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 229 Research Studies DisplayedMasho SW, Ihongbe TO, Wan W
Effectiveness of shortened time interval to postpartum visit in improving postpartum attendance: design and rationale for a randomized controlled trial.
Recent evidence suggests that there are numerous benefits to scheduling postpartum visits as early as 3 weeks post-delivery. However, findings are not conclusive due to methodological limitations. This report discussed the unique aspects of a randomized controlled trial's (RCT) design, intervention, and strategies to maintain participant retention. The study design offered unique features which ensured excellent participant completion and adherence rates, despite the presence of hard-to-track women who typically do not return for their postpartum visits.
AHRQ-funded; HS021504.
Citation: Masho SW, Ihongbe TO, Wan W .
Effectiveness of shortened time interval to postpartum visit in improving postpartum attendance: design and rationale for a randomized controlled trial.
Contemp Clin Trials 2019 Jun;81:40-43. doi: 10.1016/j.cct.2019.04.012..
Keywords: Maternal Care, Pregnancy, Women, Patient Adherence/Compliance, Research Methodologies
Lor M, Koleck TA, Bakken S
Association between health literacy and medication adherence among Hispanics with hypertension.
This study examined the association between health literacy and medication adherence among Hispanic adults with hypertension. A cross-sectional survey of 1355 Hispanic adults, mostly Dominicans who self-report hypertension was conducted. After controlling for age, sex, birth country, education level, recruitment location, depression, anxiety, and sleep disturbance inadequate health literacy was associated with a lower adherence score.
AHRQ-funded; HS019853; HS022961.
Citation: Lor M, Koleck TA, Bakken S .
Association between health literacy and medication adherence among Hispanics with hypertension.
J Racial Ethn Health Disparities 2019 Jun;6(3):517-24. doi: 10.1007/s40615-018-00550-z..
Keywords: Blood Pressure, Health Literacy, Patient Adherence/Compliance, Medication, Racial and Ethnic Minorities
Pack AP, Golin CE, Hill LM
Patient and clinician perspectives on optimizing graphical displays of longitudinal medication adherence data.
This study looked into the value of using graphical display prototypes of hypothetical daily drug concentrations measured in hair for patients to assess their medication adherence. Investigators surveyed 30 HIV-positive patients and 29 clinicians to assess their preferences for three different prototypes. Patients and clinicians generally found the prototypes acceptable, but clinicians largely preferred daily drug concentrations in bar graph display. Patients with lower health literacy had trouble understanding the link between medication-taking and drug concentrations in hair and also preferred pictographs over bar or line graphs.
AHRQ-funded; HS000032.
Citation: Pack AP, Golin CE, Hill LM .
Patient and clinician perspectives on optimizing graphical displays of longitudinal medication adherence data.
Patient Educ Couns 2019 Jun;102(6):1090-97. doi: 10.1016/j.pec.2018.12.029..
Keywords: Clinician-Patient Communication, Communication, Health Literacy, Medication, Patient Adherence/Compliance, Provider, Provider: Clinician
Mefford MT, Sephel A, Van Dyke MK
Medication-taking behaviors and perceptions among adults with heart failure (from the REasons for Geographic And Racial Differences in Stroke Study).
Medication regimens in adults with heart failure (HF) are complex which can complicate patient adherence. Individuals with HF frequently use beta blockers (BBs) for multiple indications, including hypertension and HF, but BBs can have significant side effects that may affect their use. In this study, the investigators examined medication-taking behaviors and perceptions in individuals with HF, with a particular focus on BBs.
AHRQ-funded; HS013852.
Citation: Mefford MT, Sephel A, Van Dyke MK .
Medication-taking behaviors and perceptions among adults with heart failure (from the REasons for Geographic And Racial Differences in Stroke Study).
Am J Cardiol 2019 May 15;123(10):1667-74. doi: 10.1016/j.amjcard.2019.02.024..
Keywords: Medication, Heart Disease and Health, Cardiovascular Conditions, Patient Adherence/Compliance
Turan B, Crockett KB, Buyukcan-Tetik A
Buffering internalization of HIV stigma: implications for treatment adherence and depression.
One mechanism through which social stigma of HIV affects health outcomes for people living with HIV (PLWH) is through internalization of stigma. However, this transformation of social stigma in the community into internalized stigma may not be of the same magnitude for all PLWH. In this study, the investigators examined the moderating effects of 3 personality traits-fear of negative social evaluation, attachment-related anxiety, and dispositional resilience-in transforming perceived stigma in the community into internalized stigma. They also investigated downstream effects of these moderated associations on depressive symptoms and antiretroviral treatment (ART) adherence.
AHRQ-funded; HS013852.
Citation: Turan B, Crockett KB, Buyukcan-Tetik A .
Buffering internalization of HIV stigma: implications for treatment adherence and depression.
J Acquir Immune Defic Syndr 2019 Mar;80(3):284-91. doi: 10.1097/qai.0000000000001915..
Keywords: Depression, Human Immunodeficiency Virus (HIV), Medication, Behavioral Health, Patient Adherence/Compliance, Social Stigma
Turan B, Rice WS, Crockett KB
Longitudinal association between internalized HIV stigma and antiretroviral therapy adherence for women living with HIV: the mediating role of depression.
This study investigated whether internalized HIV-related stigma predicts adherence to antiretroviral therapy (ART) longitudinally in women living with HIV in the United States; symptoms of depression as a mediator in the relationship between internalized stigma and suboptimal ART adherence was also examined. A new measure of internalized HIV-related stigma was added to the Women's Interagency HIV Study in 2013. Participants' first assessment of stigma and their assessments of other variables were used as baseline measures, and outcomes measured 2 years later. A measure of depression symptoms was assessed 18 months after the baseline. The results suggest that a higher internalized HIV-related stigma at the first assessment was a predictor of lower odds of optimal ART adherence at the two-year mark. Mediation analysis also indicated significant indirect effect on ART adherence through depression symptoms at the 18-month mark.
AHRQ-funded; HS013852.
Citation: Turan B, Rice WS, Crockett KB .
Longitudinal association between internalized HIV stigma and antiretroviral therapy adherence for women living with HIV: the mediating role of depression.
AIDS 2019 Mar;33(3):571-76. doi: 10.1097/qad.0000000000002071..
Keywords: Human Immunodeficiency Virus (HIV), Medication, Patient Adherence/Compliance, Social Stigma
Xie Z, St Clair P, Goldman DP
Racial and ethnic disparities in medication adherence among privately insured patients in the United States.
The purpose of this study was to examine the association between socioeconomic status (SES) and racial and ethnic disparities in medication adherence for three widely prescribed therapeutic classes. The investigators concluded that racial/ethnic disparities in adherence were mitigated, but persisted after controlling for detailed socioeconomic measures. They suggest that interventions should focus more on improving medication adherence of existing users, particularly in treating asymptomatic conditions.
AHRQ-funded; HS013447.
Citation: Xie Z, St Clair P, Goldman DP .
Racial and ethnic disparities in medication adherence among privately insured patients in the United States.
PLoS One 2019 Feb 14;14(2):e0212117. doi: 10.1371/journal.pone.0212117..
Keywords: Racial and Ethnic Minorities, Disparities, Patient Adherence/Compliance, Medication, Social Determinants of Health, Health Insurance
Marcum ZA, Walker RL, Jones BL
Patterns of antihypertensive and statin adherence prior to dementia: findings from the adult changes in thought study.
Using the hypothesis that changes in medication adherence might represent an early sign of cognitive impairment, this study examined antihypertensive and statin adherence trajectories in community-dwelling older adults to compare which went on to develop dementia and which did not. Data from Adult Changes in Thought (ACT), a population-based cohort study, was analyzed; 4368 participants aged 65 years or older who had at least one follow-up visit were selected, included on the basis of whether they were prevalent users of either a statin or antihypertensive medication on the first day of follow up. Research-quality dementia diagnoses were used to identify cases. Non-dementia control visits were matched by age, sex, and study cohort that occurred at similar follow-up time as the selected case dementia onset. The authors conclude that the patterns of medication adherence that emerged may be useful to identify people with higher likelihood of developing dementia.
AHRQ-funded; HS022982.
Citation: Marcum ZA, Walker RL, Jones BL .
Patterns of antihypertensive and statin adherence prior to dementia: findings from the adult changes in thought study.
BMC Geriatr 2019 Feb 14;19(1):41. doi: 10.1186/s12877-019-1058-6..
Keywords: Dementia, Elderly, Medication, Neurological Disorders, Patient Adherence/Compliance
Doll JA, Hellkamp AS, Thomas L
The association of pre- and posthospital medication adherence in myocardial infarction patients.
Nonadherence to optimal medical therapy following myocardial infarction (MI) is associated with adverse clinical outcomes such as stent thrombosis, recurrent cardiovascular events, and death. Whether adherence to medications prior to MI predicts post-MI medication adherence is unknown. In this study, the investigators assessed adherence to P2Y12 inhibitors and statins before and after admission for MI among 8,147 MI patients who had Medicare insurance with Part D prescription coverage.
AHRQ-funded; HS021092.
Citation: Doll JA, Hellkamp AS, Thomas L .
The association of pre- and posthospital medication adherence in myocardial infarction patients.
Am Heart J 2019 Feb;208:74-80. doi: 10.1016/j.ahj.2018.11.004..
Keywords: Cardiovascular Conditions, Elderly, Heart Disease and Health, Medicare, Medication, Patient Adherence/Compliance
Beauchemin M, Gradilla M, Baik D
A multi-step usability evaluation of a self-management app to support medication adherence in persons living with HIV.
The authors developed a mHealth app (WiseApp) for HIV self-management to help persons living with HIV (PLWH) self-manage their health. The purpose of this study was to evaluate the usability of the WiseApp. The results of the cognitive walkthrough with both experts and end-users informed iterative refinements to the WiseApp and finalization of a mHealth app for PLWH to better self-manage their health.
AHRQ-funded; HS025071.
Citation: Beauchemin M, Gradilla M, Baik D .
A multi-step usability evaluation of a self-management app to support medication adherence in persons living with HIV.
Int J Med Inform 2019 Feb;122:37-44. doi: 10.1016/j.ijmedinf.2018.11.012..
Keywords: Health Information Technology (HIT), Human Immunodeficiency Virus (HIV), Medication, Patient Adherence/Compliance, Patient Self-Management
Griffith DC, Farmer C, Gebo KA
Uptake and virological outcomes of single- versus multi-tablet antiretroviral regimens among treatment-naive youth in the HIV Research Network.
Researchers studied the impact of single-tablet regiments (STRs) versus multi-tablet regimens (MTRs) in the treatment of HIV with youth with HIV (YHIV) in the HIV Research Network between the ages of 13 and 24. The use of STRs was associated with greater compliance in their antiretroviral regiments and better outcomes over an 8-year period (2006-2014) at 18 US HIV clinical sites.
AHRQ-funded; 290201100007C.
Citation: Griffith DC, Farmer C, Gebo KA .
Uptake and virological outcomes of single- versus multi-tablet antiretroviral regimens among treatment-naive youth in the HIV Research Network.
HIV Med 2019 Feb;20(2):169-74. doi: 10.1111/hiv.12695..
Keywords: Children/Adolescents, Human Immunodeficiency Virus (HIV), Medication, Outcomes, Patient Adherence/Compliance, Patient-Centered Outcomes Research, Young Adults
Turan B, Crockett KB, Kempf MC
Internal working models of attachment relationships and hiv outcomes among women living with HIV.
Treatment adherence and viral suppression remain suboptimal in the United States. Attachment insecurity may be one understudied factor affecting adherence. In this study, the investigators examined cross-sectional associations of the 2 attachment-related insecurity dimensions with antiretroviral treatment (ART) adherence, HIV visit adherence, CD4 cell counts, and viral suppression. The authors suggest that interventions may need to focus on the vulnerable subpopulation with high attachment insecurity and incorporate existing strategies that address insecure attachment models.
AHRQ-funded; HS013852.
Citation: Turan B, Crockett KB, Kempf MC .
Internal working models of attachment relationships and hiv outcomes among women living with HIV.
J Acquir Immune Defic Syndr 2019 Jan;80(1):e1-e8. doi: 10.1097/qai.0000000000001872..
Keywords: Human Immunodeficiency Virus (HIV), Patient Adherence/Compliance, Women, Medication
Sun CJ, Nall JL, Rhodes SD
Perceptions of needs, assets, and priorities among black men who have sex with men with HIV: community-driven actions and impacts of a participatory photovoice process.
Black men who have sex with men (MSM) with HIV experience significant health inequities and poorer health outcomes compared with other persons with HIV. The primary aims of this study were to describe the needs, assets, and priorities of Black MSM with HIV who live in the Southern United States and identify actions to improve their health using photovoice.
AHRQ-funded; HS022981.
Citation: Sun CJ, Nall JL, Rhodes SD .
Perceptions of needs, assets, and priorities among black men who have sex with men with HIV: community-driven actions and impacts of a participatory photovoice process.
Am J Mens Health 2019 Jan-Feb;13(1):1557988318804901. doi: 10.1177/1557988318804901..
Keywords: Human Immunodeficiency Virus (HIV), Racial and Ethnic Minorities, Men's Health, Community-Based Practice, Patient Adherence/Compliance
Farias AJ, Wu WH, Du XL
Racial differences in long-term adjuvant endocrine therapy adherence and mortality among Medicaid-insured breast cancer patients in Texas: findings from TCR-Medicaid linked data.
There are racial/ethnic disparities in breast cancer mortality that may be attributed to differences in receipt of adjuvant cancer treatment. The purpose of this article was to determine whether the mortality disparities could be explained by racial/ethnic differences in long-term adherence to adjuvant endocrine therapy (AET). The investigators concluded that long-term adherence in the Medicaid population was suboptimal and racial/ethnic differences in AET adherence may partially explain disparities in mortality.
AHRQ-funded; HS018956.
Citation: Farias AJ, Wu WH, Du XL .
Racial differences in long-term adjuvant endocrine therapy adherence and mortality among Medicaid-insured breast cancer patients in Texas: findings from TCR-Medicaid linked data.
BMC Cancer 2018 Dec 4;18(1):1214. doi: 10.1186/s12885-018-5121-z..
Keywords: Cancer: Breast Cancer, Disparities, Medicaid, Patient Adherence/Compliance, Racial and Ethnic Minorities
Chudy-Onwugaje K, Abutaleb A, Buchwald A
Age modifies the association between depressive symptoms and adherence to self-testing with telemedicine in patients with inflammatory bowel disease.
This study researched the association between age and increased depressive symptoms and adherence to self-testing with telemedicine in patients with inflammatory bowel disease (IBD). It was found that patients 40 and older had worse adherence than patients younger than 40 with depressive symptoms.
AHRQ-funded; HS018975.
Citation: Chudy-Onwugaje K, Abutaleb A, Buchwald A .
Age modifies the association between depressive symptoms and adherence to self-testing with telemedicine in patients with inflammatory bowel disease.
Inflamm Bowel Dis 2018 Nov 29;24(12):2648-54. doi: 10.1093/ibd/izy194..
Keywords: Chronic Conditions, Depression, Digestive Disease and Health, Patient Adherence/Compliance, Patient Self-Management, Telehealth
Parikh K, Paul J, Foushee N
Barriers and facilitators to asthma care after hospitalization as reported by caregivers, health providers, and school nurses.
This study focused on developing a comprehensive understanding of asthma care after hospitalization of children as reported by caregivers, health providers, and school nurses. The children had a median age of 7 years, mean hospital length of stay of 1.9 days, and 56% had a previous hospitalization in the last 12 months. Family caregivers and health professionals were given individual interviews while focus groups were conducted with school nurses. There were different health beliefs about asthma knowledge between caregivers and health professionals. School nurses highlighted specific barriers that focused on medication use in schools.
AHRQ-funded; HS024554.
Citation: Parikh K, Paul J, Foushee N .
Barriers and facilitators to asthma care after hospitalization as reported by caregivers, health providers, and school nurses.
Hosp Pediatr 2018 Nov;8(11):706-17. doi: 10.1542/hpeds.2017-0182..
Keywords: Asthma, Hospitalization, Children/Adolescents, Caregiving, Patient Adherence/Compliance, Education
Badawy SM, Thompson AA, Liem RI
Beliefs about hydroxyurea in youth with sickle cell disease.
The objectives of this study were to assess beliefs about hydroxyurea using the Beliefs about Medicines Questionnaire (BMQ), and to examine the relationship of patients' beliefs to their hydroxyurea adherence and health-related quality of life (HRQOL). The investigators found that beliefs about hydroxyurea correlated with HRQOL scores and adherence levels. The authors suggest that addressing patients' concerns about hydroxyurea and medications overall as well as routine assessment of adherence and beliefs could help to overcome adherence barriers.
AHRQ-funded; HS023011.
Citation: Badawy SM, Thompson AA, Liem RI .
Beliefs about hydroxyurea in youth with sickle cell disease.
Hematol Oncol Stem Cell Ther 2018 Sep;11(3):142-48. doi: 10.1016/j.hemonc.2018.01.001..
Keywords: Children/Adolescents, Medication, Patient Adherence/Compliance, Quality of Life, Sickle Cell Disease
Kang H, Lobo JM, Kim S
Cost-related medication non-adherence among U.S. adults with diabetes.
The purpose of this study is to examine factors that affect cost-related medication non-adherence (CRN), defined as taking medication less than as prescribed because of cost, among adults with diabetes and to determine their relative contribution in explaining CRN. Among other results, the study found that Insulin users had 1.24 times higher risk of CRN compared to those not on insulin.
AHRQ-funded; HS018542.
Citation: Kang H, Lobo JM, Kim S .
Cost-related medication non-adherence among U.S. adults with diabetes.
Diabetes Res Clin Pract 2018 Sep;143:24-33. doi: 10.1016/j.diabres.2018.06.016..
Keywords: Diabetes, Healthcare Costs, Medication, Patient Adherence/Compliance
Flory JH, Keating SJ, Siscovick D
Identifying prevalence and risk factors for metformin non-persistence: a retrospective cohort study using an electronic health record.
Non-persistence may be a significant barrier to the use of metformin. The objective of this study was to assess reasons for metformin non-persistence, and whether initial metformin dosing or use of extended release (ER) formulations affect persistence to metformin therapy. The investigators concluded that their data supported the routine prescribing of low starting doses of metformin as a tool to improve persistence.
AHRQ-funded; HS023898.
Citation: Flory JH, Keating SJ, Siscovick D .
Identifying prevalence and risk factors for metformin non-persistence: a retrospective cohort study using an electronic health record.
BMJ Open 2018 Jul 23;8(7):e021505. doi: 10.1136/bmjopen-2018-021505..
Keywords: Diabetes, Electronic Health Records (EHRs), Health Information Technology (HIT), Medication, Patient Adherence/Compliance, Outcomes, Patient-Centered Outcomes Research, Risk
Turi KN, Gebretsadik T, Lee RL
Seasonal patterns of asthma medication fills among diverse populations of the United States.
Nonadherence to controller and overuse of reliever asthma medications are associated with exacerbations. In this study, the investigators aimed to determine patterns of seasonal asthma medication use and to identify time period(s) during which interventions to improve medication adherence could reduce asthma morbidity. The investigators concluded that a seasonal pattern of asthma medication fill rates likely represented a reactive response to a loss of disease control and increased symptoms.
AHRQ-funded; HS019669; HS022093.
Citation: Turi KN, Gebretsadik T, Lee RL .
Seasonal patterns of asthma medication fills among diverse populations of the United States.
J Asthma 2018 Jul;55(7):764-70. doi: 10.1080/02770903.2017.1362426..
Keywords: Asthma, Chronic Conditions, Medication, Patient Adherence/Compliance
Beebe L, Smith KD, Oppizzi LM
Telephone Intervention-Problem Solving (TIPS) for schizophrenia spectrum disorders: responses of stable outpatients over nine months.
In this study, the investigators conducted a descriptive analysis of data gathered during calls to 87 stable outpatients with schizophrenia spectrum disorders, receiving weekly telephone intervention-problem solving (TIPS) for nine months. The investigators suggest that their findings regarding racial differences in antipsychotic delivery method warrant further investigation.
AHRQ-funded; HS022166.
Citation: Beebe L, Smith KD, Oppizzi LM .
Telephone Intervention-Problem Solving (TIPS) for schizophrenia spectrum disorders: responses of stable outpatients over nine months.
Issues Ment Health Nurs 2018 Jul;39(7):561-67. doi: 10.1080/01612840.2018.1431824..
Keywords: Ambulatory Care and Surgery, Medication, Behavioral Health, Patient Adherence/Compliance
Kanters AE, Morris AM, Albrahamse PH
The effect of peer support on colorectal cancer patients' adherence to guideline-concordant multidisciplinary care.
Dis Colon Rectum 2018 Jul;61(7):817-23. doi: 10.1097/dcr.0000000000001067.
The purpose of this study was to evaluate the effect of peer support on the attitudes of patients with colorectal cancer toward chemotherapy and their adherence to it. The study demonstrated that exposure to peer support is associated with higher adjuvant chemotherapy adherence.
The purpose of this study was to evaluate the effect of peer support on the attitudes of patients with colorectal cancer toward chemotherapy and their adherence to it. The study demonstrated that exposure to peer support is associated with higher adjuvant chemotherapy adherence.
AHRQ-funded; HS000053.
Citation: Kanters AE, Morris AM, Albrahamse PH .
The effect of peer support on colorectal cancer patients' adherence to guideline-concordant multidisciplinary care.
Dis Colon Rectum 2018 Jul;61(7):817-23. doi: 10.1097/dcr.0000000000001067..
Keywords: Cancer: Colorectal Cancer, Treatments, Guidelines, Medication, Patient Adherence/Compliance
Farias AJ, Wu WH, Du XL
Racial and geographic disparities in adherence and discontinuation to adjuvant endocrine therapy in Texas Medicaid-insured patients with breast cancer.
The purpose of the study is to examine disparities in adjuvant endocrine therapy (AET) adherence and discontinuation among Texas Medicaid-insured early-stage breast cancer patients. The studies concluded that patients from the Texas/Mexico border had higher odds of adherence compared to other regions. There are substantial racial and geographic disparities in AET adherence and discontinuation among Texas Medicaid-insured women.
AHRQ-funded; HS018956.
Citation: Farias AJ, Wu WH, Du XL .
Racial and geographic disparities in adherence and discontinuation to adjuvant endocrine therapy in Texas Medicaid-insured patients with breast cancer.
Med Oncol 2018 Jun 20;35(7):113. doi: 10.1007/s12032-018-1168-6..
Keywords: Cancer: Breast Cancer, Disparities, Medicaid, Patient Adherence/Compliance, Racial and Ethnic Minorities
Fredericksen RJ, Gibbons L, Brown S
Medication understanding among patients living with multiple chronic conditions: implications for patient-reported measures of adherence.
The purpose of this study was to assess knowledge of names and purposes of prescribed medications among patients with multiple chronic conditions. The investigators found that many patients demonstrated difficulty identifying the name and purpose of prescribed medications; this did not differ by demographic group or medication storage type. They suggest that patients may benefit from routine review of medications with their provider in order to improve health literacy, outcomes, and patient-reported adherence measurement.
AHRQ-funded; HS022242.
Citation: Fredericksen RJ, Gibbons L, Brown S .
Medication understanding among patients living with multiple chronic conditions: implications for patient-reported measures of adherence.
Res Social Adm Pharm 2018 Jun;14(6):540-44. doi: 10.1016/j.sapharm.2017.06.009..
Keywords: Chronic Conditions, Health Literacy, Medication, Patient Adherence/Compliance
Favier LA, Taylor J, Loiselle Rich K
Barriers to adherence in juvenile idiopathic arthritis: a multicenter collaborative experience and preliminary results.
The purpose of our study was to design and implement a standardized approach to identifying adherence barriers for youth with juvenile idiopathic arthritis (JIA) and to assess the frequency of adherence barriers in patients and their caregivers across treatment modalities. It concluded that implementing a standardized tool assessing adherence barriers in the JIA population across multiple clinical settings is feasible.
AHRQ-funded; HS021114.
Citation: Favier LA, Taylor J, Loiselle Rich K .
Barriers to adherence in juvenile idiopathic arthritis: a multicenter collaborative experience and preliminary results.
J Rheumatol 2018 May;45(5):690-96. doi: 10.3899/jrheum.171087.
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Keywords: Caregiving, Patient Adherence/Compliance, Quality Improvement, Arthritis, Children/Adolescents