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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 575 Research Studies Displayed
Yakovchenko V, Morgan TR, Chinman MJ
Mapping the road to elimination: a 5-year evaluation of implementation strategies associated with hepatitis C treatment in the Veterans Health Administration.
While few countries and healthcare systems are on track to meet the World Health Organization's hepatitis C virus (HCV) elimination goals, the US Veterans Health Administration (VHA) has been a leader in these efforts. In this study the investigators aimed to determine which implementation strategies were associated with successful national viral elimination implementation within the VHA. They conducted a five-year, longitudinal cohort study of the VHA Hepatic Innovation Team (HIT) Collaborative between October 2015 and September 2019.
AHRQ-funded; HS019461.
Citation:
Yakovchenko V, Morgan TR, Chinman MJ .
Mapping the road to elimination: a 5-year evaluation of implementation strategies associated with hepatitis C treatment in the Veterans Health Administration.
BMC Health Serv Res 2021 Dec 18;21(1):1348. doi: 10.1186/s12913-021-07312-4..
Keywords:
Hepatitis, Chronic Conditions, Veterans
McCarthy SR, Golembiewski EH, Gravholt DL
Documentation of psychosocial distress and its antecedents in children with rare or life-limiting chronic conditions.
This study’s purpose was to characterize current medical record documentation practices around psychosocial distress among children with rare or life-limiting chronic conditions and their families. Medical records were reviewed for 60 patients with rare or life-limiting chronic conditions followed by a pediatric complex care program. Study team members extracted both structured data elements and note narratives from the most recent clinician visit. Psychosocial topics were analyzed using a mixed quantitative and qualitative approach. Psychosocial distress topics noted included child and parent emotional problems, parent social support, sibling emotional or physical problems, family structure (e.g., whether parents were together), and financial concern. However, 35% of notes lacked any mention of psychosocial concerns. The authors emphasized that this documentation is important to improve the ability of healthcare providers to identity and intervene on psychosocial concerns and their risk factors.
AHRQ-funded; HS026379.
Citation:
McCarthy SR, Golembiewski EH, Gravholt DL .
Documentation of psychosocial distress and its antecedents in children with rare or life-limiting chronic conditions.
Children 2022 May 5;9(5). doi: 10.3390/children9050664..
Keywords:
Children/Adolescents, Chronic Conditions
McQueen A, Kreuter MW, Herrick CJ
Associations among social needs, health and healthcare utilization, and desire for navigation services among US Medicaid beneficiaries with type 2 diabetes.
The purpose of this study was to determine the number and types of social needs experienced by Medicaid beneficiaries with type 2 diabetes and how these social needs are associated with key health indicators. Findings showed that having more social needs was associated with a wide range of indicators of poor health and well-being. Study participants with the greatest social need burden were most open to intervention.
AHRQ-funded; HS019455.
Citation:
McQueen A, Kreuter MW, Herrick CJ .
Associations among social needs, health and healthcare utilization, and desire for navigation services among US Medicaid beneficiaries with type 2 diabetes.
Health Soc Care Community 2022 May;30(3):1035-44. doi: 10.1111/hsc.13296..
Keywords:
Diabetes, Chronic Conditions, Medicaid, Social Determinants of Health
Hollowell M, Hudmon KS, Perkins SM
Evaluation of a modified and abbreviated scale for assessing chronic illness care for medication therapy management practice.
The purpose of the study was to evaluate the validity and internal consistency of the Assessment of Chronic Illness Care (ACIC) abbreviated, 12-item scale as a novel instrument for measuring Medication Therapy Management (MTM) care delivery. Researchers administered the instrument to pharmacists employed at 27,560 community pharmacies. The study concluded that when applied to the measurement of chronic illness care within the MTM setting, the abbreviated ACIC showed acceptable validity and internal consistency, and could serve as a valuable tool.
AHRQ-funded; HS022119.
Citation:
Hollowell M, Hudmon KS, Perkins SM .
Evaluation of a modified and abbreviated scale for assessing chronic illness care for medication therapy management practice.
Res Social Adm Pharm 2022 May;18(5):2804-10. doi: 10.1016/j.sapharm.2021.06.006..
Keywords:
Chronic Conditions, Medication, Provider: Pharmacist, Care Management
Ferucci ED, Arnold RI, Holck P
Factors associated with telemedicine use for chronic disease specialty care in the Alaska Tribal Health System, 2015-2019.
The purpose of this study was to explore and describe factors associated with telemedicine use in the setting of usual care in the Alaskan Tribal Health System (ATHS) prior to the COVID-19 pandemic. The researchers collected electronic health records (EHR) data from 2015 through 2019 for 3,075 patients with chronic diseases requiring specialty care from 4 regions in the ATHS to identify ever users (799) and never users (2,276) of telemedicine. The study found that the factors of male gender, age, geographic region, rate of outpatient visits per year, and having had at least one cardiology clinic visit were all associated with telemedicine use.
AHRQ-funded; HS026208.
Citation:
Ferucci ED, Arnold RI, Holck P .
Factors associated with telemedicine use for chronic disease specialty care in the Alaska Tribal Health System, 2015-2019.
Telemed J E Health 2022 May;28(5):682-89. doi: 10.1089/tmj.2021.0131..
Keywords:
Telehealth, Chronic Conditions, Racial / Ethnic Minorities, Health Information Technology (HIT)
Brennan MB, Powell WR, Kaiksow F
Association of race, ethnicity, and rurality with major leg amputation or death among Medicare beneficiaries hospitalized with diabetic foot ulcers.
The authors report that diabetic foot ulcer patients self-identifying as Black and also those living in disadvantaged and rural neighborhoods are at an increased risk of above-ankle amputations. The purpose of the study was to evaluate Medicare beneficiaries hospitalized with diabetic foot ulcers to assess whether intersecting identities of Black race, ethnicity, and living in a disadvantaged neighborhood or rural residence were associated with a higher risk of major leg amputation or death. The retrospective study looked at 2013-2014 data from the US National Medicare Claims Data Database of patients hospitalized with a diabetic foot ulcer. The study focused on major leg amputation or death during hospitalization or within 30 days of discharge from the hospital. The study cohort included 124,487 patients with a mean age of 71.5 years. Of those, 71,286 were men (57.3%), 21,649 (17.4%) identified as Black, and 13,100 (10.5%) were rural. Major leg amputations or death were experienced by 17.6% of the cohort, 18.3% of rural patients, and 21.9% patients who identified as Black. The proportion of those experiencing major leg amputations or death among the 1239 rural patients identifying as Black was 28%, which exceeded by more than 2-fold the expected excess for rural patients plus those identifying as Black, reflecting a significant interaction between race and rural residence. The study concluded that rural patients identifying as Black had a more than 10% increased risk of major leg amputation or death when compared with the full cohort, and that when investigating disparities in major leg amputations and death in patients with diabetic foot ulcers, a perspective of intersectionality should be considered.
AHRQ-funded; HS026279.
Citation:
Brennan MB, Powell WR, Kaiksow F .
Association of race, ethnicity, and rurality with major leg amputation or death among Medicare beneficiaries hospitalized with diabetic foot ulcers.
JAMA Netw Open 2022 Apr;5(4):e228399. doi: 10.1001/jamanetworkopen.2022.8399..
Keywords:
Diabetes, Chronic Conditions, Racial / Ethnic Minorities
Kim HN, Nance RM, Lo Re V
Development and validation of a model for prediction of end-stage liver disease in people with HIV.
The authors developed and validated a risk-prediction model for end-stage liver disease (ESLD) among people with HIV (PWH). They developed and validated a risk prediction model for ESLD among PWH who received care in 12 cohorts of the North American AIDS Cohort Collaboration on Research and Design and found that their model of readily accessible clinical parameters predicted ESLD in a large diverse population of PWH.
AHRQ-funded; 90047713.
Citation:
Kim HN, Nance RM, Lo Re V .
Development and validation of a model for prediction of end-stage liver disease in people with HIV.
J Acquir Immune Defic Syndr 2022 Apr;89(4):396-404. doi: 10.1097/qai.0000000000002886..
Keywords:
Chronic Conditions, Human Immunodeficiency Virus (HIV), Risk
Cabana MD, Robinson K, Plavin J
Partnering to improve pediatric asthma quality.
The purpose of this article was to explore the need for partnering between emergency departments (Eds) and primary care physicians (PCPs) to improve asthma quality measures, practice level improvements for both PCPs and EDs, and ultimately improve outcomes for children with asthma. Proper and timely management of asthma is thought to prevent ED visits, and the responsibility for addressing improvements in PCP performance should be shared by the PCP practices and health care payors and plans. The ability to measure the drivers of asthma-related visits to the ED may be outside of what a PCP practice can address, and so practices must be able to partner with health plans to successfully measure and develop system-wide interventions for quality and outcomes improvement. Although a child’s asthma may be managed in their PCP office, treatment of asthma issues often takes place in an ED setting or urgent care clinic that may be completely isolated from the patient’s PCP provider and system. Health plans can fill in the missing pieces to provide feedback on performance which can reduce ED visits, improve medication adherence and management, and provide actionable and timely data about hospital visits and discharge to PCP practices for quality improvements. Social determinants and comorbidities play a role in addressing ED visits for asthma. Health plan, public health systems, and provider coordination, integration, and partnerships are required to effectively address those issues and improve outcomes. The authors conclude that a systems approach and thoughtful partnerships across disciplines will be required beyond the PCP practice level to improve the outcomes of children with asthma.
AHRQ-funded; HS025297.
Citation:
Cabana MD, Robinson K, Plavin J .
Partnering to improve pediatric asthma quality.
Acad Pediatr 2022 Apr;22(3S):S73-S75. doi: 10.1016/j.acap.2021.06.013..
Keywords:
Children/Adolescents, Asthma, Chronic Conditions, Emergency Department, Quality Measures, Quality Improvement, Quality of Care
Aboumatar H, Pitts S, Sharma R
Patient engagement strategies for adults with chronic conditions: an evidence map.
Existing research indicates that patient and family engagement (PFE) in health care is necessary for improving outcomes. The purpose of this study was to explore the evidence on PFE strategies for adults with chronic conditions and identify the areas where additional research is needed. The authors searched existing databases, including CINAHL, Cochrane, EMBASE, and PubMed, for data between January 2015 and September 2021, to identify systematic reviews on strategies for engaging patients with chronic conditions. The study also included their caregivers. Strategies were categorized into the following levels: direct patient care, health system, and community-policy. The authors discovered 131 reviews of direct patient care strategies, 5 reviews of health system strategies, and no reviews of community-policy strategies. The study concluded that there is much more available evidence on the effects of direct patient care strategies on PFE than on the effects of the health system or community policy strategies. In addition, the evidence map created by the researchers focused on reviews which did not provide details of individual chronic disease interventions. The authors concluded that the evidence map created provides awareness of the research gaps related to efforts to improve patient and family engagement for patients with chronic conditions.
AHRQ-funded; 290201500006I.
Citation:
Aboumatar H, Pitts S, Sharma R .
Patient engagement strategies for adults with chronic conditions: an evidence map.
Syst Rev 2022 Mar 5;11(1):39. doi: 10.1186/s13643-021-01873-5..
Keywords:
Patient and Family Engagement, Chronic Conditions, Evidence-Based Practice
Remigio RV, Turpin R, Raimann JG, et al.
Assessing proximate intermediates between ambient temperature, hospital admissions, and mortality in hemodialysis patients.
This study investigated whether pre-dialysis systolic blood pressure (preSBP) and interdialytic weight gain (IDWG) in individuals with end-stage kidney disease (ESKD) can independently mediate the association between ambient temperature, all-cause hospital admissions (ACHA), and all-cause mortality (ACM). The study population consisted of 1981 ESKD patients receiving hemodialysis treatments at Fresenius Medical Care facilities in Philadelphia County, PA, from 2011 to 2019. Within a time-to-event framework, the authors estimated the association between daily maximum dry-bulb temperature (TMAX) and, as separate models, ACHA and ACM during warmer calendar months. Based on Lag 2- Lag 1 temporal ordering, and a 1 °C increase in daily maximum dry-bulb temperature (TMAX), the authors found an increased hazard of ACHA by 1.4% and ACM 7.5%. Short-term lag exposures to 1 °C increase in temperature predicted mean reductions in IDWG and preSBP by 0.013-0.015% and 0.168-0.229 mmHg.
AHRQ-funded; HS027716.
Citation:
Remigio RV, Turpin R, Raimann JG, et al..
Assessing proximate intermediates between ambient temperature, hospital admissions, and mortality in hemodialysis patients.
Environ Res 2022 Mar;204(Pt B):112127. doi: 10.1016/j.envres.2021.112127..
Keywords:
Kidney Disease and Health, Chronic Conditions, Hospitalization
Fisher KA, Kennedy K, Bloomstone S
Can sharing clinic notes improve communication and promote self-management? A qualitative study of patients with COPD.
The purpose of this study was to explore the effect of physicians sharing their clinical notes with patients with chronic obstructive pulmonary disease (COPD) and assess the impact on patient-physician communication and patient self-management. The researchers conducted interviews with 30 patients with COPD, asking them to review their clinic notes. The participants were primarily White (93.3%) with an average age of 65.5 years; more than 50% reported having a high school degree or less, almost half reported sometimes requiring help to read medical materials, and half had challenges understanding spoken information. The study found that patients reported that having the clinic notes gave them an opportunity to learn more about their condition, and encouraged their self-management by reminding them of their action steps, serving as prompts for seeking information, and motivating them. Patients indicated positive reactions to those physician notes that implied their clinician considered them as a person, listened to them, and noticed details about them. The majority of patients reported negative reactions to incorrect information in the notes, wording that they considered disapproving, and medical terms. The study concluded that the act of providers sharing their clinical notes with their patients can serve multiple purposes, including encouraging the exchange of information and self-management, and improving the relationship between patients and providers.
AHRQ-funded; HS024596.
Citation:
Fisher KA, Kennedy K, Bloomstone S .
Can sharing clinic notes improve communication and promote self-management? A qualitative study of patients with COPD.
Patient Educ Couns 2022 Mar;105(3):726-33. doi: 10.1016/j.pec.2021.06.004..
Keywords:
Respiratory Conditions, Chronic Conditions, Clinician-Patient Communication, Communication, Patient Self-Management
Encinosa W, Bernard D, Selden TM
Opioid and non-opioid analgesic prescribing before and after the CDC's 2016 opioid guideline.
This study examined opioid and non-opioid prescribing before and after the issuing of CDC’s 2016 opioid guideline. The authors developed a theory of physician prescribing behavior under the CDC’s two-pronged incentive structure. They used MEPS survey data to empirically corroborate the theory that the regulations and guidelines have the intended effects of reducing opioid prescriptions for acute and chronic pain, as well as the predicted unintended effects-income effects cause regulations on acute pain treatment to increase chronic pain opioid prescriptions and the chronic pain treatment guidelines spillover to reduce opioids for acute pain. They also found that the guidelines work as intended in terms of the reduced usage, with chronic pain patients shifting to non-opioids and tapering off opioid doses.
AHRQ-authored.
Citation:
Encinosa W, Bernard D, Selden TM .
Opioid and non-opioid analgesic prescribing before and after the CDC's 2016 opioid guideline.
Int J Health Econ Manag 2022 Mar;22(1):1-52. doi: 10.1007/s10754-021-09307-4..
Keywords:
Medical Expenditure Panel Survey (MEPS), Opioids, Practice Patterns, Medication, Pain, Chronic Conditions
Choi K, Becerra-Culqui T, Bhakta B
Parent intentions to vaccinate children with autism spectrum disorder against COVID-19.
This study’s purpose was to investigate associations between parent vaccine confidence and intentions to have their child with autism vaccinated with the COVID-19 vaccine. A cross-sectional, web-based survey of 332 parents of children with autism spectrum disorder who were members of an integrated healthcare system in Southern California was conducted from May to July 2021. Approximately 35% of parents were going to vaccinate their child against COVID-19. Positive vaccine beliefs, healthcare provider trust, or parent vaccination status were associated with intention to vaccinate.
AHRQ-funded; HS026407.
Citation:
Choi K, Becerra-Culqui T, Bhakta B .
Parent intentions to vaccinate children with autism spectrum disorder against COVID-19.
J Pediatr Nurs 2022 Mar-Apr;63:108-10. doi: 10.1016/j.pedn.2021.11.019..
Keywords:
Children/Adolescents, COVID-19, Vaccination, Autism, Chronic Conditions
Jaladanki S, Schechter SB, Genies MC
Strategies for sustaining high-quality pediatric asthma care in community hospitals.
This study’s objective was to identify strategies associated with sustained guideline adherence and high-quality pediatric asthma care in community hospitals. Hospitals who were part of the Pathways for Improving Pediatric Asthma Care (PIPA) national quality improvement (QI) intervention were included. Clinicians (n = 19) involved in clinical care of children hospitalized with asthma were interviewed from five higher- and three lower-performing hospitals. Higher-performing hospitals had dedicated local champions who consistently provided reminders of evidence-based practices and delivered ongoing education. These champions also modified/developed electronic health record (EHR) tools. Lower-performing hospital clinicians described unique barriers, including delays in modifying the EHR and lack of automation of EHR tools. For all hospitals, barriers to sustainability included challenges with quality monitoring, decreasing focus of local champions over time, and ongoing difficulties developing around evidence-based practices.
AHRQ-funded; HS027041.
Citation:
Jaladanki S, Schechter SB, Genies MC .
Strategies for sustaining high-quality pediatric asthma care in community hospitals.
Health Serv Res 2022 Feb;57(1):125-36. doi: 10.1111/1475-6773.13870..
Keywords:
Children/Adolescents, Asthma, Respiratory Conditions, Chronic Conditions, Hospitals, Quality of Care
Schuttner L, Hockett Sherlock S, Simons C
Factors affecting primary care physician decision-making for patients with complex multimorbidity: a qualitative interview study.
Researchers sought to describe factors affecting physician decision-making when care planning for complex patients with multimorbidity within the team-based, patient-centered medical home setting in the integrated healthcare system of the U.S. Department of Veterans Affairs, the Veterans Health Administration (VHA). They found that primary care physicians described internal, external, and relationship-based factors that affected their care planning for high-risk and complex patients with multimorbidity in the VHA.
AHRQ-funded; HS026369.
Citation:
Schuttner L, Hockett Sherlock S, Simons C .
Factors affecting primary care physician decision-making for patients with complex multimorbidity: a qualitative interview study.
BMC Prim Care 2022 Feb 5;23(1):25. doi: 10.1186/s12875-022-01633-x..
Keywords:
Primary Care, Decision Making, Chronic Conditions, Patient-Centered Healthcare
Kunneman M, Branda ME, Ridgeway JL
Making sense of diabetes medication decisions: a mixed methods cluster randomized trial using a conversation aid intervention.
The purpose of this trial was to determine the effectiveness of a shared decision-making (SDM) tool versus guideline-informed usual care in translating evidence into primary care, and to explore how use of the tool changed patient perspectives about diabetes medication decision making. Findings showed that using an SDM conversation aid improved patient knowledge and involvement in SDM without impacting treatment choice, encounter length, medication adherence, or improved diabetes control in patients with type 2 diabetes.
AHRQ-funded; HS018339.
Citation:
Kunneman M, Branda ME, Ridgeway JL .
Making sense of diabetes medication decisions: a mixed methods cluster randomized trial using a conversation aid intervention.
Endocrine 2022 Feb;75(2):377-91. doi: 10.1007/s12020-021-02861-4..
Keywords:
Diabetes, Medication, Decision Making, Patient-Centered Healthcare, Clinician-Patient Communication, Chronic Conditions
Schmajuk G, Li J, Evans M
Quality of care for patients with systemic lupus erythematosus: data from the American College of Rheumatology RISE Registry.
Although multiple national quality measures focus on the management and safety of rheumatoid arthritis, few measures address the care of patients with systemic lupus erythematosus (SLE). In this study, the objective was to apply a group of quality measures relevant to the care of patients with SLE, and use the American College of Rheumatology's Rheumatology Informatics System for Effectiveness (RISE) registry to assess nationwide variations in care.
AHRQ-funded; HS024412.
Citation:
Schmajuk G, Li J, Evans M .
Quality of care for patients with systemic lupus erythematosus: data from the American College of Rheumatology RISE Registry.
Arthritis Care Res 2022 Feb;74(2):179-86. doi: 10.1002/acr.24446..
Keywords:
Chronic Conditions, Quality Measures, Quality of Care
Izadi Z, Schmajuk G, Gianfrancesco M
Significant gains in rheumatoid arthritis quality measures among RISE Registry practices.
This study examined performance on rheumatoid arthritis (RA) quality measures and assessed the association between practice characteristics and changes in performance over time among participating practices. The authors analyzed data from practices enrolled in the American College of Rheumatology Rheumatology Informatics System for Effectiveness (RISE) registry from 2015 to 2017. Eight quality measures in the areas of RA disease management, cardiovascular risk reduction, and patient safety were analyzed. Data from 59,986 patients from 54 practices were examined. Cohort characteristics were a mean age of 62 years, 77% female, 69% Caucasian, and most patients (46%) were seen in a single-specialty group practice. Measures related to RA functional status and disease activity assessment improved over time, with single-specialty group practices having the fastest rates of improvement across all measures.
AHRQ-funded; HS025638; HS024412.
Citation:
Izadi Z, Schmajuk G, Gianfrancesco M .
Significant gains in rheumatoid arthritis quality measures among RISE Registry practices.
Arthritis Care Res 2022 Feb;74(2):219-28. doi: 10.1002/acr.24444..
Keywords:
Arthritis, Chronic Conditions, Quality Measures, Quality Indicators (QIs), Registries, Quality of Care
Demianczyk AC, Bechtel Driscoll CF, Karpyn A
Coping strategies used by mothers and fathers following diagnosis of congenital heart disease.
This study’s objective was to identify parental coping strategies following diagnosis of congenital heart disease (CHD) and compare use of coping strategies among different groups (mothers vs. fathers, prenatal vs. postnatal diagnosis). A diverse sample of 34 parents (20 mothers and 14 fathers) of young children with CHD participated in semistructured interviews. Parents described using between 1 and 10 different adaptive and maladaptive strategies measured by the COPE Inventory, an instrument that assesses common adult responses to stress. Mothers were more likely than fathers to report a focus on and venting of emotions (70% vs 21.43%) and behavioral disengagement (25% vs. 0%). Parents who had received a prenatal diagnosis described a greater variety of coping strategies compared to parents who received a postnatal CHD diagnosis (6.23 vs 4.52) and more often reported positive reinterpretation and growth, behavioral disengagement, and denial.
AHRQ-funded; HS026393.
Citation:
Demianczyk AC, Bechtel Driscoll CF, Karpyn A .
Coping strategies used by mothers and fathers following diagnosis of congenital heart disease.
Child Care Health Dev 2022 Jan;48(1):129-38. doi: 10.1111/cch.12913..
Keywords:
Children/Adolescents, Heart Disease and Health, Cardiovascular Conditions, Chronic Conditions
Staiger B
Disruptions to the patient-provider relationship and patient utilization and outcomes: evidence from Medicaid managed care.
The patient-provider relationship is considered a cornerstone to delivering high-value healthcare. However, in Medicaid managed care settings, disruptions to this relationship are disproportionately common. In this paper, the researcher evaluated the impact of a primary provider's exit from a Medicaid managed care plan on adult beneficiary healthcare utilization and outcomes.
AHRQ-funded; HS026128.
Citation:
Staiger B .
Disruptions to the patient-provider relationship and patient utilization and outcomes: evidence from Medicaid managed care.
J Health Econ 2022 Jan;81:102574. doi: 10.1016/j.jhealeco.2021.102574..
Keywords:
Medicaid, Clinician-Patient Communication, Healthcare Delivery, Chronic Conditions
Kumar V, Encinosa W
Explaining the obesity paradox in healthcare utilization among people with type 2 diabetes.
The authors sought to examine changes in the relationship between BMI and number of visits in diabetic vs nondiabetic populations, controlling for confounding risk factors. Using MEPS data, they found that the obesity paradox does not exist at the utilization level and is due to the presence of statistical biases such as confounding and reverse causation.
AHRQ-authored.
Citation:
Kumar V, Encinosa W .
Explaining the obesity paradox in healthcare utilization among people with type 2 diabetes.
Diabetol Int 2022 Jan;13(1):232-43. doi: 10.1007/s13340-021-00530-5..
Keywords:
Medical Expenditure Panel Survey (MEPS), Obesity, Diabetes, Chronic Conditions, Healthcare Utilization
Hobson JM, Gilstrap SR, Owens MA
Intersectional HIV and chronic pain stigma: implications for mood, sleep, and pain severity.
This study discusses chronic pain stigma in persons with HIV (PWH) and the consequences for mental and physical health which can lead to poor chronic pain outcome. This cross-sectional study enrolled 91 PWH and chronic pain patients, with six participants disqualified. Participants provided blood to determine CD 4+ count and viral load. They also completed standardized self-report questionnaires that assessed their experiences of HIV and chronic pain stigma, as well as depressive symptoms, experiences of insomnia, and pain severity. Measures used in the questionnaires included the HIV Stigma Mechanisms Scale, the Internalized Stigma of Chronic Pain scale, the Center for Epidemiologic Studies Depression (CED-S) Scale, the Insomnia Severity Index (ISI), and the Brief Pain Inventory Short-Form (BFI-SF). Participants were also questioned on opioid use. Results showed that for intersectional HIV and chronic pain stigma, 38% of participants were categorized as “high”, 28% were categorized as “moderate”, and 34% were categorized as “low”.
AHRQ-funded; HS013852.
Citation:
Hobson JM, Gilstrap SR, Owens MA .
Intersectional HIV and chronic pain stigma: implications for mood, sleep, and pain severity.
J Int Assoc Provid AIDS Care 2022 Jan-Dec;21:23259582221077941. doi: 10.1177/23259582221077941..
Keywords:
Human Immunodeficiency Virus (HIV), Pain, Chronic Conditions, Social Stigma, Depression
White AEC, Hood-Medland EA, Kravitz RL
Visit linearity in primary care visits for patients with chronic pain on long-term opioid therapy.
Physicians and patients report frustration after primary care visits for chronic pain. The need to shift between multiple clinical topics to address competing demands during visits may contribute to this frustration. This study created a novel measure, "visit linearity," to assess visit organization and examined whether visits that required less shifting back and forth between topics were associated with better patient and physician visit experiences.
AHRQ-funded; HS022236.
Citation:
White AEC, Hood-Medland EA, Kravitz RL .
Visit linearity in primary care visits for patients with chronic pain on long-term opioid therapy.
J Gen Intern Med 2022 Jan;37(1):78-86. doi: 10.1007/s11606-021-06917-z..
Keywords:
Opioids, Pain, Chronic Conditions, Primary Care, Medication
Boehmer KR, Pine KH, Whitman S
Do patients with high versus low treatment and illness burden have different needs? A mixed-methods study of patients living on dialysis.
The authors sought to understand the differences that exist between patients with end-stage kidney disease reporting high versus low treatment and illness burden. They found that patients on dialysis reporting the greatest illness and treatment burden have difficulties that their low-burden counterparts do not report, which may be amenable to intervention.
AHRQ-funded; HS026379.
Citation:
Boehmer KR, Pine KH, Whitman S .
Do patients with high versus low treatment and illness burden have different needs? A mixed-methods study of patients living on dialysis.
PLoS One 2021 Dec 28;16(12):e0260914. doi: 10.1371/journal.pone.0260914..
Keywords:
Dialysis, Kidney Disease and Health, Chronic Conditions
Agbalajobi OM, Gmelin T, Moon AM
Characteristics of opioid prescribing to outpatients with chronic liver diseases: a call for action.
This retrospective cohort study investigated opioid prescribing patterns among patients with chronic liver disease (CLD) at a single medical center. These patients (12,425) were followed for one year from October 2015 to September 2016. Nearly half (47%) were prescribed opioids over a one-year period, with 17% receiving high-risk prescriptions. Characteristics associated with high-risk opioid prescriptions included female gender, Medicaid insurance, cirrhosis and baseline chronic pain, depression, anxiety, substance use disorder, and Charlson comorbidity score. Non-alcoholic fatty liver disease was associated with decreased high-risk opioid prescriptions.
AHRQ-funded; HS019461.
Citation:
Agbalajobi OM, Gmelin T, Moon AM .
Characteristics of opioid prescribing to outpatients with chronic liver diseases: a call for action.
PLoS One 2021 Dec 17;16(12):e0261377. doi: 10.1371/journal.pone.0261377..
Keywords:
Opioids, Medication, Practice Patterns, Pain, Chronic Conditions
