National Healthcare Quality and Disparities Report
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Search All Research Studies
Topics
- Ambulatory Care and Surgery (1)
- Behavioral Health (1)
- Blood Pressure (1)
- (-) Care Management (17)
- Children/Adolescents (1)
- Chronic Conditions (6)
- Community-Based Practice (1)
- (-) Diabetes (17)
- Elderly (2)
- Electronic Health Records (EHRs) (3)
- Emergency Department (1)
- Healthcare Delivery (3)
- Health Information Technology (HIT) (5)
- Inpatient Care (1)
- Kidney Disease and Health (1)
- Maternal Care (1)
- Medicaid (1)
- Medication (2)
- Nursing Homes (1)
- Patient-Centered Healthcare (3)
- Patient-Centered Outcomes Research (3)
- Patient Adherence/Compliance (2)
- Patient Safety (2)
- Patient Self-Management (3)
- Practice Patterns (1)
- Pregnancy (1)
- Primary Care (4)
- Quality Improvement (1)
- Quality of Care (2)
- Racial and Ethnic Minorities (1)
- Teams (2)
- Telehealth (1)
- Women (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 17 of 17 Research Studies DisplayedOikonomidi 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
Miller-Rosales C, Rodriguez HP
Interdisciplinary primary care team expertise and diabetes care management.
Researchers examined whether care team role expertise is associated with patients' experiences of chronic care for type 2 diabetes and whether the relationship is stronger for small community health center (CHC) sites. Results of surveys conducted with adults with diabetes that assessed nonphysician team roles involved in managing their chronic care were integrated with clinical and administrative data from 14 CHCs. They found that patients with access to care team expertise in self-management support, including diabetes educators, nutritionists, community health workers, and other general staff report better experiences of chronic care. They concluded that these team roles may reduce barriers to patient self-management and improve patients' overall experiences of chronic care, particularly in small CHC sites.
Citation: Miller-Rosales C, Rodriguez HP .
Interdisciplinary primary care team expertise and diabetes care management.
J Am Board Fam Med 2021 Jan-Feb;34(1):151-61. doi: 10.3122/jabfm.2021.01.200187..
Keywords: Primary Care, Diabetes, Teams, Care Management, Community-Based Practice
Barry-Menkhaus SA, Wagner DV, Riley AR
Small interventions for big change: brief strategies for distress and self-management amongst youth with type 1 diabetes.
In this article, the authors review existing evidence for brief interventions, describe several untested clinical strategies, and make recommendations for accelerating the translational study of brief interventions among youth with type 1 diabetes.
AHRQ-funded; HS022981.
Citation: Barry-Menkhaus SA, Wagner DV, Riley AR .
Small interventions for big change: brief strategies for distress and self-management amongst youth with type 1 diabetes.
Curr Diab Rep 2020 Jan 30;20(1):3. doi: 10.1007/s11892-020-1290-7..
Keywords: Diabetes, Patient-Centered Healthcare, Patient Self-Management, Patient Adherence/Compliance, Care Management, Patient-Centered Outcomes Research, Healthcare Delivery, Children/Adolescents
Goins RT, Jones J, Schure M
Type 2 diabetes management among older American Indians: beliefs, attitudes, and practices.
This study’s purpose was to examine beliefs, attitudes, and practices of older Native Americans regarding type 2 diabetes mellitus (T2DM) management. This disease is one the leading causes of morbidity and mortality among Native Americans, and they are twice as likely to have T2DM, and over three times the mortality rate from T2DM as Whites. Semi-structured in-depth qualitative interviews were conducted with 28 participants with a mean age of 73 years, with 57% female. Participants’ mean confidence score of their T2DM management was 8.0 on a scale of 1 to 10 and their mean Hb1Ac was 7.3.%. Overall 5 themes were discussed: sociocultural factors, causes and consequences, cognitive and affective assessment, diet and exercise, and medical management.
AHRQ-funded; HS000078.
Citation: Goins RT, Jones J, Schure M .
Type 2 diabetes management among older American Indians: beliefs, attitudes, and practices.
Ethn Health 2020 Nov;25(8):1055-71. doi: 10.1080/13557858.2018.1493092..
Keywords: Diabetes, Chronic Conditions, Elderly, Racial and Ethnic Minorities, Patient Self-Management, Care Management
Griffey RT, Schneider RM, Peterson C
Diabetic ketoacidosis management in the emergency department: implementation of a protocol to reduce variability and improve safety.
The authors studied the impact of a standardizing emergency department diabetic ketoacidosis management in two phases: rollout of a diabetic ketoacidosis pathway in their computerized order entry system followed by audit and feedback. They evaluated adherence, clinical process, operational, and safety measures following these interventions. They found that adherence to the pathway was initially slow, improving significantly after audit and feedback. They observed mixed improvements in clinical processes, no changes in operational metrics, and reductions in variability for several measures.
AHRQ-funded; HS025052.
Citation: Griffey RT, Schneider RM, Peterson C .
Diabetic ketoacidosis management in the emergency department: implementation of a protocol to reduce variability and improve safety.
J Healthc Qual 2019 Nov/Dec;41(6):e61-e69. doi: 10.1097/jhq.0000000000000211..
Keywords: Emergency Department, Diabetes, Patient Safety, Care Management
Wu SS, Chan KS, Bae J
Electronic clinical reminder and quality of primary diabetes care.
The goal of this retrospective cohort study was to examine the association of EMR's clinical reminder use with a comprehensive set of diabetes quality metrics in office-based physicians and within solo- versus multi-physician practices. Data on visits made by adults with diabetes were identified from the National Ambulatory Medical Care Survey and a multiple logistic regression was used to test for associations between clinical reminder use and recommended services by the American Diabetes Association. The researchers found no statistically significant relationship that suggests clinical reminder use improves diabetes process guidelines for solo practices, and they conclude that other resource efforts are needed to reduce gaps in primary diabetes care.
AHRQ-funded; HS000029.
Citation: Wu SS, Chan KS, Bae J .
Electronic clinical reminder and quality of primary diabetes care.
Prim Care Diabetes 2019 Apr;13(2):150-57. doi: 10.1016/j.pcd.2018.08.007..
Keywords: Care Management, Chronic Conditions, Diabetes, Electronic Health Records (EHRs), Health Information Technology (HIT), Primary Care, Quality of Care
Ramirez M, Maranon R, Fu J
Primary care provider adherence to an alert for intensification of diabetes blood pressure medications before and after the addition of a "chart closure" hard stop.
The purpose of this study was to evaluate provider responses to a narrowly targeted Best Practice Advisory (BPA) alert regarding the intensification of blood pressure medications for persons with diabetes before and after implementation of a ‘chart closure’ hard stop. Researchers designed a BPA that sent alerts via an electronic health record system during outpatient encounters when patients with diabetes had elevated blood pressures and were not on angiotensin receptor blocking medications. These alerts were implemented in eight primary care practices within UCLA Health. Data on provider responses to the alerts was compared before and after implementing a ‘chart closure’ hard stop. Providers responded to alerts more often after the ‘chart closure’ hard stop was implemented. The researchers conclude that targeting specific omitted medication classes can produce specific alerts that may reduce alert fatigue, and that using a ‘chart closure’ hard stop may prompt providers to take action without major disruptions to their workflow.
AHRQ-funded; HS000046.
Citation: Ramirez M, Maranon R, Fu J .
Primary care provider adherence to an alert for intensification of diabetes blood pressure medications before and after the addition of a "chart closure" hard stop.
J Am Med Inform Assoc 2018 Sep;25(9):1167-74. doi: 10.1093/jamia/ocy073..
Keywords: Blood Pressure, Diabetes, Primary Care, Electronic Health Records (EHRs), Health Information Technology (HIT), Medication, Care Management
Pantalone KM, Misra-Hebert AD, Hobbs TM
Clinical inertia in type 2 diabetes management: evidence from a large, real-world data set.
The failure of clinicians to intensify therapy when clinically indicated has been termed “clinical inertia.” This paper discusses clinical inertia in diabetes 2 management.
AHRQ-funded; HS024128.
Citation: Pantalone KM, Misra-Hebert AD, Hobbs TM .
Clinical inertia in type 2 diabetes management: evidence from a large, real-world data set.
Diabetes Care 2018 Jul;41(7):e113-e14. doi: 10.2337/dc18-0116..
Keywords: Care Management, Diabetes, Patient-Centered Outcomes Research
Dickens LT, Naylor RN
Clinical management of women with monogenic diabetes during pregnancy.
This study discusses clinical management of women with monogenic diabetes during pregnancy. Monogenic diabetes is rare and only accounts for 1-2% of all diabetes cases so it is frequently misdiagnoses as one of the other diabetes types. Diabetes treatment is different for this type of diabetes, and if untreated can cause fetal mutations. However, if treated there can be transplacental transfer of the medication (sulfonylurea). The study authors recommend large prospective studies be conducted to better define the need and timing of initiation of insulin treatment.
AHRQ-funded; HS023007.
Citation: Dickens LT, Naylor RN .
Clinical management of women with monogenic diabetes during pregnancy.
Curr Diab Rep 2018 Feb 15;18(3):12. doi: 10.1007/s11892-018-0982-8..
Keywords: Care Management, Chronic Conditions, Diabetes, Maternal Care, Pregnancy, Women
Bowen ME, Rumana U, Kilgore EA
A user-centered glucose-insulin data display for the inpatient setting.
Researchers sought to develop a set of user-centered displays of capillary glucose data and insulin dose to improve inpatient management of insulin-dependent diabetes. Their proposed conceptual data display prototype is designed to simplify the presentation and visualization of key information needed for treatment decisions. The goal is also to enhance clinician's ability to identify opportunities to optimize insulin dosing and decrease end users' cognitive load and error rates.
AHRQ-funded; HS022895.
Citation: Bowen ME, Rumana U, Kilgore EA .
A user-centered glucose-insulin data display for the inpatient setting.
Stud Health Technol Inform 2017;245:684-88.
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Keywords: Care Management, Diabetes, Health Information Technology (HIT), Inpatient Care, Patient Safety
Olesiuk WJ, Farley JF, Domino ME
Do medical homes offer improved diabetes care for Medicaid enrollees with co-occurring schizophrenia?
The purpose of this study was to determine whether Medicaid recipients with co-occurring diabetes and schizophrenia that are medical-home-enrolled are more likely to receive guideline-concordant diabetes care than those who are not medical-home-enrolled, controlling for confounders. The study concluded that medical-home enrollment is generally associated with greater likelihood of receiving guideline-concordant diabetes care for Medicaid enrollees with diabetes and schizophrenia.
AHRQ-funded; HS023099; HS019659; HS000032.
Citation: Olesiuk WJ, Farley JF, Domino ME .
Do medical homes offer improved diabetes care for Medicaid enrollees with co-occurring schizophrenia?
J Health Care Poor Underserved 2017;28(3):1030-41. doi: 10.1353/hpu.2017.0094..
Keywords: Care Management, Diabetes, Medicaid, Behavioral Health, Patient-Centered Healthcare
Zullo AR, Dore DD, Gutman R
National glucose-lowering treatment complexity is greater in nursing home residents than community-dwelling adults.
This letter describes common glucose-lowering medication usage patterns for a national cross-section of U.S. adults aged 65 and older residing in nursing home (NH) and community settings from 2007 to 2010. The study results suggest that continued efforts are warranted to improve glucose-lowering medication management and simplify treatment regimens in the NH; that the relative importance of CER questions regarding specific glucose-lowering treatments may differ according to the care setting; and that CER studies of glucose-lowering treatments in older adults must address the combination use of medications, especially in NH residents.
AHRQ-funded; HS022998.
Citation: Zullo AR, Dore DD, Gutman R .
National glucose-lowering treatment complexity is greater in nursing home residents than community-dwelling adults.
J Am Geriatr Soc 2016 Nov;64(11):e233-e35. doi: 10.1111/jgs.14485.
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Keywords: Care Management, Chronic Conditions, Diabetes, Elderly, Medication, Nursing Homes
Patil SJ, Ruppar T, Koopman RJ
Peer support interventions for adults with diabetes: a meta-analysis of hemoglobin A1c outcomes.
This study aimed to estimate the effect of peer support interventions delivered by people affected by diabetes (those with the disease or a caregiver) on hemoglobin A1c (HbA1c) levels in adults. It found that peer support interventions for diabetes overall achieved a statistically significant but minor improvement in HbA1c levels.
AHRQ-funded; HS022140.
Citation: Patil SJ, Ruppar T, Koopman RJ .
Peer support interventions for adults with diabetes: a meta-analysis of hemoglobin A1c outcomes.
Ann Fam Med 2016 Nov;14(6):540-51. doi: 10.1370/afm.1982.
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Keywords: Care Management, Diabetes, Patient-Centered Outcomes Research
Chung S, Zhao B, Lauderdale D
Initiation of treatment for incident diabetes: evidence from the electronic health records in an ambulatory care setting.
The researchers examined patterns and predictors of initiation of treatment for incident diabetes in an ambulatory care setting in the US. They found that only half of patients were treated during the first year following diabetes incidence, and only 20% of patients received both medication prescription and lifestyle modification interventions.
AHRQ-funded; HS019815.
Citation: Chung S, Zhao B, Lauderdale D .
Initiation of treatment for incident diabetes: evidence from the electronic health records in an ambulatory care setting.
Prim Care Diabetes 2015 Feb;9(1):23-30. doi: 10.1016/j.pcd.2014.04.005..
Keywords: Ambulatory Care and Surgery, Care Management, Diabetes, Electronic Health Records (EHRs), Health Information Technology (HIT), Primary Care, Practice Patterns
Pathak RD, Schroeder EB, Seaquist ER
Severe hypoglycemia requiring medical intervention in a large cohort of adults with diabetes receiving care in U.S. integrated health care delivery systems: 2005-2011.
The researchers quantified the burden of severe hypoglycemia requiring medical intervention in a well-defined population of insured individuals receiving care for diabetes . Annual rates of severe hypoglycemia ranged from 1.4 to 1.6 events per 100 person-years. Rates of severe hypoglycemia were higher among those with older age, chronic kidney disease, congestive heart failure, cardiovascular disease, depression, and higher A1C levels.
AHRQ-funded; HS019859.
Citation: Pathak RD, Schroeder EB, Seaquist ER .
Severe hypoglycemia requiring medical intervention in a large cohort of adults with diabetes receiving care in U.S. integrated health care delivery systems: 2005-2011.
Diabetes Care 2016 Mar;39(3):363-70. doi: 10.2337/dc15-0858.
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Keywords: Care Management, Diabetes, Healthcare Delivery, Kidney Disease and Health
Magnan EM, Palta M, Pandhi N
The relationship of individual comorbid chronic conditions to diabetes care quality.
The aim of this study was to determine which chronic conditions were related to lack of achievement or achievement of diabetes care quality goals to determine potential targets for future interventions. It found that 62 chronic conditions varied in their relationships to diabetes care goal achievement for specific care goals. For example, congestive heart failure was related to lack of achievement of cholesterol management goals.
AHRQ-funded; HS018368; HS021899.
Citation: Magnan EM, Palta M, Pandhi N .
The relationship of individual comorbid chronic conditions to diabetes care quality.
BMJ Open Diabetes Res Care 2015 Jul 23;3(1):e000080. doi: 10.1136/bmjdrc-2015-000080..
Keywords: Care Management, Chronic Conditions, Diabetes, Quality of Care
Taliani CA, Bricker PL, Adelman AM
Implementing effective care management in the patient-centered medical home.
The investigators explored how a disparate group of patient-centered medical homes (PCMHs) embedded care management in their team care environment to identify best practices. They concluded that PCMHs may want to ensure that care managers are available to meet with patients during visits, support patient self-management, fully leverage the electronic medical record for team messaging and patient tracking, and ensure integration into the care team with office huddles and ongoing communication.
AHRQ-funded; HS019150.
Citation: Taliani CA, Bricker PL, Adelman AM .
Implementing effective care management in the patient-centered medical home.
Am J Manag Care 2013 Dec;19(12):957-64.
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Keywords: Care Management, Diabetes, Healthcare Delivery, Patient-Centered Healthcare, Quality Improvement, Teams