National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Blood Pressure (1)
- Cardiovascular Conditions (1)
- Care Management (1)
- Case Study (1)
- Children/Adolescents (1)
- (-) Chronic Conditions (18)
- COVID-19 (1)
- Diabetes (1)
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- Newborns/Infants (1)
- Nutrition (1)
- Opioids (4)
- Pain (4)
- Patient-Centered Healthcare (1)
- Patient Safety (1)
- Practice-Based Research Network (PBRN) (1)
- Practice Patterns (3)
- Prevention (5)
- Primary Care (4)
- Primary Care: Models of Care (1)
- Public Health (1)
- Quality of Care (1)
- Respiratory Conditions (2)
- Screening (1)
- Skin Conditions (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 18 of 18 Research Studies DisplayedTracer H, Haselby C
AHRQ Author: Tracer H
Hormone therapy for the primary prevention of chronic conditions in postmenopausal people.
This case study described a 50-year-old woman whose last menstrual cycle was more than a year previous. Case study questions related to the USPSTF recommendation on hormone therapy addressed whether this patient would benefit from hormone therapy to prevent the onset of chronic conditions that become more common after menopause.
AHRQ-authored.
Citation: Tracer H, Haselby C .
Hormone therapy for the primary prevention of chronic conditions in postmenopausal people.
Am Fam Physician 2023 Jun; 107(6):645-46..
Keywords: U.S. Preventive Services Task Force (USPSTF), Guidelines, Evidence-Based Practice, Prevention, Chronic Conditions, Women
Mills J, Barnhart H
AHRQ Author: Mills J
Screening for prediabetes and type 2 diabetes in children and adolescents.
This Putting Prevention into Practice case study is used to increase understanding of the USPSTF final recommendation on screening for prediabetes and type 2 diabetes in children and adolescents. A case study was presented using a 12-year-old-patient with no specific concerns but had gained 18 pounds since their last wellness visit and lives a sedentary lifestyle. The patient’s family history of type 2 diabetes mellitus in maternal and paternal grandparents is described. Three multiple-choice questions are presented regarding harms and benefits of screening for prediabetes and type 2 diabetes for that patient.
AHRQ-authored.
Citation: Mills J, Barnhart H .
Screening for prediabetes and type 2 diabetes in children and adolescents.
Am Fam Physician 2023 Jan; 107(1):79-80..
Keywords: U.S. Preventive Services Task Force (USPSTF), Children/Adolescents, Diabetes, Screening, Evidence-Based Practice, Guidelines, Prevention, Chronic Conditions, Case Study
Gartlehner G, Patel SV, Reddy S
Hormone therapy for the primary prevention of chronic conditions in postmenopausal persons: updated evidence report and systematic review for the US Preventive Services Task Force.
This US Preventive Services Task Force (USPSTF) recommendation is an updated evidence report and systematic review on the use of hormone therapy in postmenopausal persons for the primary prevention of chronic conditions. The reviewers included 20 trials (N = 39,145) and 3 cohort studies (N = 1,155,410) from a dual review of abstracts, full-text articles, and study quality. Harms and benefits were compared for participants using estrogen only compared with estrogen plus progestin. Participants using estrogen only compared with placebo had significantly lower risks for diabetes and fractures, but increased for gallbladder disease over 7.1 years, stroke over 7.2 years, venous thromboembolism over 7.2 years and urinary incontinence over 1 year. For participants using estrogen plus progestin some benefits were found, but there was also an increased risk of harms significantly for invasive breast cancer, gallbladder disease, venous thromboembolism, probable dementia, and urinary incontinence.
AHRQ-funded; 75Q80120D00007.
Citation: Gartlehner G, Patel SV, Reddy S .
Hormone therapy for the primary prevention of chronic conditions in postmenopausal persons: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2022 Nov 1;328(17):1747-65. doi: 10.1001/jama.2022.18324..
Keywords: U.S. Preventive Services Task Force (USPSTF), Prevention, Evidence-Based Practice, Guidelines, Chronic Conditions, Women
Ong T, Onchiri FM, Britto MT
Impact of guideline-recommended dietitian assessments on weight gain in infants with cystic fibrosis.
This study’s purpose was to characterize nutrition management for infants with cystic fibrosis (CF) with inadequate weight gain and to assess association of dietitian assessments and center-level weight-for-age Z-scores (WAZ). Encounter data from 226 infants was used from across 28 US CF Centers from the Baby Observational Nutritional study between January 2012 through December 2017. The authors identified dietitian assessments and consensus guideline-recommended responses to inadequate weight gain: calorie increases, pancreatic enzyme replacement therapy (PERT) increases, or shortened time to next visit. They compared center assessments by funnel plot and summarized median WAZ by center. Of 2,527 visits, 808 visits had identified inadequate weight gain, distributed in 216 infants. Assessments occurred in 77% of visits but varied widely between centers (range 17% - 98%). They used funnel plot analysis to identify high-performers for frequent dietitian assessments (range 92% - 98%) and 4 under-performers (range 17% - 56%). High-performers treated inadequate weight gain more often with adequate calories (80% vs 52%) and closer follow-up (63% vs 49%) compared to underperformers. Three of 4 high-performing sites met center nutrition goals for positive median WAZ at 2 years old unlike 3 under-performers, despite similar patient characteristics.
AHRQ-funded; HS026393.
Citation: Ong T, Onchiri FM, Britto MT .
Impact of guideline-recommended dietitian assessments on weight gain in infants with cystic fibrosis.
J Cyst Fibros 2022 Jan; 21(1):115-22. doi: 10.1016/j.jcf.2021.08.005..
Keywords: Newborns/Infants, Respiratory Conditions, Chronic Conditions, Nutrition, Evidence-Based Practice, Guidelines
Bierman AS, Wang J, O'Malley PG
AHRQ Author: Bierman AS, Wang J, O'Malley PG, Moss DK
Transforming care for people with multiple chronic conditions: Agency for Healthcare Research and Quality's research agenda.
This article describes issues addressing the needs of those with multiple chronic conditions and discusses the AHRQ research agenda.
AHRQ-authored.
Citation: Bierman AS, Wang J, O'Malley PG .
Transforming care for people with multiple chronic conditions: Agency for Healthcare Research and Quality's research agenda.
Health Serv Res 2021 Oct;56(Suppl 1):973-79. doi: 10.1111/1475-6773.13863..
Keywords: Chronic Conditions, Health Services Research (HSR), Healthcare Delivery, Quality of Care, Primary Care, Guidelines, Evidence-Based Practice
Carey RM, Wright JT, Taler SJ
Guideline-driven management of hypertension: an evidence-based update.
This paper is an evidence-based update to the 2017 American College of Cardiology/American Heart Association Blood Pressure Guideline. The authors conducted a literature review of relevant observational studies, randomized clinical trials, and meta-analyses published between January 2018 and March 2021. Topics included blood pressure (BP) measurement, patient evaluation, patient evaluation for secondary hypertension, cardiovascular disease risk assessment and BP threshold for drug therapy, lifestyle and pharmacological management, treatment target BP goal, management of hypertension in older adults, diabetes, chronic kidney disease, resistant hypertension, and optimization of care using patient, provider, and health system approaches.
AHRQ-funded; HS027944.
Citation: Carey RM, Wright JT, Taler SJ .
Guideline-driven management of hypertension: an evidence-based update.
Circ Res 2021 Apr 2;128(7):827-46. doi: 10.1161/circresaha.121.318083..
Keywords: Blood Pressure, Guidelines, Evidence-Based Practice, Cardiovascular Conditions, Chronic Conditions
Navis A, George MC, Nmashie A
Validation of the Safer Opioid Prescribing Evaluation Tool (SOPET) for assessing adherence to the Centers for Disease Control opioid prescribing guidelines.
This study assessed the use of the Safer Opioid Prescribing Evaluation Tool (SOPET) which was designed to improve the implementation of the 2016 Centers for Disease Control Guidelines on the prescription of opioids for chronic pain. Four raters with varying levels of clinical experience were trained to use the SOPET and then used it to evaluate 21 baseline patient scenarios. Inter-rater reliability was measured using intraclass correlation coefficient (ICC) estimates and their 95% confidence intervals for the total SOPET score based on a mean-rating absolute-agreement, two-way random-effects model. Inter-rater reliability was found to be good for the three physician raters (0.92, 0.97, and 0.99). However, inter-rater reliability for the non-physician rater was lower (0.67).
AHRQ-funded; HS025641.
Citation: Navis A, George MC, Nmashie A .
Validation of the Safer Opioid Prescribing Evaluation Tool (SOPET) for assessing adherence to the Centers for Disease Control opioid prescribing guidelines.
Pain Med 2020 Dec 25;21(12):3655-59. doi: 10.1093/pm/pnaa138..
Keywords: Opioids, Medication, Medication: Safety, Patient Safety, Guidelines, Practice Patterns, Pain, Chronic Conditions, Evidence-Based Practice
Gelfand JM, Armstrong AW, Bell S
National Psoriasis Foundation COVID-19 Task Force guidance for management of psoriatic disease during the pandemic: Vversion 1.
This article describes the process that was used to create the first version of a guidance document for management of psoriatic disease during the COVID-19 pandemic developed by the National Psoriasis Foundation. A task force of 18 physician voting members with expertise in dermatology, rheumatology, epidemiology, infectious diseases, and critical care was created with supplementation by nonvoting members. A Delphi process was created, out of which 22 guidance statements were approved. All guidance statements were recommended, with 9 of them high consensus, and the remaining 13 were moderate consensus. Topics covered included how COVID-19 can impact patients, how medical care can be optimized during the pandemic, and what patients can do to lower their risk of getting infected with COVID-19. This guidance will be updated by the TF as new data emerges.
AHRQ-funded; HS026372.
Citation: Gelfand JM, Armstrong AW, Bell S .
National Psoriasis Foundation COVID-19 Task Force guidance for management of psoriatic disease during the pandemic: Vversion 1.
J Am Acad Dermatol 2020 Dec;83(6):1704-16. doi: 10.1016/j.jaad.2020.09.001..
Keywords: Skin Conditions, Chronic Conditions, Care Management, Evidence-Based Practice, Guidelines, COVID-19
Heins SE, Castillo RC
The impact of morphine equivalent daily dose threshold guidelines on prescribed dose in a workers' compensation population.
This study evaluated the impact of dissemination Morphine Equivalent Daily Dose (MEDD) guidelines to state workers’ compensation boards to discourage high-dose opioid use among injured workers receiving workers’ compensation. The study used workers compensations claims data from 2010-2013 from 2 guideline states and 3 control states. The policy implementation showed a 9.26 mg decrease in MEDD after adjusting for covariates, state fixed-effects, and time trends. The decreases became more pronounced over the study period.
AHRQ-funded; HS025557.
Citation: Heins SE, Castillo RC .
The impact of morphine equivalent daily dose threshold guidelines on prescribed dose in a workers' compensation population.
Med Care 2020 Mar;58(3):241-47. doi: 10.1097/mlr.0000000000001269..
Keywords: Opioids, Medication, Pain, Chronic Conditions, Practice Patterns, Guidelines
Livingston CJ, Allison RD, Niebuhr DW
AHRQ Author: Niebuhr DW
Preventive medicine physicians and the Centers for Disease Control and Prevention's 6|18 Initiative.
This paper describes the American College of Preventive Medicine (ACPM) and Centers for Disease Control and Prevention (CDC) work done as part of the cooperative 5-year agreement called the 6|18 Initiative to improve population health through primary care and public health integration. This initiative is called 6|18 because its’ aim was to target six common and high-cost health behaviors/conditions with 18 proven interventions. CDC created three different buckets to describe the preventions. The six health behaviors/conditions targeted included reducing tobacco use, control high blood pressure, improve antibiotic use, control asthma, prevent unintended pregnancy, and prevent type 2 diabetes. The initiative aligned recommendations from national and professional societies and focused the guidelines from the U.S. Preventive Services Task Force (USPSTF). After six telephone-moderated discussions of the authors, three themes were developed as to how physicians may perceive the 6|18 interventions. The problems included lack of knowledge/awareness, variations in financial incentives and operational challenges such as time constraints.
AHRQ-authored.
Citation: Livingston CJ, Allison RD, Niebuhr DW .
Preventive medicine physicians and the Centers for Disease Control and Prevention's 6|18 Initiative.
Am J Prev Med 2019 Jul;57(1):127-33. doi: 10.1016/j.amepre.2019.02.014..
Keywords: Prevention, Primary Care, Public Health, Evidence-Based Practice, U.S. Preventive Services Task Force (USPSTF), Guidelines, Chronic Conditions
Callaghan BC, Reynolds E, Banerjee M
Longitudinal pattern of pain medication utilization in peripheral neuropathy patients.
The authors of this article investigated the pattern and utilization of neuropathic pain medications in peripheral neuropathy patients. They found that opioid initiation and transition to chronic opioid therapy were frequent in the studied population despite few patients receiving more than one guideline-recommended medication. They concluded that efforts are needed to decrease opioid utilization and to increase guideline-recommended medication use in order to improve current neuropathic pain treatment.
AHRQ-funded; HS017690.
Citation: Callaghan BC, Reynolds E, Banerjee M .
Longitudinal pattern of pain medication utilization in peripheral neuropathy patients.
Pain 2019 Mar;160(3):592-99. doi: 10.1097/j.pain.0000000000001439..
Keywords: Chronic Conditions, Guidelines, Healthcare Utilization, Medication, Neurological Disorders, Opioids, Pain, Practice Patterns
Gartlehner G, Patel SV, Feltner C
Hormone therapy for the primary prevention of chronic conditions in postmenopausal women: evidence report and systematic review for the US Preventive Services Task Force.
This review updated evidence for the US Preventive Services Task Force on the benefits and harms of hormone therapy in reducing risks for chronic conditions. It concluded that hormone therapy for the primary prevention of chronic conditions in menopausal women is associated with some beneficial effects but also with a substantial increase of risks for harms. The available evidence regarding benefits and harms of early initiation of hormone therapy is inconclusive.
AHRQ-funded; 290201200015I.
Citation: Gartlehner G, Patel SV, Feltner C .
Hormone therapy for the primary prevention of chronic conditions in postmenopausal women: evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2017 Dec 12;318(22):2234-49. doi: 10.1001/jama.2017.16952.
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Keywords: Chronic Conditions, Evidence-Based Practice, Guidelines, Prevention, U.S. Preventive Services Task Force (USPSTF), Women
Bierman AS, Tinetti ME
AHRQ Author: Bierman AS
Precision medicine to precision care: managing multimorbidity.
Multimorbidity is the most common condition managed in practice. The authors argue that health-care delivery must be transformed to provide precision care to people with multimorbidity. Accomplishing this transition will require a change in practice, research, and policy from disease-specific to patient-centered models of care delivery.
AHRQ-authored.
Citation: Bierman AS, Tinetti ME .
Precision medicine to precision care: managing multimorbidity.
Lancet 2016 Dec 3;388(10061):2721-23. doi: 10.1016/s0140-6736(16)32232-2.
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Keywords: Healthcare Delivery, Chronic Conditions, Guidelines, Patient-Centered Healthcare, Primary Care, Primary Care: Models of Care
Wilson KC, Gould MK, Krishnan JA
An official American Thoracic Society workshop report. A framework for addressing multimorbidity in clinical practice guidelines for pulmonary disease, critical illness, and sleep disorders.
The American Thoracic Society convened a workshop to establish a strategy to address multimorbidity within clinical practice guidelines. This report describes a framework that addresses multimorbidity in each of the key steps of guideline development: topic selection, panel composition, identifying clinical questions, searching for and synthesizing evidence, rating the quality of that evidence, summarizing benefits and harms, formulating recommendations, and rating the strength of the recommendations.
AHRQ-funded; HS020672.
Citation: Wilson KC, Gould MK, Krishnan JA .
An official American Thoracic Society workshop report. A framework for addressing multimorbidity in clinical practice guidelines for pulmonary disease, critical illness, and sleep disorders.
Ann Am Thorac Soc 2016 Mar;13(3):S12-21. doi: 10.1513/AnnalsATS.201601-007ST.
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Keywords: Sleep Problems, Guidelines, Evidence-Based Practice, Chronic Conditions, Respiratory Conditions
Callaghan BC, Kerber KA, Burke JF
Headaches and neuroimaging—reply.
The authors of this letter, replying to two letters commenting on their earlier article on headaches and neuroimaging, find that they all share the view that neuroimaging is overused in headache presentations. They also discuss the potential downsides of interventions to reduce use, the impact of medical malpractice on overuse of tests, and the lack of consensus in defining low-value tests.
AHRQ-funded; HS017690
Citation: Callaghan BC, Kerber KA, Burke JF .
Headaches and neuroimaging—reply.
JAMA Intern Med. 2015 Feb;175(2):313-4. doi: 10.1001/jamainternmed.2014.7014..
Keywords: Neurological Disorders, Healthcare Costs, Chronic Conditions, Guidelines
Mold JW, Aspy CB, Smith PD
Leveraging practice-based research networks to accelerate implementation and diffusion of chronic kidney disease guidelines in primary care practices: a prospective cohort study.
This study was conducted to determine whether practice-based research networks (PBRNs) could increase dissemination, implementation, and diffusion of evidence-based treatment guidelines for chronic kidney disease by leveraging early adopter practices. After the intervention, the initial four PBRNs increased the use of ACEIs/ARBs, discontinuation of NSAIDs, testing for anemia, and testing and/or treatment for vitamin D deficiency. Most were able to recruit two additional practices, which also increased their use of ACEIs/ARBs and testing and/or treatment of vitamin D deficiency. The researchers concluded that, with some assistance, early adopter practices can facilitate the diffusion of evidence-based approaches to other practices.
AHRQ-funded; HS019945.
Citation: Mold JW, Aspy CB, Smith PD .
Leveraging practice-based research networks to accelerate implementation and diffusion of chronic kidney disease guidelines in primary care practices: a prospective cohort study.
Implement Sci 2014 Nov 23;9:169. doi: 10.1186/s13012-014-0169-x.
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Keywords: Practice-Based Research Network (PBRN), Primary Care, Kidney Disease and Health, Chronic Conditions, Guidelines, Implementation
Callaghan BC, Kerber KA, Pace RJ
Headaches and neuroimaging: high utilization and costs despite guidelines.
Little is known about recent headache neuroimaging utilization, associated expenditures, and temporal trends. Looking at 51.1 million outpatient headache visits over 4 years, this study found that neuroimaging is ordered during 12% of these visits, costs $1 billion annually, and is increasing over time.
AHRQ-funded; HS017690
Citation: Callaghan BC, Kerber KA, Pace RJ .
Headaches and neuroimaging: high utilization and costs despite guidelines.
JAMA Intern Med. 2014 May;174(5):819-21. doi: 10.1001/jamainternmed.2014.173..
Keywords: Neurological Disorders, Healthcare Utilization, Guidelines, Healthcare Costs, Chronic Conditions
Nuckols TK, Anderson L, Popescu I
Opioid prescribing: a systematic review and critical appraisal of guidelines for chronic pain.
This review evaluated the quality and content of guidelines on the use of opioids for chronic pain. Despite limited evidence and variable development methods, it concluded that recent guidelines on chronic pain agree on several opioid risk mitigation strategies, including upper dosing thresholds; cautions with certain medications; attention to drug–drug and drug–disease interactions; and use of risk assessment tools, treatment agreements, and urine drug testing.
AHRQ-funded; HS017954.
Citation: Nuckols TK, Anderson L, Popescu I .
Opioid prescribing: a systematic review and critical appraisal of guidelines for chronic pain.
Ann Intern Med 2014 Jan 7;160(1):38-47. doi: 10.7326/0003-4819-160-1-201401070-00732..
Keywords: Opioids, Pain, Guidelines, Medication, Evidence-Based Practice, Chronic Conditions