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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
551 to 575 of 700 Research Studies DisplayedHong MK, Wilcox L, Machado D
Care partnerships: toward technology to support teens' participation in their health care.
The authors conducted 38 in-depth interviews along with nine non-participant observations of clinical consultations to better understand common challenges and needs that could be supported through design. They drew their findings to propose design goals for sociotechnical systems to support teens in partnering in their care, highlighting the need for design to support gradually evolving partnerships in care.
AHRQ-funded; HS021393.
Citation: Hong MK, Wilcox L, Machado D .
Care partnerships: toward technology to support teens' participation in their health care.
Proc SIGCHI Conf Hum Factor Comput Syst 2016 May 7;2016:5337-49. doi: 10.1145/2858036.2858508.
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Keywords: Children/Adolescents, Chronic Conditions, Patient and Family Engagement, Patient Self-Management
Thompson CF, Price CP, Huang JH
A pilot study of symptom profiles from a polyp vs an eosinophilic-based classification of chronic rhinosinusitis.
Researchers hypothesized that appropriate chronic rhinosinusitis (CRS) subclassification would increase homogeneity of baseline symptoms, and identify characteristic symptoms of each subtype. They found that subclassifying CRS with symptoms alone is difficult with neither polyp status nor eosinophilia giving a distinctive clinical symptom profile. However, certain symptoms may help otolaryngologists identify CRS subtypes, which may help guide future treatments.
AHRQ-funded; HS023011.
Citation: Thompson CF, Price CP, Huang JH .
A pilot study of symptom profiles from a polyp vs an eosinophilic-based classification of chronic rhinosinusitis.
Int Forum Allergy Rhinol 2016 May;6(5):500-7. doi: 10.1002/alr.21687.
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Keywords: Chronic Conditions, Diagnostic Safety and Quality, Respiratory Conditions
Navarra AM, Schlau R, Murray M
Assessing nursing care needs of children with complex medical conditions: The Nursing-Kids Intensity of Care Survey (N-KICS).
The researchers designed and tested the Nursing-Kids Intensity of Care Survey (N-KICS) tool and describe intensity of nursing care for children with complex medical conditions. Their psychometric evaluation confirmed an acceptable standard for reliability and validity and feasibility. Intensity scores were highest for nursing care related to infection control, medication administration, nutrition, diaper changes, hygiene, neurological and respiratory support, and standing program.
AHRQ-funded; HS021470.
Citation: Navarra AM, Schlau R, Murray M .
Assessing nursing care needs of children with complex medical conditions: The Nursing-Kids Intensity of Care Survey (N-KICS).
J Pediatr Nurs 2016 May-Jun;31(3):299-310. doi: 10.1016/j.pedn.2015.11.012.
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Keywords: Children/Adolescents, Chronic Conditions, Disabilities, Long-Term Care, Nursing, Vulnerable Populations
Balbale SN, Etingen B, Malhiot A
Perceptions of chronic illness care among veterans with multiple chronic conditions.
The purpose of this study was to use the Patient Assessment of Chronic Illness Care (PACIC) instrument to examine perceptions of chronic care among veterans with multiple chronic conditions (MCC). The authors concluded that quality improvements are needed to strengthen care continuity and coordination.
AHRQ-funded; HS000084.
Citation: Balbale SN, Etingen B, Malhiot A .
Perceptions of chronic illness care among veterans with multiple chronic conditions.
Mil Med 2016 May;181(5):439-44. doi: 10.7205/milmed-d-15-00207..
Keywords: Chronic Conditions, Patient Experience, Quality Improvement
Shirley DK, Kaner RJ, Glesby MJ
Screening for chronic obstructive pulmonary disease (COPD) in an urban HIV clinic: a pilot study.
This study aimed to determine the predictive value of a COPD screening strategy validated in the general population and to identify HIV-related factors associated with decreased lung function. It found that questionnaire and peak flow together had low sensitivity, but abnormal peak flow shows potential as a screening tool for COPD in HIV/AIDS. These data suggest that lung function may be influenced by HIV-related factors.
AHRQ-funded; HS000066.
Citation: Shirley DK, Kaner RJ, Glesby MJ .
Screening for chronic obstructive pulmonary disease (COPD) in an urban HIV clinic: a pilot study.
AIDS Patient Care STDS 2015 May;29(5):232-9. doi: 10.1089/apc.2014.0265..
Keywords: Human Immunodeficiency Virus (HIV), Screening, Chronic Conditions, Respiratory Conditions, Urban Health
Ryu E, Chamberlain AM, Pendergraft RS
Quantifying the impact of chronic conditions on a diagnosis of major depressive disorder in adults: a cohort study using linked electronic medical records.
In this study, the researchers aimed to quantify the relative contribution of selected chronic conditions to identify the conditions most influential to major depressive disorder (MDD) risk in adults and identify differences by age. Their results suggest that specific chronic conditions such as diabetes mellitus and rheumatoid arthritis/osteoarthritis may have greater influence than others on the risk of MDD.
AHRQ-funded; HS023077.
Citation: Ryu E, Chamberlain AM, Pendergraft RS .
Quantifying the impact of chronic conditions on a diagnosis of major depressive disorder in adults: a cohort study using linked electronic medical records.
BMC Psychiatry 2016 Apr 26;16:114. doi: 10.1186/s12888-016-0821-x.
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Keywords: Chronic Conditions, Depression, Electronic Health Records (EHRs), Primary Care
Bernard D, Selden T, Yeh S
AHRQ Author: Bernard D, Selden T
Financial burdens and barriers to care among nonelderly adults: the role of functional limitations and chronic conditions.
The researchers examined the financial burdens and barriers to care among nonelderly adults, focusing on the role of functional limitations and chronic conditions. Functional limitations and chronic conditions were associated with increased prevalence of burdens and financial barriers in all insurance categories, with the exception that an association between functional limitations and the prevalence of burdens was not observed for public coverage.
AHRQ-authored.
Citation: Bernard D, Selden T, Yeh S .
Financial burdens and barriers to care among nonelderly adults: the role of functional limitations and chronic conditions.
Disabil Health J 2016 Apr;9(2):256-64. doi: 10.1016/j.dhjo.2015.09.003.
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Keywords: Medical Expenditure Panel Survey (MEPS), Healthcare Costs, Chronic Conditions, Access to Care, Health Services Research (HSR)
Budiman-Mak E, Epstein N, Brennan M
Systolic blood pressure variability and lower extremity amputation in a non-elderly population with diabetes.
This study's objective is to examine whether systolic blood pressure has any prognostic value for lower-extremity amputations. The authors concluded that this study showed a significant graded relationship between systolic blood pressure variability and risk of major amputation among non-elderly persons with diabetes.
AHRQ-funded; HS018542.
Citation: Budiman-Mak E, Epstein N, Brennan M .
Systolic blood pressure variability and lower extremity amputation in a non-elderly population with diabetes.
Diabetes Res Clin Pract 2016 Apr;114:75-82. doi: 10.1016/j.diabres.2016.01.010.
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Keywords: Diabetes, Blood Pressure, Risk, Chronic Conditions
Zullig LL, Whitson HE, Hastings SN
A systematic review of conceptual frameworks of medical complexity and new model development.
The authors sought to develop a conceptual model of complexity addressing gaps identified in a review of published conceptual models. Their Cycle of Complexity model illustrated relationships between acute shocks and medical events, healthcare access and utilization, workload and capacity, and patient preferences in the context of interpersonal, organizational, and community factors.
AHRQ-funded; HS023085; HS023099.
Citation: Zullig LL, Whitson HE, Hastings SN .
A systematic review of conceptual frameworks of medical complexity and new model development.
J Gen Intern Med 2016 Mar;31(3):329-37. doi: 10.1007/s11606-015-3512-2.
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Keywords: Access to Care, Chronic Conditions, Health Services Research (HSR)
Wilson KC, Gould MK, Krishnan JA
An official American Thoracic Society workshop report. A framework for addressing multimorbidity in clinical practice guidelines for pulmonary disease, critical illness, and sleep disorders.
The American Thoracic Society convened a workshop to establish a strategy to address multimorbidity within clinical practice guidelines. This report describes a framework that addresses multimorbidity in each of the key steps of guideline development: topic selection, panel composition, identifying clinical questions, searching for and synthesizing evidence, rating the quality of that evidence, summarizing benefits and harms, formulating recommendations, and rating the strength of the recommendations.
AHRQ-funded; HS020672.
Citation: Wilson KC, Gould MK, Krishnan JA .
An official American Thoracic Society workshop report. A framework for addressing multimorbidity in clinical practice guidelines for pulmonary disease, critical illness, and sleep disorders.
Ann Am Thorac Soc 2016 Mar;13(3):S12-21. doi: 10.1513/AnnalsATS.201601-007ST.
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Keywords: Sleep Problems, Guidelines, Evidence-Based Practice, Chronic Conditions, Respiratory Conditions
Fritz JM, Rundell SD, Dougherty P
Deconstructing chronic low back pain in the older adult-step by step evidence and expert-based recommendations for evaluation and treatment. Part vi: Lumbar spinal stenosis.
This article is the sixth in a series of articles designed to deconstruct chronic low back pain (CLBP) in older adults. It focuses on the evaluation and management of lumbar spinal stenosis (LSS), the most common condition for which older adults undergo spinal surgery. It concluded that lumbar spinal stenosis exists not uncommonly in older adults with CLBP and management often can be accomplished without surgery.
AHRQ-funded; HS022982.
Citation: Fritz JM, Rundell SD, Dougherty P .
Deconstructing chronic low back pain in the older adult-step by step evidence and expert-based recommendations for evaluation and treatment. Part vi: Lumbar spinal stenosis.
Pain Med 2016 Mar;17(3):501-10. doi: 10.1093/pm/pnw011..
Keywords: Back Health and Pain, Elderly, Chronic Conditions, Treatments, Surgery
Domino ME, Jackson C, Beadles CA
Do primary care medical homes facilitate care transitions after psychiatric discharge for patients with multiple chronic conditions?
The purpose of this manuscript is to assess outpatient follow-up rates with primary care and mental health providers following psychiatric discharge by medical home enrollment and medical complexity. Hospitalized persons with multiple chronic conditions including serious mental illness enrolled in a medical home were more likely to receive timely outpatient follow-up with a primary care provider but not with a mental health specialist.
AHRQ-funded; HS000032; HS019659.
Citation: Domino ME, Jackson C, Beadles CA .
Do primary care medical homes facilitate care transitions after psychiatric discharge for patients with multiple chronic conditions?
Gen Hosp Psychiatry 2016 Mar-Apr;39:59-65. doi: 10.1016/j.genhosppsych.2015.11.002.
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Keywords: Primary Care, Patient-Centered Healthcare, Behavioral Health, Hospitalization, Chronic Conditions
Lo Re V, 3rd, Carbonari DM, Lewis JD
Oral azole antifungal medications and risk of acute liver injury, overall and by chronic liver disease status.
The researchers evaluated incidence rates of acute liver injury associated with oral azole antifungals. They concluded that rates of acute liver injury were similarly low for fluconazole, ketoconazole, and itraconazole. Events were more common among voriconazole and posaconazole users but were comparable. Pre-existing chronic liver disease increased risk of azole-induced liver injury.
AHRQ-funded; HS018372.
Citation: Lo Re V, 3rd, Carbonari DM, Lewis JD .
Oral azole antifungal medications and risk of acute liver injury, overall and by chronic liver disease status.
Am J Med 2016 Mar;129(3):283-91.e5. doi: 10.1016/j.amjmed.2015.10.029.
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Keywords: Antimicrobial Stewardship, Medication, Kidney Disease and Health, Chronic Conditions, Adverse Drug Events (ADE)
Skinner HG, Coffey R, Jones J
AHRQ Author: Heslin KC, Moy E
The effects of multiple chronic conditions on hospitalization costs and utilization for ambulatory care sensitive conditions in the United States: a nationally representative cross-sectional study.
A purpose of this study was to evaluate how multiple chronic conditions relate to inpatient hospitalization costs. It found that compared with costs for patients with 0 or 1 chronic condition, hospitalization costs per stay for overall ambulatory care sensitive conditions were 19 percent higher for those with 2 or 3 , 32 percent higher for those with 4 or 5, and 31 percent higher for those with 6+ conditions.
AHRQ-authored; AHRQ-funded; 290201300002C.
Citation: Skinner HG, Coffey R, Jones J .
The effects of multiple chronic conditions on hospitalization costs and utilization for ambulatory care sensitive conditions in the United States: a nationally representative cross-sectional study.
BMC Health Serv Res 2016 Mar 1;16:77. doi: 10.1186/s12913-016-1304-y.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Chronic Conditions, Hospitalization, Healthcare Utilization, Healthcare Costs
Chung CF, Dew K, Cole A
Boundary negotiating artifacts in personal informatics: patient-provider collaboration with patient-generated data.
This paper examines patient expectations and current collaboration practices around patient-generated data. It finds that collaboration occurs in every stage of self- tracking and that patients and providers create boundary negotiating artifacts to support the collaboration. Building upon current practices with patient-generated data, the authors use these theories of patient and provider collaboration to analyze misunderstandings and privacy concerns.
AHRQ-funded; HS023654.
Citation: Chung CF, Dew K, Cole A .
Boundary negotiating artifacts in personal informatics: patient-provider collaboration with patient-generated data.
CSCW 2016 Feb 27:770-86. doi: 10.1145/2818048.2819926..
Keywords: Chronic Conditions, Health Information Technology (HIT), Clinician-Patient Communication, Patient Self-Management
Kuo YF, Raji MA, Chen NW
Trends in opioid prescriptions among Part D Medicare recipients From 2007 to 2012.
The researchers used national Medicare data from 2007-2012 to assess temporal and geographic trends in rates of opioid prescription and relationship to opioid toxicity and different state regulations in Part D Medicare recipients. Their analyses of the Medicare data demonstrated substantial growth in opioid prescriptions from 2007 to 2011 and large variation in opioid prescriptions across states.
AHRQ-funded; HS022134.
Citation: Kuo YF, Raji MA, Chen NW .
Trends in opioid prescriptions among Part D Medicare recipients From 2007 to 2012.
Am J Med 2016 Feb;129(2):221.e21-30. doi: 10.1016/j.amjmed.2015.10.002..
Keywords: Chronic Conditions, Elderly, Medicare, Medication, Opioids, Pain
Bogner HR, Joo JH, Hwang S
Does a depression management program decrease mortality in older adults with specific medical conditions in primary care? An exploratory analysis.
The objective of this study was to determine whether treating depression decreases mortality from various chronic medical conditions. It found evidence of a statistically significant intervention effect on mortality for diabetes mellitus in persons with major depression.
AHRQ-funded; HS023445.
Citation: Bogner HR, Joo JH, Hwang S .
Does a depression management program decrease mortality in older adults with specific medical conditions in primary care? An exploratory analysis.
J Am Geriatr Soc 2016 Jan;64(1):126-31. doi: 10.1111/jgs.13711..
Keywords: Chronic Conditions, Depression, Elderly, Mortality, Primary Care
Cleynen I, Boucher G, Jostins L
Inherited determinants of Crohn's disease and ulcerative colitis phenotypes: a genetic association study.
The researchers undertook the largest genotype association study, to date, in widely used clinical subphenotypes of inflammatory bowel disease with the goal of further understanding the biological relations between between Crohn's disease and ulcerative colitis. Their data support a continuum of disorders within inflammatory bowel disease, much better explained by three groups (ileal Crohn's disease, colonic Crohn's disease, and ulcerative colitis) than by Crohn's disease and ulcerative colitis as currently defined.
AHRQ-funded; HS021747.
Citation: Cleynen I, Boucher G, Jostins L .
Inherited determinants of Crohn's disease and ulcerative colitis phenotypes: a genetic association study.
Lancet 2016 Jan 9;387(10014):156-67. doi: 10.1016/s0140-6736(15)00465-1.
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Keywords: Genetics, Digestive Disease and Health, Chronic Conditions
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
Ratanawongsa N, Barton JL, Lyles CR
Association between clinician computer use and communication with patients in safety-net clinics.
The researchers studied associations between clinician computer use and communication with patients with diverse chronic diseases in safety-net clinics. They found that high computer use by clinicians in safety-net clinics was associated with lower patient satisfaction and observable communication differences.
AHRQ-funded; HS022561; HS022408.
Citation: Ratanawongsa N, Barton JL, Lyles CR .
Association between clinician computer use and communication with patients in safety-net clinics.
JAMA Intern Med 2016 Jan;176(1):125-8. doi: 10.1001/jamainternmed.2015.6186.
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Keywords: Clinician-Patient Communication, Communication, Chronic Conditions, Patient Experience, Electronic Health Records (EHRs), Health Information Technology (HIT)
Berliner E
AHRQ Author: Berliner E
Multisociety letter to the Agency for Healthcare Research and Quality: serious methodological flaws plague technology assessment on pain management injection therapies for low back pain.
The recent publication of an AHRQ report on Pain Management Injection Therapies for Low Back Pain has raised significant concerns for physicians who utilize injection procedures to treat patients suffering with pain and functional limitations resulting from spinal pathology. The authors are concerned that the methodology used by the report cannot and does not make such determinations, and that the conclusions may lead to egregious denial of access to these procedures for many patients suffering from low back pain.
AHRQ-authored.
Citation: Berliner E .
Multisociety letter to the Agency for Healthcare Research and Quality: serious methodological flaws plague technology assessment on pain management injection therapies for low back pain.
Pain Med 2016 Jan;17(1):10-15. doi: 10.1111/pme.12934..
Keywords: Back Health and Pain, Care Management, Chronic Conditions, Evidence-Based Practice, Health Services Research (HSR), Pain, Research Methodologies
Hannum SM, Rubinstein RL
The meaningfulness of time; narratives of cancer among chronically ill older adults.
The authors sought to describe how chronically ill older adults experience a new cancer diagnosis and the effects of this on their interpretations of personal health, aging, and the future. Among the fifteen participants, they found that perceived time was fragmented into three distinct segments: the Recalled Past, the Existent Present, and the Imagined Future. They discussed implications for how older adults understood their cancer.
AHRQ-funded; HS020177.
Citation: Hannum SM, Rubinstein RL .
The meaningfulness of time; narratives of cancer among chronically ill older adults.
J Aging Stud 2016 Jan;36:17-25. doi: 10.1016/j.jaging.2015.12.006.
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Keywords: Elderly, Cancer, Chronic Conditions, Health Status
McCoy RG, Van Houten HK, Ross JS
HbA1c overtesting and overtreatment among US adults with controlled type 2 diabetes, 2001-13: observational population based study.
The researchers sought to determine the extent and effect of excessive testing for glycated hemoglobin (HbA1c) among adults with controlled type 2 diabetes. They found that in a US cohort of adults with stable and controlled type 2 diabetes, more than 60% received too many HbA1c tests, a practice associated with potential overtreatment with hypoglycemic drugs.
AHRQ-funded; HS018339.
Citation: McCoy RG, Van Houten HK, Ross JS .
HbA1c overtesting and overtreatment among US adults with controlled type 2 diabetes, 2001-13: observational population based study.
BMJ 2015 Dec 8;351:h6138. doi: 10.1136/bmj.h6138..
Keywords: Chronic Conditions, Diabetes, Healthcare Utilization, Medication, Patient-Centered Outcomes Research
Quan J, Lee AK, Handley MA
Automated telephone self-management support for diabetes in a low-income health plan: a health care utilization and cost analysis.
The objective was to determine whether automated telephone self-management support for low-income, linguistically diverse health plan members with diabetes affects health care utilization or cost. It found no significant differences in emergency department visits and hospitalizations or in costs.
AHRQ-funded; HS020684; HS017261; HS022561.
Citation: Quan J, Lee AK, Handley MA .
Automated telephone self-management support for diabetes in a low-income health plan: a health care utilization and cost analysis.
Popul Health Manag 2015 Dec;18(6):412-20. doi: 10.1089/pop.2014.0154.
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Keywords: Diabetes, Chronic Conditions, Patient Self-Management, Low-Income, Healthcare Costs
Pillay J, Armstrong MJ, Butalia S
Behavioral programs for type 1 diabetes mellitus: a systematic review and meta-analysis.
The purpose of this review and meta-analysis was to determine the effects of behavioral programs for patients with type 1 diabetes on behavioral, clinical, and health outcomes and to investigate factors that might moderate effect. It concluded that behavioral programs for type 1 diabetes offer some benefit for glycemic control, at least at short-term follow-up, but improvement for other outcomes has not been shown.
AHRQ-funded; 2902012000131.
Citation: Pillay J, Armstrong MJ, Butalia S .
Behavioral programs for type 1 diabetes mellitus: a systematic review and meta-analysis.
Ann Intern Med 2015 Dec 1;163(11):836-47. doi: 10.7326/m15-1399..
Keywords: Diabetes, Education: Patient and Caregiver, Patient Self-Management, Patient-Centered Outcomes Research, Lifestyle Changes, Chronic Conditions