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Research Studies is a monthly compilation of research articles funded by AHRQ or authored by AHRQ researchers and recently published in journals or newsletters.
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1 to 25 of 726 Research Studies Displayed
Bender M, Williams M, Cruz MF
A study protocol to evaluate the implementation and effectiveness of the Clinical Nurse Leader care model in improving quality and safety outcomes.
The authors discuss the Clinical Nurse Leader care model, a Hybrid Type II Implementation-Effectiveness study to evaluate the effect of the care model on standardized quality and safety outcomes and to identify implementation characteristics that are sufficient and necessary to achieve outcomes. Findings are expected to elucidate Registered Nurse's mechanisms of action as organized into frontline models of care and link actions to improved care quality and safety.
AHRQ-funded; HS027181.
Citation:
Bender M, Williams M, Cruz MF .
A study protocol to evaluate the implementation and effectiveness of the Clinical Nurse Leader care model in improving quality and safety outcomes.
Nurs Open 2021 Nov;8(6):3688-96. doi: 10.1002/nop2.910..
Keywords:
Implementation, Quality Improvement, Quality of Care, Patient Safety, Nursing, Evidence-Based Practice
Bierman AS, Wang J, O'Malley PG
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
Baughman AW, Renton M, Wehbi NK
Building community and resilience in Massachusetts nursing homes during the COVID-19 pandemic.
Researchers discuss the partnership of the Massachusetts Senior Care Association and Hebrew SeniorLife with AHRQ ECHO National Nursing Home COVID-19 Action Network (the Network). This educational program provided 16 weeks of free weekly virtual sessions to 295 eligible nursing homes. The Network weekly meetings were a source of connection, emotional support, and validation and may be a valuable mechanism to support resilience and wellbeing for nursing home staff.
AHRQ-funded; 75Q80120C00003.
Citation:
Baughman AW, Renton M, Wehbi NK .
Building community and resilience in Massachusetts nursing homes during the COVID-19 pandemic.
J Am Geriatr Soc 2021 Oct;69(10):2716-21. doi: 10.1111/jgs.17389..
Keywords:
COVID-19, Elderly, Nursing Homes, Evidence-Based Practice, Provider: Health Personnel, Education: Continuing Medical Education, Training
Austin EJ, LeRouge C, Lee JR
A learning health systems approach to integrating electronic patient-reported outcomes across the health care organization.
The authors reported on their effort to develop generalizable learnings that can support the integration of electronic patient-reported outcome measures into clinical practice within a learning health system (LHS) framework. They concluded that the guidelines produced from this work highlighted the complex, multidisciplinary nature of implementing change within LHS contexts, as well as the value of action research approaches to enable rapid, iterative learning that leverages the knowledge and experience of communities of practice.
AHRQ-funded; HS023785.
Citation:
Austin EJ, LeRouge C, Lee JR .
A learning health systems approach to integrating electronic patient-reported outcomes across the health care organization.
Learn Health Syst 2021 Oct;5(4):e10263. doi: 10.1002/lrh2.10263..
Keywords:
Learning Health Systems, Health Information Technology (HIT), Patient-Centered Outcomes Research, Outcomes, Evidence-Based Practice
Cantor A, Dana T, Griffin JC
Screening for chlamydial and gonococcal infections: updated evidence report and systematic review for the US Preventive Services Task Force.
This is the evidence summary and updated review for the September 2021 U.S. Preventive Services Task Force final recommendation on screening for chlamydial and gonococcal infections among sexually active women 25 years or older and sexually active men. The Task Force concluded that for women screening is recommended, but for men the current evidence is insufficient to assess the balance of benefits and harms. This systematic review screened over 2200 articles and included 20 articles. The articles included helped to answer the 4 key questions that were included in the research plan.
AHRQ-funded; 290201500009I.
Citation:
Cantor A, Dana T, Griffin JC .
Screening for chlamydial and gonococcal infections: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2021 Sep 14;326(10):957-66. doi: 10.1001/jama.2021.10577..
Keywords:
U.S. Preventive Services Task Force (USPSTF), Sexual Health, Infectious Diseases, Screening, Evidence-Based Practice, Guidelines, Prevention
Smith BM, Sharma R, Das A
Patient and family engagement strategies for children and adolescents with chronic diseases: a review of systematic reviews.
Patient and family engagement is important for family-centered care, particularly for children and adolescents with chronic disease. In this study the investigators aimed to 1) identify available evidence from systematic reviews on engagement strategies used to help children, adolescents, and their caregivers manage chronic conditions, and 2) identify gaps in the literature. They searched PubMed and CINAHL from January 2015 to January 2020 for systematic reviews on patient and family engagement strategies in the pediatrics population (<18 years).
AHRQ-funded; 290201500006I.
Citation:
Smith BM, Sharma R, Das A .
Patient and family engagement strategies for children and adolescents with chronic diseases: a review of systematic reviews.
Patient Educ Couns 2021 Sep;104(9):2213-23. doi: 10.1016/j.pec.2021.02.026..
Keywords:
Children/Adolescents, Patient and Family Engagement, Chronic Conditions, Patient-Centered Healthcare, Evidence-Based Practice, Patient Self-Management
Garsa A, Jang JK, Baxi S
Radiation therapy for brain metastases: a systematic review.
This systematic review synthesizes the available evidence on radiation therapy for brain metastases. A literature search was conducted using the major medical databases and included randomized controlled trials and large observational studies which evaluated whole brain radiation therapy (WBRT) and stereotactic radiosurgery (SRS) alone or in combination as initial or postoperative treatment, with or without systemic therapy for adults with brain metastases due to lung cancer, breast cancer, or melanoma. No statistically significant difference in overall survival was found with a combination of SRS plus WBRT compared with SRS alone or WBRT alone. Radiation therapy after surgery did not improve overall survival compared with surgery alone. WBRT plus systemic therapy was associated with increased risks for vomiting compared with WBRT alone. There was not enough data on patient-relevant outcomes such as quality of life, functional status, and cognitive effects.
AHRQ-funded; 290201500010I.
Citation:
Garsa A, Jang JK, Baxi S .
Radiation therapy for brain metastases: a systematic review.
Pract Radiat Oncol 2021 Sep-Oct;11(5):354-65. doi: 10.1016/j.prro.2021.04.002..
Keywords:
Cancer, Surgery, Treatments, Patient-Centered Outcomes Research, Evidence-Based Practice
Fan T, Stefanos R
Screening for colorectal cancer.
This AHRQ-authored Putting Preventions in Practice quiz has three questions and answers on the US Preventive Services Task Force final recommendation on screening for colorectal cancer. A case study is presented with questions on the best behavioral interventions, the effect of a patient’s age on the counseling approach, and what is an appropriate test and interval for colorectal screening. References are also provided at the end of the answers.
AHRQ-authored.
Citation:
Fan T, Stefanos R .
Screening for colorectal cancer.
Am Fam Physician 2021 Sep 1;104(3):295-96..
Keywords:
U.S. Preventive Services Task Force (USPSTF), Cancer: Colorectal Cancer, Cancer, Screening, Prevention, Guidelines, Evidence-Based Practice, Case Study
Trent SA, George N, Havranek EP
Established evidence-based treatment guidelines help mitigate disparities in quality of emergency care.
Evidence-based guidelines are often cited as a means of ensuring high-quality care for all patients. The objective of this study was to assess whether emergency department (ED) adherence to core evidence-based guidelines differed by patient sex and race/ethnicity and to assess the effect of ED guideline adherence on patient outcomes by sex and race/ethnicity. The investigators concluded that longstanding, nationally reported evidence-based guidelines can help eliminate sex and race/ethnicity disparities in quality of care.
AHRQ-funded; HS022400.
Citation:
Trent SA, George N, Havranek EP .
Established evidence-based treatment guidelines help mitigate disparities in quality of emergency care.
Acad Emerg Med 2021 Sep;28(9):1051-60. doi: 10.1111/acem.14235..
Keywords:
Evidence-Based Practice, Guidelines, Emergency Department, Disparities, Quality of Care
Pillay J, Donovan L, Guitard S
Screening for gestational diabetes: updated evidence report and systematic review for the US Preventive Services Task Force.
The objective of this study was to update the 2012 review on screening for gestational diabetes to inform the US Preventive Services Task Force. The investigators concluded that direct evidence on screening vs no screening remained limited. One- vs 2-step screening was not significantly associated with improved health outcomes. At or after 24 weeks of gestation, treatment of gestational diabetes was significantly associated with improved health outcomes.
Citation:
Pillay J, Donovan L, Guitard S .
Screening for gestational diabetes: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2021 Aug 10;326(6):539-62. doi: 10.1001/jama.2021.10404..
Keywords:
U.S. Preventive Services Task Force (USPSTF), Diabetes, Pregnancy, Screening, Evidence-Based Practice, Women, Prevention, Guidelines
Darling KE, Warnick J, Hadley W
Reactions to the U.S. Preventive Services Task Force guidelines for the management of adolescent obesity: a multi-informant qualitative approach.
This study measured reactions by adolescents, parents, and physicians to the U.S. Preventive Services Task Force guidelines for the management of adolescent obesity. The guidelines recommended those identified should be referred to comprehensive weight management programs consisting of at least 26 contact hours and focus on multiple targets of behavior. In-depth interviews were conducted with 7 adolescents, 7 parents, and 4 physicians. In general, participants viewed the guidelines positively but identified changes that may be necessary to increase the feasibility of adolescents engaging in programs that meet these guidelines. Participants also noted the importance of flexibility within programs.
AHRQ-funded; HS02707.
Citation:
Darling KE, Warnick J, Hadley W .
Reactions to the U.S. Preventive Services Task Force guidelines for the management of adolescent obesity: a multi-informant qualitative approach.
Clin Obes 2021 Aug;11(4):e12451. doi: 10.1111/cob.12451..
Keywords:
U.S. Preventive Services Task Force (USPSTF), Children/Adolescents, Obesity, Guidelines, Evidence-Based Practice
Marin JR, Rodean J, Mannix RC
Association of clinical guidelines and decision support with CT use in pediatric mild traumatic brain injury.
The objective of this study was to examine whether the presence of clinical guidelines and clinical decision support (CDS) for mild traumatic brain injury (mTBI) were associated with lower head computed tomography (CT) use. The investigators concluded that clinical guidelines for mTBI, and particularly CDS, were associated with lower rates of head CT use without adverse clinical outcomes.
AHRQ-funded; HS026006.
Citation:
Marin JR, Rodean J, Mannix RC .
Association of clinical guidelines and decision support with CT use in pediatric mild traumatic brain injury.
J Pediatr 2021 Aug;235:178-83.e1. doi: 10.1016/j.jpeds.2021.04.026..
Keywords:
Children/Adolescents, Clinical Decision Support (CDS), Decision Making, Health Information Technology (HIT), Brain Injury, Guidelines, Evidence-Based Practice, Imaging
Vu K, Zhou J, Everhart A
Uptake of evidence by physicians: de-adoption of erythropoiesis-stimulating agents after the TREAT trial.
Variation in de-adoption of ineffective or unsafe treatments is not well-understood. In this study the investigators examined de-adoption of erythropoiesis-stimulating agents (ESA) in anemia treatment among patients with chronic kidney disease (CKD) following new clinical evidence of harm and ineffectiveness (the TREAT trial) and the FDA's revision of its safety warning. The investigators found that physician specialty had a dominant role in prescribing decision, and specializations with higher use of treatment (nephrologists) were more responsive to new evidence of unsafety and ineffectiveness.
AHRQ-funded; HS025164.
Citation:
Vu K, Zhou J, Everhart A .
Uptake of evidence by physicians: de-adoption of erythropoiesis-stimulating agents after the TREAT trial.
BMC Nephrol 2021 Aug 21;22(1):284. doi: 10.1186/s12882-021-02491-y..
Keywords:
Evidence-Based Practice, Medication: Safety, Medication, Patient Safety, Practice Patterns, Provider: Physician
Murad MH, Chang SM, Fiordalisi CV
Improving the utility of evidence synthesis for decision makers in the face of insufficient evidence.
The authors identified and suggested strategies to make insufficient evidence ratings in systematic reviews more actionable. A workgroup comprising members from AHRQ’s Evidence-Based Practice Program convened throughout 2020. They identified five strategies for supplementing systematic review findings when evidence on benefits or harms is expected to be, or found to be, insufficient: 1) reconsider eligible study designs, 2) summarize indirect evidence, 3) summarize contextual and implementation evidence, 4) consider modelling, and 5) incorporate unpublished health system data in the evidence synthesis. While these strategies may not increase the strength of evidence, they may improve the utility of reports for decision makers.
AHRQ-authored; AHRQ-funded; 290201700003C; 290201500013I; 290201500008I; 290201500007I; 290201500011I; 290201500010I; 290201500002I; 290201500005I; 290201500012I; 290201500006I.
Citation:
Murad MH, Chang SM, Fiordalisi CV .
Improving the utility of evidence synthesis for decision makers in the face of insufficient evidence.
J Clin Epidemiol 2021 Jul;135:170-75. doi: 10.1016/j.jclinepi.2021.02.028..
Keywords:
Evidence-Based Practice, Decision Making, Patient-Centered Outcomes Research
Katheria A, Lee HC, Knol R
A review of different resuscitation platforms during delayed cord clamping.
Researchers have brought together an international group that have been intimately involved in the development or use of resuscitation equipment designed to be used with infants while the umbilical cord is still intact. In this review, they presented the benefits and limitations of devices that have been developed or are in use. They also reviewed published trials and ongoing studies using these respective devices.
AHRQ-funded; HS023506.
Citation:
Katheria A, Lee HC, Knol R .
A review of different resuscitation platforms during delayed cord clamping.
J Perinatol 2021 Jul;41(7):1540-48. doi: 10.1038/s41372-021-01052-3..
Keywords:
Pregnancy, Evidence-Based Practice
Tracer H, Pierre J
Screening for lung cancer.
This paper is part of the “Putting Prevention into Practice” series. It provides an evidence-based case study related to lung cancer screening. Questions and answers related to the case are included.
AHRQ-authored.
Citation:
Tracer H, Pierre J .
Screening for lung cancer.
Am Fam Physician 2021 Jul 1;104(1):79-80..
Keywords:
U.S. Preventive Services Task Force (USPSTF), Cancer: Lung Cancer, Cancer, Screening, Prevention, Case Study, Evidence-Based Practice
Pham-Singer H, Onakomaiya M, Cuthel A
Using a customer relationship management system to manage a quality improvement intervention.
HealthyHearts New York City (HHNYC), one of 7 cooperatives funded through the Agency for Healthcare Research and Quality's EvidenceNOW initiative, evaluated the impact of practice facilitation on implementation of the Million Hearts guidelines for cardiovascular disease prevention and treatment. Tracking the intervention required a system to facilitate process data collection that was also user-friendly and flexible. Coupled with protocols and training, a strategically planned and customizable customer relationship management system (CRMS) was implemented to support the quality improvement intervention with 257 small independent practices.
AHRQ-funded; HS023922.
Citation:
Pham-Singer H, Onakomaiya M, Cuthel A .
Using a customer relationship management system to manage a quality improvement intervention.
Am J Med Qual 2021 Jul-Aug;36(4):247-54. doi: 10.1177/1062860620953214..
Keywords:
Quality Improvement, Quality of Care, Implementation, Evidence-Based Practice, Cardiovascular Conditions, Heart Disease and Health, Primary Care
Silverstein M, Kemper AR, Henderson JT
Importance of assessing wellbeing for United States Preventive Services Task Force recommendations.
The investigators discuss the importance of assessing wellbeing for United States Preventive Services Task Force recommendations despite the current data limitations. They discuss the pathway out of the current limitations of the data on meaningful health outcomes for child and adolescent preventive services. They assert that developing measures of subjective wellbeing for children and families and deploying them at appropriate time intervals in prevention trials offers a promising, although admittedly challenging, pathway out of the child health evidence void.
AHRQ-authored.
Citation:
Silverstein M, Kemper AR, Henderson JT .
Importance of assessing wellbeing for United States Preventive Services Task Force recommendations.
Pediatrics 2021 Jul;148(Suppl 1):s37-s39. doi: 10.1542/peds.2021-050693H..
Keywords:
U.S. Preventive Services Task Force (USPSTF), Children/Adolescents, Evidence-Based Practice, Guidelines, Screening, Prevention
Bishop JR, Huang RS, Brown JT
Pharmacogenomics education, research and clinical implementation in the state of Minnesota.
This article looks at the development and implementation of formal pharmacogenomic (PGx) clinical programs at several healthcare organizations across Minnesota. These programs increase drug safety and effectiveness. The article reviews the state of PGx activities in the state of Minnesota including educational programs, research, national consortia involvement, technology, clinical implementation and utilization and reimbursement, and outlines the challenges and opportunities in equitable implementation of these activities.
AHRQ-funded; HS026379.
Citation:
Bishop JR, Huang RS, Brown JT .
Pharmacogenomics education, research and clinical implementation in the state of Minnesota.
Pharmacogenomics 2021 Jul;22(11):681-91. doi: 10.2217/pgs-2021-0058..
Keywords:
Medication, Implementation, Learning Health Systems, Evidence-Based Practice, Patient-Centered Outcomes Research
Pasalic D, Barocas DA, Huang LC
Five-year outcomes from a prospective comparative effectiveness study evaluating external-beam radiotherapy with or without low-dose-rate brachytherapy boost for localized prostate cancer.
This retrospective cohort study’s objective was to determine if there were differences in treatment-related regret or survival between prostate cancer patients who received external-beam radiation therapy (EBRT) with or without a brachytherapy boost (EBRT-LDR), over a 5-year period. The cohort included 695 men who met inclusion criteria and received either EBRT (n=583) or EBRT-LDR (n=112). Men who received either treatment reported clinically worse urinary irritation and bowel function through 3 years but resolved after 5 years. Men who received EBRT-LDR continued to report moderate- to-big problems with urinary function bother and frequent urination at 5 years. There was no difference in treatment-related regret or survival between patients who received either treatment.
AHRQ-funded; HS019356; HS022640.
Citation:
Pasalic D, Barocas DA, Huang LC .
Five-year outcomes from a prospective comparative effectiveness study evaluating external-beam radiotherapy with or without low-dose-rate brachytherapy boost for localized prostate cancer.
Cancer 2021 Jun 1;127(11):1912-25. doi: 10.1002/cncr.33388..
Keywords:
Cancer: Prostate Cancer, Cancer, Comparative Effectiveness, Evidence-Based Practice, Outcomes, Patient-Centered Outcomes Research, Treatments
Arkhipova-Jenkins I, Helfand M, Armstrong C
Antibody response after SARS-CoV-2 infection and implications for immunity : a rapid living review.
This rapid literature review synthesizes evidence on the prevalence, levels, and durability of detectable antibodies after SARS-CoV-2 infection and whether the antibodies confer natural immunity. Seven databases were searched from January 1 to December 15, 2020, limited to peer-reviewed publications in English. Two investigators extracted study data and rated quality. Moderate-strength evidence suggested that most adults develop detectable levels of IgM and IgG antibodies after infection with SARS-CoV-2 and IgG levels peak approximately 25 days after symptom onset and can remain detectable for at least 120 days. Moderate-strength evidence suggested that IgM levels peak at approximately 20 days and then decline. There is low-strength evidence that most adults generate neutralizing antibodies. Reasons why some adults do not develop antibodies after SARS-CoV-2 are unclear.
AHRQ-funded; 290201700003C.
Citation:
Arkhipova-Jenkins I, Helfand M, Armstrong C .
Antibody response after SARS-CoV-2 infection and implications for immunity : a rapid living review.
Ann Intern Med 2021 Jun;174(6):811-21. doi: 10.7326/m20-7547..
Keywords:
COVID-19, Infectious Diseases, Genetics, Evidence-Based Practice
Greenberg JK, Otun A, Nasraddin A
Electronic clinical decision support for children with minor head trauma and intracranial injuries: a sociotechnical analysis.
This paper discusses the development of an evidence-based clinical decision support (CDS) for management of children with minor head trauma (MHT) and evaluates the sociotechnical environment impacting the implementation of electronic CDS, including workflow and communication, institutional culture, and hardware and software infrastructure. Semi-structured qualitative focus group interviews were conducted with 28 physicians and four information technology specialists between March and May 2020. Five primary themes were identified through inductive thematic analysis: 1) clinical impact; 2) stakeholders and users; 3) tool content; 4) clinical practice integration; and 5) post-implementation evaluation measures. Participants generally supported CDS use to determine an appropriate level-of-care. However, some had mixed feelings regarding how the tool could best be used by neurosurgeons versus non-neurosurgeons. Feedback helped refine the tool content and highlighted potential technical and workflow barriers to address prior to implementation.
AHRQ-funded; HS027075.
Citation:
Greenberg JK, Otun A, Nasraddin A .
Electronic clinical decision support for children with minor head trauma and intracranial injuries: a sociotechnical analysis.
BMC Med Inform Decis Mak 2021 May 19;21(1):161. doi: 10.1186/s12911-021-01522-w.
.
.
Keywords:
Children/Adolescents, Clinical Decision Support (CDS), Brain Injury, Health Information Technology (HIT), Evidence-Based Practice, Decision Making
Silverberg JI, Lei D, Yousaf M
What are the best endpoints for eczema area and severity index and scoring atopic dermatitis in clinical practice? A prospective observational study.
This prospective observational study’s objective was to determine the minimal important changes (MICs) of the Eczema Area and Severity Index (EASI) and Scoring Atopic Dermatitis (SCORAD) across all severities of atopic dermatitis (AD). Questionnaires and evaluation by a dermatologist (n =826) were used to determine the MIC of percentage and absolute improvement of EASI and SCORAD scores in adults and children. Absolute MICs for EASI, SCORAD, and O-SCORAD varied by baseline severity and EASI 50, SCORAD 35 and O-SCORAD 35 were meaningful percentage MICs regardless of baseline AD severity.
AHRQ-funded; HS023011.
Citation:
Silverberg JI, Lei D, Yousaf M .
What are the best endpoints for eczema area and severity index and scoring atopic dermatitis in clinical practice? A prospective observational study.
Br J Dermatol 2021 May;184(5):888-95. doi: 10.1111/bjd.19457..
Keywords:
Skin Conditions, Patient-Centered Outcomes Research, Evidence-Based Practice
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
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:
Tobacco Use, Blood Pressure, Hypertension, Primary Care, Cardiovascular Conditions, Prevention, Evidence-Based Practice, Patient-Centered Outcomes Research, Outcomes
