ Med 2017 Jan;59(1):47-53. doi: 10.1097/jom.0000000000000916.
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Keywords: Guidelines, Quality of Care, Neurological Disorders, Patient-Centered Healthcare, Quality Indicators (QIs)
Narayanan J, Dobrin S, Choi J
Structured clinical documentation in the electronic medical record to improve quality and to support practice-based research in epilepsy.
The researchers describe a stepwise process for building structured clinical documentation support tools in the electronic medical record (EMR) that define best practices in epilepsy, and describe how they incorporated these toolkits into their clinical workflow. These tools write notes and capture hundreds of fields of data including several score tests. They also summarize brain imaging, blood laboratory, and electroencephalography results, and document neuromodulation treatments.
AHRQ-funded; HS024057.
Citation: Narayanan J, Dobrin S, Choi J .
Structured clinical documentation in the electronic medical record to improve quality and to support practice-based research in epilepsy.
Epilepsia 2017 Jan;58(1):68-76. doi: 10.1111/epi.13607.
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Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Neurological Disorders, Quality of Care, Quality Improvement, Tools & Toolkits, Workflow
Conlon C, Asch S, Hanson M
Assessing the value of high-quality care for work-associated carpal tunnel syndrome in a large integrated health care system: study design.
The researchers described the design of a study that is assessing quality of care for work-associated carpal tunnel syndrome and associations with clinical outcomes and costs. They found that time off work was generally short and related to surgery. They recommended systematic efforts to evaluate and improve quality of medical care for this condition.
AHRQ-funded; HS018982.
Citation: Conlon C, Asch S, Hanson M .
Assessing the value of high-quality care for work-associated carpal tunnel syndrome in a large integrated health care system: study design.
Perm J 2016 Fall;20(4):87-95. doi: 10.7812/tpp/15-220.
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Keywords: Healthcare Delivery, Quality of Care, Injuries and Wounds, Neurological Disorders, Patient-Centered Outcomes Research