National Healthcare Quality and Disparities Report
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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
76 to 100 of 122 Research Studies DisplayedYawn BP, Wollan PC, Rank MA
Use of asthma APGAR tools in primary care practices: a cluster-randomized controlled trial.
The purpose of this study was to assess patient and practice outcomes after introducing the Asthma APGAR (Activities, Persistent, triGGers, Asthma medications, Response to therapy) tools into primary care practices. It concluded that introduction of the Asthma APGAR tools improves rates of asthma control; reduces asthma-related ED, urgent care, and hospital visits; and increases practices' adherence to asthma management guidelines.
AHRQ-funded; HS022126.
Citation: Yawn BP, Wollan PC, Rank MA .
Use of asthma APGAR tools in primary care practices: a cluster-randomized controlled trial.
Ann Fam Med 2018 Mar;16(2):100-10. doi: 10.1370/afm.2179.
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Keywords: Asthma, Patient-Centered Outcomes Research, Primary Care, Medical Expenditure Panel Survey (MEPS), Tools & Toolkits
Cardet JC, Louisias M, King TS
Income is an independent risk factor for worse asthma outcomes.
The authors investigated whether low income, low education, and high perceived stress were independent risk factors for treatment failure and asthma exacerbations in the context of a randomized controlled trial. They found that participants with lower income were more likely to experience adverse asthma outcomes independent of education, perceived stress, race, and medication adherence.
AHRQ-funded; HS022986.
Citation: Cardet JC, Louisias M, King TS .
Income is an independent risk factor for worse asthma outcomes.
J Allergy Clin Immunol 2018 Feb;141(2):754-60.e3. doi: 10.1016/j.jaci.2017.04.036..
Keywords: Asthma, Chronic Conditions, Low-Income, Outcomes, Patient-Centered Outcomes Research, Risk, Social Determinants of Health
Kaiser SV, Rodean J, Bekmezian A
Rising utilization of inpatient pediatric asthma pathways.
The objectives of this study were to: 1) Describe inpatient pediatric asthma pathway design and implementation across a large hospital network and (2) Compare characteristics of hospitals with and without pathways. The investigators concluded that from 2005-2015, there was a dramatic rise in implementation of inpatient pediatric asthma pathways. They found variation in many aspects of pathway design and implementation.
AHRQ-funded; HS024554; HS024592.
Citation: Kaiser SV, Rodean J, Bekmezian A .
Rising utilization of inpatient pediatric asthma pathways.
J Asthma 2018 Feb;55(2):196-207. doi: 10.1080/02770903.2017.1316392..
Keywords: Asthma, Care Coordination, Children/Adolescents, Inpatient Care
Wang Z, Pianosi PT, Keogh KA
The diagnostic accuracy of fractional exhaled nitric oxide testing in asthma: a systematic review and meta-analyses.
This study evaluated the diagnostic accuracy of fractional exhaled nitric oxide (FeNO) measurement in individuals with suspected asthma. It concluded that fractional exhaled nitric oxide measurement has moderate accuracy to diagnose asthma in individuals aged 5 years and older. Test performance may be modestly better in corticosteroid-naive asthmatics, children, and nonsmokers than in the general population with suspected asthma.
AHRQ-funded; 290201500013I.
Citation: Wang Z, Pianosi PT, Keogh KA .
The diagnostic accuracy of fractional exhaled nitric oxide testing in asthma: a systematic review and meta-analyses.
Mayo Clin Proc 2018 Feb;93(2):191-98. doi: 10.1016/j.mayocp.2017.11.012.
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Keywords: Asthma, Diagnostic Safety and Quality
Stone C, Gebretsadik T, Lee RL
Trends in health care utilization for asthma exacerbations among diverse populations with asthma in the United States.
This article discusses trends in asthma hospitalization and outpatient visit rates from 2004 to 2010. The rates for all populations included in this study went down during the time period, in particular the population from the Tennessee Medicaid program (49%). Other populations used in the study included subjects 4 to 50 years enrolled in the US Department of Defense Military Health System (MHS), and 3 large integrated health delivery systems (IHCDS) of the Population Based Effectiveness in Asthma and Lung Diseases (PEAL) Network. The 3 PEAL health plans included Harvard Pilgrim Health Care, Kaiser Permanente Georgia, and Kaiser Permanent Northern California. A total of 473,524 subjects in those 3 study populations were identified. These downward trends are encouraging but need to continue, particularly in diverse populations.
AHRQ-funded; HS019669; HS022093.
Citation: Stone C, Gebretsadik T, Lee RL .
Trends in health care utilization for asthma exacerbations among diverse populations with asthma in the United States.
J Allergy Clin Immunol Pract 2018 Jan - Feb;6(1):295-97.e5. doi: 10.1016/j.jaip.2017.07.038..
Keywords: Asthma, Healthcare Utilization, Hospitalization, Healthcare Delivery, Chronic Conditions, Ambulatory Care and Surgery
Palmsten K, Hulugalle A, Bandoli G
Agreement between maternal report and medical records during pregnancy: medications for rheumatoid arthritis and asthma.
This study examined the agreement between maternal report and medical records during pregnancy for rheumatoid arthritis and asthma-related medications. The investigators concluded that agreement was higher for medications typically used continuously than sporadically. Information on medication use from medical records alone may not be adequate when studying the impact of intermittently used medications during pregnancy on perinatal outcomes.
AHRQ-funded; HS018474.
Citation: Palmsten K, Hulugalle A, Bandoli G .
Agreement between maternal report and medical records during pregnancy: medications for rheumatoid arthritis and asthma.
Paediatr Perinat Epidemiol 2018 Jan;32(1):68-77. doi: 10.1111/ppe.12415..
Keywords: Asthma, Medication, Pregnancy, Arthritis
Rudin RS, Fanta CH, Predmore Z
Core components for a clinically integrated mhealth app for asthma symptom monitoring.
The aim of the study was to apply user-centered design principles to efficiently identify core components for a mHealth-based asthma symptom-monitoring intervention using patient-reported outcomes (PROs).
AHRQ-funded; HS023960.
Citation: Rudin RS, Fanta CH, Predmore Z .
Core components for a clinically integrated mhealth app for asthma symptom monitoring.
Appl Clin Inform 2017 Oct;8(4):1031-43. doi: 10.4338/aci-2017-06-ra-0096.
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Keywords: Asthma, Chronic Conditions, Health Information Technology (HIT), System Design
Louisias M, Phipatanakul W
Managing asthma in low-income, underrepresented minority, and other disadvantaged pediatric populations: closing the gap.
The authors review current understanding of the epidemiology and etiology of disparities in asthma. They also highlight current and emerging literature on solutions to tackle disparities while underscoring gaps and pressing future directions. Tailored, multicomponent approaches including the home, school, and clinician-based interventions show great promise. Managing asthma in disadvantaged populations can be challenging as they tend to have disproportionately worse outcomes due to a multitude of factors.
AHRQ-funded; HS022986.
Citation: Louisias M, Phipatanakul W .
Managing asthma in low-income, underrepresented minority, and other disadvantaged pediatric populations: closing the gap.
Curr Allergy Asthma Rep 2017 Sep 15;17(10):68. doi: 10.1007/s11882-017-0734-x.
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Keywords: Asthma, Children/Adolescents, Low-Income, Racial and Ethnic Minorities, Vulnerable Populations
Kato E, Rajupet S
AHRQ Author: Kato E
Primary interventions to support breastfeeding.
This case study involves a 26-year-old woman, who presents for a routine prenatal visit at 28 weeks’ gestation. Her medical history is significant for poorly controlled asthma, and her family history is significant for breast cancer diagnosed in her mother. It poses three multiple choice questions together with the U.S. Preventive Services Task Force recommendations and related background information.
AHRQ-authored.
Citation: Kato E, Rajupet S .
Primary interventions to support breastfeeding.
Am Fam Physician 2017 Apr 15;95(8):517-18.
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Keywords: U.S. Preventive Services Task Force (USPSTF), Breast Feeding, Primary Care, Pregnancy, Asthma
duRivage N, Ross M, Mayne SL
Asthma Control Test.
In this study, the investigators compared results of a modified version of the Asthma Control Test using parent proxy report (PP-ACT) with results reported by children and parents using the validated Childhood-Asthma Control Test (C-ACT). ). The investigators indicate that that while the PP-ACT missed few children with uncontrolled asthma and may simplify reporting of asthma control in circumstances when child report is not feasible or creates barriers to survey receipt, limitations of proxy reporting should be considered.
AHRQ-funded; HS022689.
Citation: duRivage N, Ross M, Mayne SL .
Asthma Control Test.
Clin Pediatr 2017 Apr;56(4):341-47. doi: 10.1177/0009922816675013..
Keywords: Asthma, Caregiving, Children/Adolescents, Chronic Conditions, Patient Self-Management
Carroll KN, Gebretsadik T, Escobar GJ
Respiratory syncytial virus immunoprophylaxis in high-risk infants and development of childhood asthma.
This study sought to determine whether greater adherence to immunoprophylaxis in infants at high risk for severe respiratory syncytial virus (RSV) would be associated with decreased childhood asthma in a Medicaid population. The investigation of RSV immunoprophylaxis in high-risk children primarily found nonsignificant associations on prevention of asthma in specific preterm groups .
AHRQ-funded; HS018454.
Citation: Carroll KN, Gebretsadik T, Escobar GJ .
Respiratory syncytial virus immunoprophylaxis in high-risk infants and development of childhood asthma.
J Allergy Clin Immunol 2017 Jan;139(1):66-71.e3. doi: 10.1016/j.jaci.2016.01.055.
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Keywords: Asthma, Newborns/Infants, Children/Adolescents, Respiratory Conditions, Vaccination
Marshall GD, Jr., Bielory L, Walter Canonica G
The year in review: the best of 2016 in the Annals.
Last year brought a large increase in publications on the topics of rhinitis and rhinosinusitis. However, new therapeutics are always of great interest to the practicing clinician and thus top the list. Also discussed are significant articles on the topics of asthma and lower airway diseases, systemic allergic and immune disorders, and allergen immunotherapy.
AHRQ-funded; HS024599.
Citation: Marshall GD, Jr., Bielory L, Walter Canonica G .
The year in review: the best of 2016 in the Annals.
Ann Allergy Asthma Immunol 2017 Jan;118(1):4-9. doi: 10.1016/j.anai.2016.11.005.
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Keywords: Asthma, Respiratory Conditions, Respiratory Conditions
Strom MA, Silverberg JI
Asthma, hay fever, and food allergy are associated with caregiver-reported speech disorders in US children.
This study sought to determine whether asthma, hay fever, and food allergy are associated with speech disorder in children and whether disease severity, sleep disturbance, or ADD/ADHD modified such associations. It concluded that childhood asthma, hay fever, and food allergy are associated with increased risk of speech disorder.
AHRQ-funded; HS023011.
Citation: Strom MA, Silverberg JI .
Asthma, hay fever, and food allergy are associated with caregiver-reported speech disorders in US children.
Pediatr Allergy Immunol 2016 Sep;27(6):604-11. doi: 10.1111/pai.12580.
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Keywords: Asthma, Children/Adolescents, Respiratory Conditions
Wu AC, Li L, Fung V
Mismatching among guidelines, providers, and parents on controller medication use in children with asthma.
The authors sought to assess provider prescribing patterns for asthma controller medications and to assess how frequently parental reports of children's asthma controller medicine use were mismatched with provider recommendations. They found that mismatches between parental reports and provider intentions regarding how the child was supposed to use inhaled steroids occurred for half of the children. They recommended that efforts focus on ways to reduce these mismatches.
AHRQ-funded; HS019669.
Citation: Wu AC, Li L, Fung V .
Mismatching among guidelines, providers, and parents on controller medication use in children with asthma.
J Allergy Clin Immunol Pract 2016 Sep-Oct;4(5):910-6. doi: 10.1016/j.jaip.2016.04.004.
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Keywords: Asthma, Children/Adolescents, Guidelines, Medication, Practice Patterns
Wu AC, Butler MG, Li L
Primary adherence to controller medications for asthma is poor.
The objective of this study was to compare real-world adherence, including both primary and secondary adherence, to the major controller regimens (inhaled corticosteroids (ICSs), leukotriene antagonists (LTRAs), or ICS/long-acting b-agonists (ICS/LABAs) in diverse, insured populations. It found that adherence to controller medications is poor and many patients do not ever fill prescriptions for controller medications. However, primary adherence to ICSs was better than to LTRAs and ICS/LABAs.
AHRQ-funded; HS019669.
Citation: Wu AC, Butler MG, Li L .
Primary adherence to controller medications for asthma is poor.
Ann Am Thorac Soc 2015 Feb;12(2):161-6. doi: 10.1513/AnnalsATS.201410-459OC..
Keywords: Asthma, Patient Adherence/Compliance, Medication, Comparative Effectiveness
Fiks AG, DuRivage N, Mayne SL
Adoption of a portal for the primary care management of pediatric asthma: a mixed-methods implementation study.
The researchers evaluated the feasibility of using a patient portal for pediatric asthma in primary care. Fewer than three percent of those families invited to enroll used the portal. The authors found that although use of the portal was associated with higher treatment engagement, their results suggested that achieving widespread portal adoption is unlikely in the short term.
AHRQ-funded; HS021645; HS022689.
Citation: Fiks AG, DuRivage N, Mayne SL .
Adoption of a portal for the primary care management of pediatric asthma: a mixed-methods implementation study.
J Med Internet Res 2016 Jun 29;18(6):e172. doi: 10.2196/jmir.5610.
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Keywords: Web-Based, Primary Care, Children/Adolescents, Patient-Centered Healthcare, Asthma
Press VG, Arora VM, Trela KC
Effectiveness of interventions to teach metered-dose and diskus inhaler techniques. A randomized trial.
This study evaluated the relative effects of two different educational strategies (teach-to-goal instruction vs. brief verbal instruction) in adults hospitalized with asthma or chronic obstructive pulmonary disease. It concluded that, Acute care events were less common among teach-to-goal participants than brief intervention participants at 30 days (17 percent vs. 36 percent,), but not at 90 days.
AHRQ-funded; HS016967.
Citation: Press VG, Arora VM, Trela KC .
Effectiveness of interventions to teach metered-dose and diskus inhaler techniques. A randomized trial.
Ann Am Thorac Soc 2016 Jun;13(6):816-24. doi: 10.1513/AnnalsATS.201509-603OC.
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Keywords: Asthma, Respiratory Conditions, Comparative Effectiveness, Health Literacy, Medication
Johnson KB, Patterson BL, Ho YX
The feasibility of text reminders to improve medication adherence in adolescents with asthma.
The goal of this study was to assess the impact of MyMediHealth (MMH) - a website and a short messaging service (SMS)-based reminder system - on medication adherence and perceived self-efficacy in adolescents with asthma. The investigators found that MMH was associated with improved medication adherence, perceived quality of life, and self-efficacy.
AHRQ-funded; HS018168.
Citation: Johnson KB, Patterson BL, Ho YX .
The feasibility of text reminders to improve medication adherence in adolescents with asthma.
J Am Med Inform Assoc 2016 May;23(3):449-55. doi: 10.1093/jamia/ocv158..
Keywords: Asthma, Children/Adolescents, Health Information Technology (HIT), Medication, Patient Adherence/Compliance
Palmsten K, Schatz M, Chan PH
Validation of the pregnancy asthma control test.
The researchers sought to validate telephone administration of a modified version of the Asthma Control Test (ACT) during pregnancy. They found that the Pregnancy Asthma Control Test (p-ACT) demonstrated good internal consistency, varied in the expected direction by impairment level, and was responsive to changes in asthma course. Telephone administration of the p-ACT was reliable and valid for assessing asthma control during pregnancy.
AHRQ-funded; HS018474.
Citation: Palmsten K, Schatz M, Chan PH .
Validation of the pregnancy asthma control test.
J Allergy Clin Immunol Pract 2016 Mar-Apr;4(2):310-15.e1. doi: 10.1016/j.jaip.2015.11.019.
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Keywords: Pregnancy, Asthma, Diagnostic Safety and Quality, Patient-Centered Outcomes Research
Speck AL, Hess M, Baptist AP
An electronic asthma self-management intervention for young African American adults.
The objective of this study was to develop and assess the feasibility of an electronic asthma self-management program for young African American adults. The researchers found that all subjects completing the 2-week postprogram survey reported that the program was helpful, and 97% would recommend it to others. Asthma control as measured by the Asthma Control Test improved, and asthma quality of life as measured by the Mini Asthma Quality of Life Questionnaire also improved. They concluded that the Breathe Michigan program is feasible for recruitment and retention, and demonstrated an improvement in asthma control and quality of life for young African American adults.
AHRQ-funded; HS020977.
Citation: Speck AL, Hess M, Baptist AP .
An electronic asthma self-management intervention for young African American adults.
J Allergy Clin Immunol Pract 2016 Jan-Feb;4(1):89-95.e2. doi: 10.1016/j.jaip.2015.08.007.
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Keywords: Asthma, Health Information Technology (HIT), Racial and Ethnic Minorities, Patient Self-Management, Young Adults
Drury KE, Schaeffer M, Silverberg JL
Association between atopic disease and anemia in US children.
Atopic disease is associated with chronic inflammation, food allergen avoidance, and use of systemic immunosuppressant medications. All these factors have been shown to be associated with anemia. This study investigated whether atopic disease is associated with increased risk of childhood anemia. It concluded that the association between atopic disease and anemia was reproducible in multiple cohorts.
AHRQ-funded; HS023011.
Citation: Drury KE, Schaeffer M, Silverberg JL .
Association between atopic disease and anemia in US children.
JAMA Pediatr 2016 Jan;170(1):29-34. doi: 10.1001/jamapediatrics.2015.3065..
Keywords: Asthma, Children/Adolescents, Chronic Conditions, Risk
Nkoy F, Fassl B, Stone B
Improving pediatric asthma care and outcomes across multiple hospitals.
This study aimed to assess the impact of an evidence-based care process model 5 years after implementation at Primary Children's Hospital, a tertiary care facility, and after its dissemination to 7 community hospitals. The intervention resulted in sustained, long-term improvement in asthma care and outcomes at the tertiary care hospital and successful dissemination to community hospitals.
AHRQ-funded; HS018166; HS018678.
Citation: Nkoy F, Fassl B, Stone B .
Improving pediatric asthma care and outcomes across multiple hospitals.
Pediatrics 2015 Dec;136(6):e1602-10. doi: 10.1542/peds.2015-0285..
Keywords: Children/Adolescents, Asthma, Hospitalization, Evidence-Based Practice, Patient-Centered Outcomes Research
Miligkos M, Bannuru RR, Alkofide H
Leukotriene-receptor antagonists versus placebo in the treatment of asthma in adults and adolescents: a systematic review and meta-analysis.
The purpose of this study was to determine the benefits and harms of leukotriene-receptor antagonists (LTRAs) as monotherapy or in combination with inhaled corticosteroids compared with placebo in adults and adolescents with asthma. It found that leukotriene-receptor antagonists as monotherapy improved asthma control compared with placebo, but which patients are most likely to respond to treatment with LTRAs remains unclear.
AHRQ-funded; HS021396.
Citation: Miligkos M, Bannuru RR, Alkofide H .
Leukotriene-receptor antagonists versus placebo in the treatment of asthma in adults and adolescents: a systematic review and meta-analysis.
Ann Intern Med 2015 Nov 17;163(10):756-67. doi: 10.7326/m15-1059.
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Keywords: Asthma, Children/Adolescents, Medication, Comparative Effectiveness
Wechsler ME, Yawn BP, Fuhlbrigge AL
Anticholinergic vs long-acting beta-agonist in combination with inhaled corticosteroids in Black adults with asthma: the BELT randomized clinical trial.
The researchers compared the effectiveness and safety of tiotropium vs long-acting beta agonists (LABAs), when used with inhaled corticosteroids (ICS) in black adults with asthma. They found that among black adults with asthma treated with ICS, adding a LABA did not improve time to asthma exacerbation compared with adding tiotropium. These findings were not affected by polymorphisms at the Arg16Gly locus of ADRB2.
AHRQ-funded; HS019408.
Citation: Wechsler ME, Yawn BP, Fuhlbrigge AL .
Anticholinergic vs long-acting beta-agonist in combination with inhaled corticosteroids in Black adults with asthma: the BELT randomized clinical trial.
JAMA 2015 Oct 27;314(16):1720-30. doi: 10.1001/jama.2015.13277..
Keywords: Comparative Effectiveness, Patient Safety, Asthma, Medication
Luo G, Stone BL, Fassl B
Predicting asthma control deterioration in children.
The researchers developed and tested the first set of models for predicting a child’s asthma control deterioration one week prior to occurrence. Their best model successfully predicted a child’s asthma control level one week ahead. With adequate accuracy, the model could be integrated into electronic asthma self-monitoring systems.
AHRQ-funded; HS018166; HS018678.
Citation: Luo G, Stone BL, Fassl B .
Predicting asthma control deterioration in children.
BMC Med Inform Decis Mak 2015 Oct 14;15:84. doi: 10.1186/s12911-015-0208-9..
Keywords: Asthma, Children/Adolescents, Health Information Technology (HIT), Patient Self-Management