National Healthcare Quality and Disparities Report
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Topics
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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
201 to 225 of 225 Research Studies DisplayedNykiel-Bailey SM, McAllister JD, Schrock CR
Difficult airway consultation service for children: steps to implement and preliminary results.
The article demonstrates how to implement a consultative service focusing on difficult airway (DAW) identification, management and education. The initial 3-month experience confirmed that a majority of pediatric DAW events are associated with congenital or acquired abnormalities. Through appropriate consultation and leadership, the Difficult Airway Service was able to physically and electronically identify pediatric patients with a DAW and provide management.
AHRQ-funded; HS022265.
Citation: Nykiel-Bailey SM, McAllister JD, Schrock CR .
Difficult airway consultation service for children: steps to implement and preliminary results.
Paediatr Anaesth 2015 Apr;25(4):363-71. doi: 10.1111/pan.12625..
Keywords: Care Management, Children/Adolescents, Respiratory Conditions, Patient Safety, Risk
Maynard G, Kulasa K, Ramos P
Impact of a hypoglycemia reduction bundle and a systems approach to inpatient glycemic management.
In order to improve inpatient glycemic management in a 550-bed academic medical center, the researchers implemented a hypoglycemia reduction bundle, proactive surveillance of glycemic outliers, and an interdisciplinary data-driven approach to glycemic management. By using this approach with multiple mutually reinforcing interventions, they were able to cut severe inpatient hypoglycemia by more than half, while simultaneously improving glycemic control.
AHRQ-funded; HS020594
Citation: Maynard G, Kulasa K, Ramos P .
Impact of a hypoglycemia reduction bundle and a systems approach to inpatient glycemic management.
Endocr Pract. 2015 Apr;21(4):355-67. doi: 10.4158/ep14367.or..
Keywords: Care Management, Inpatient Care, Prevention
Snyder ME, Earl TR, Gilchrist S
Collaborative drug therapy management: case studies of three community-based models of care.
The objectives of this study were to understand how collaborative drug therapy management (CDTM) practices were implemented in 3 community settings and to identify common and unique facilitators and barriers to implementing CDTM. The authors believe that the models described in this study could be used to strengthen clinical–community linkages through team-based care, particularly for chronic disease prevention and management.
AHRQ-funded; HS022119.
Citation: Snyder ME, Earl TR, Gilchrist S .
Collaborative drug therapy management: case studies of three community-based models of care.
Prev Chronic Dis 2015 Mar 26;12:E39. doi: 10.5888/pcd12.140504..
Keywords: Care Management, Case Study, Community-Based Practice, Medication, Primary Care: Models of Care, Provider: Pharmacist
Agwu AL, Lee L, Fleishman JA
AHRQ Author: Fleishman JA
Aging and loss to follow-up among youth living with human immunodeficiency virus in the HIV Research Network.
The researchers sought to evaluate loss to follow-up in the year after each birthday from the 18th through the 25th in a large multisite HIV cohort in the United States. Among the 647 21-year-old youth who were engaged in care, 20 percent were lost to follow-up in the year after their 21st birthday.
AHRQ-authored; AHRQ-funded; 2901100007.
Citation: Agwu AL, Lee L, Fleishman JA .
Aging and loss to follow-up among youth living with human immunodeficiency virus in the HIV Research Network.
J Adolesc Health 2015 Mar;56(3):345-51. doi: 10.1016/j.jadohealth.2014.11.009..
Keywords: Care Management, Chronic Conditions, Human Immunodeficiency Virus (HIV), Patient Adherence/Compliance, Young Adults
Abdelsattar ZM, Reames BN, Regenbogen SE
Critical evaluation of the scientific content in clinical practice guidelines.
The researchers sought to critically evaluate clinical practice guidelines (CPGs) on the basis of their overall development quality, the evidence base used to synthesize recommendations, and the scientific agreement between CPGs on key processes of care. They concluded that there is significant variation in CPG development processes, with associated differences in scientific content and interpretation of evidence, resulting in conflicting recommendations.
AHRQ-funded: HS000053.
Citation: Abdelsattar ZM, Reames BN, Regenbogen SE .
Critical evaluation of the scientific content in clinical practice guidelines.
Cancer 2015 Mar 1;121(5):783-9. doi: 10.1002/cncr.29124..
Keywords: Care Management, Evidence-Based Practice, Guidelines, Quality of Care
Polsky S, Donahoo WT, Lyons EE
Evaluation of care management intensity and bariatric surgical weight loss.
This study examined the effect of pre- and postoperative care management on weight loss following bariatric surgery. It found no statistically significant associations between either preoperative or postoperative care management intensity and postoperative change in body mass index at year 1 or year 2. Results were limited by heterogeneity of care management across sites and an inability to assess adherence to care management programs.
AHRQ-funded; HS019912.
Citation: Polsky S, Donahoo WT, Lyons EE .
Evaluation of care management intensity and bariatric surgical weight loss.
Am J Manag Care 2015 Mar;21(3):182-9..
Keywords: Care Management, Obesity, Obesity: Weight Management, Patient Adherence/Compliance, Surgery
Huet AL, Frail CK, Lake LM
Impact of passive and active promotional strategies on patient acceptance of medication therapy management services.
The researchers assessed the impact of passive and active promotional strategies on patient acceptance of medication therapy management (MTM) services, and identified reasons for patient acceptance or refusal. No significant differences were identified among the four promotional methods or between active and passive methods in the analyses. Patients' most frequent reasons for accepting MTM services were potential cost savings and review of how the medications were working.
AHRQ-funded; HS022119.
Citation: Huet AL, Frail CK, Lake LM .
Impact of passive and active promotional strategies on patient acceptance of medication therapy management services.
J Am Pharm Assoc 2015 Mar-Apr;55(2):178-81. doi: 10.1331/JAPhA.2015.14091.
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Keywords: Care Management, Community-Based Practice, Health Promotion, Medication, Patient Adherence/Compliance, Provider: Pharmacist
Dauw CA, Alruwaily AF, Bierlein MJ
Provider variation in the quality of metabolic stone management.
The researchers quantified the degree of variation in repeat 24-hour urine testing attributable to providers and assessed differences in repeat testing rates between specialist and primary care physicians. They found, that, while most variation in follow-up testing was attributable to the patient, the provider contribution was nontrivial (18 percent). The specialty of the ordering provider was also important.
AHRQ-funded; HS020927.
Citation: Dauw CA, Alruwaily AF, Bierlein MJ .
Provider variation in the quality of metabolic stone management.
J Urol 2015 Mar;193(3):885-90. doi: 10.1016/j.juro.2014.09.111..
Keywords: Care Management, Chronic Conditions, Practice Patterns
Snyder ME, Pater KS, Frail CK
Utility of a brief screening tool for medication-related problems.
The objective of this study was to estimate the psychometric properties of a brief self-administered scale as a screening tool for medication-related problems (MRPs). Its findings suggest scores on the nine-item scale are a statistically significant, although fairly modest, predictor of MRPs when controlling for other significant predictors of problems.
AHRQ-funded; HS022119.
Citation: Snyder ME, Pater KS, Frail CK .
Utility of a brief screening tool for medication-related problems.
Res Social Adm Pharm 2015 Mar-Apr;11(2):253-64. doi: 10.1016/j.sapharm.2014.08.005..
Keywords: Care Management, Community-Based Practice, Medication, Provider: Pharmacist, Screening
Schroeder MC, Robinson JG, Chapman CG
Use of statins by Medicare beneficiaries post myocardial infarction: poor physician quality or patient-centered care?
This study assessed whether patterns of statin use by Medicare beneficiaries post-discharge may be due to a mix of high-quality and low-quality physicians. It found that the distribution of statin fill rates across physicians was normal, with no clear distinctions in physician quality. Physicians, especially cardiologists, with relatively younger and healthier patient populations had higher rates of statin use.
AHRQ-funded; HS019574.
Citation: Schroeder MC, Robinson JG, Chapman CG .
Use of statins by Medicare beneficiaries post myocardial infarction: poor physician quality or patient-centered care?
Inquiry 2015 Feb 27;52. doi: 10.1177/0046958015571131..
Keywords: Care Management, Medication, Heart Disease and Health, Medicare, Patient-Centered Healthcare, Practice Patterns
Erickson KF, Mell MW, Winkelmayer WC
Provider visit frequency and vascular access interventions in hemodialysis.
This study sought to determine whether more frequent face-to-face provider (physician and advanced practitioner) visits lead to more procedures and therapeutic interventions aimed at preserving arteriovenous fistulas and grafts and improved vascular access outcomes. It found that more frequent face-to-ace provider visits were associated with more procedures and therapeutic interventions aimed at preserving vascular accesses, but not with prolonged vascular access survival.
AHRQ-funded; HS019178.
Citation: Erickson KF, Mell MW, Winkelmayer WC .
Provider visit frequency and vascular access interventions in hemodialysis.
Clin J Am Soc Nephrol 2015 Feb 6;10(2):269-77. doi: 10.2215/cjn.05540614..
Keywords: Care Management, Dialysis, Kidney Disease and Health, Outcomes, Ambulatory Care and Surgery
Pavlik VN, Chan W, Hyman DJ
Designing and evaluating health systems level hypertension control interventions for African-Americans: lessons from a pooled analysis of three cluster randomized trials.
This study conducted a pooled analysis of three projects that aimed to evaluate clinically feasible interventions to effect changes in medical care delivery leading to an increased proportion of African American patients with controlled blood pressure (BP). The analysis of trial results to determine the magnitude of the combined intervention effect found that pooled BP did not differ significantly between intervention and control clusters.
AHRQ-funded; HS021667.
Citation: Pavlik VN, Chan W, Hyman DJ .
Designing and evaluating health systems level hypertension control interventions for African-Americans: lessons from a pooled analysis of three cluster randomized trials.
Curr Hypertens Rev 2015;11(2):123-31..
Keywords: Blood Pressure, Racial and Ethnic Minorities, Healthcare Delivery, Prevention, Care Management
Cagle JG, Zimmerman S, Cohen LW
EMPOWER: an intervention to address barriers to pain management in hospice.
The researchers tested the preliminary efficacy of the Effective Management of Pain: Overcoming Worries to Enable Relief (EMPOWER) intervention. At two weeks, caregivers in the intervention group reported better knowledge about pain management, fewer concerns about pain and pain medications, lower patient pain over the past week, and trended toward improvement in most other areas under study. EMPOWER had a greater effect for black subjects vs. whites on reducing concern about stigma. At three months, the intervention group trended better on most study outcomes. The researchers concluded that EMPOWER is a promising model to reduce barriers to pain management in hospice.
AHRQ-funded; HS019068.
Citation: Cagle JG, Zimmerman S, Cohen LW .
EMPOWER: an intervention to address barriers to pain management in hospice.
J Pain Symptom Manage 2015 Jan;49(1):1-12. doi: 10.1016/j.jpainsymman.2014.05.007.
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Keywords: Care Management, Caregiving, Comparative Effectiveness, Education: Patient and Caregiver, Medication, Pain, Palliative Care
Shaikh U, Berrong J, Nettiksimmons J
Impact of electronic health record clinical decision support on the management of pediatric obesity.
The investigators assessed the impact of electronic health record-based clinical decision support in improving the diagnosis and management of pediatric obesity. They found a statistically significant increase in the diagnosis of overweight/obesity, scheduling of follow-up appointments, frequency of ordering recommended laboratory investigations, and assessment and counseling for nutrition and physical activity.
AHRQ-funded; HS018567.
Citation: Shaikh U, Berrong J, Nettiksimmons J .
Impact of electronic health record clinical decision support on the management of pediatric obesity.
Am J Med Qual 2015 Jan-Feb;30(1):72-80. doi: 10.1177/1062860613517926.
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Keywords: Care Management, Children/Adolescents, Clinical Decision Support (CDS), Diagnostic Safety and Quality, Electronic Health Records (EHRs), Health Information Technology (HIT), Obesity, Obesity: Weight Management
Admon AJ, Seymour CW, Gershengorn HB
Hospital-level variation in ICU admission and critical care procedures for patients hospitalized for pulmonary embolism.
The researchers examined the relationship between intensive care unit (ICU) use for patients with pulmonary embolism (PE) and cost, mortality, readmission, and procedure use in 263 hospitals. They found wide variations in ICU admission rates for acute PE without a detectable impact on mortality, cost, or readmission.
AHRQ-funded; HS020672
Citation: Admon AJ, Seymour CW, Gershengorn HB .
Hospital-level variation in ICU admission and critical care procedures for patients hospitalized for pulmonary embolism.
Chest. 2014 Dec;146(6):1452-61. doi: 10.1378/chest.14-0059..
Keywords: Blood Clots, Care Management, Critical Care, Healthcare Delivery, Intensive Care Unit (ICU)
Banerjee T, Enayati M, Keller JM
Monitoring patients in hospital beds using unobtrusive depth sensors.
The researchers presented an approach for patient activity recognition in hospital rooms using depth data collected using a Kinect sensor. They described a technique to reduce false alerts such as pillows falling off the bed or equipment movement. They tested their algorithm on 96 hours obtained in two hospital rooms from the University of Missouri Hospital.
AHRQ-funded; HS018477.
Citation: Banerjee T, Enayati M, Keller JM .
Monitoring patients in hospital beds using unobtrusive depth sensors.
Conf Proc IEEE Eng Med Biol Soc 2014;2014:5904-7. doi: 10.1109/embc.2014.6944972.
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Keywords: Care Management, Inpatient Care, Health Information Technology (HIT), Patient Safety
Merlin JS, Walcott M, Ritchie C
'Two pains together': patient perspectives on psychological aspects of chronic pain while living with HIV.
The researchers’ objective was to explore HIV-infected patients’ perspectives on psychological aspects of chronic pain using in-depth qualitative interviews. Key themes that emerged included the close relationship between mood and pain; mood and pain in the context of living with HIV; use of alcohol/drugs to self-medicate for pain; and the challenge of receiving prescription pain medications while dealing with substance use disorders.
AHRQ-funded; HS021694.
Citation: Merlin JS, Walcott M, Ritchie C .
'Two pains together': patient perspectives on psychological aspects of chronic pain while living with HIV.
PLoS One 2014 Nov 3;9(11):e111765. doi: 10.1371/journal.pone.0111765..
Keywords: Care Management, Chronic Conditions, Human Immunodeficiency Virus (HIV), Pain, Patient-Centered Outcomes Research, Patient Self-Management
Aldrich H, Gance-Cleveland B, Schmiege S
School-based health center providers' treatment of overweight children.
The purpose of this study was to determine self-reported treatment practices of school-based health center (SBHC) providers when caring for overweight/obese children. SBHC providers reported patient/parent barriers to be more significant to treatment than clinician/setting barriers. Most providers (97%) indicated childhood overweight needs treatment, yet only 36% indicated that they initiate treatment in children who do not want to control their weight. SBHC providers also did not commonly refer these children to specialists.
AHRQ-funded; HS018646.
Citation: Aldrich H, Gance-Cleveland B, Schmiege S .
School-based health center providers' treatment of overweight children.
J Pediatr Nurs 2014 Nov-Dec;29(6):521-7. doi: 10.1016/j.pedn.2014.05.007.
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Keywords: Care Management, Children/Adolescents, Education, Obesity, Prevention, Obesity: Weight Management
Jacoby VL, Jacoby A, Learman LA
Use of medical, surgical and complementary treatments among women with fibroids.
This study examined the use of medical management, uterus-preserving surgery, and complementary treatments among women with uterine fibroids. It found that uterus-preserving fibroid surgery is effective, but many symptomatic women can be successfully treated with nonsurgical management, including complementary and alternative therapy.
AHRQ-funded; HS011657; HS07373; HS09478.
Citation: Jacoby VL, Jacoby A, Learman LA .
Use of medical, surgical and complementary treatments among women with fibroids.
Eur J Obstet Gynecol Reprod Biol 2014 Nov;182:220-5. doi: 10.1016/j.ejogrb.2014.09.004..
Keywords: Care Management, Complementary and Alternative Medicine, Medication, Surgery, Treatments, Women
Snyder ME, Frail CK, Jaynes H
Predictors of medication-related problems among Medicaid patients participating in a pharmacist-provided telephonic medication therapy management program.
The objective of this study was to identify predictors of medication-related problems (MRPs) among Medicaid patients participating in a telephonic medication therapy management (MTM) program. The analysis of study results supports the relative importance of number of medications as a predictor of MRPs in the Medicaid population and identifies other predictors.
AHRQ-funded; HS022119.
Citation: Snyder ME, Frail CK, Jaynes H .
Predictors of medication-related problems among Medicaid patients participating in a pharmacist-provided telephonic medication therapy management program.
Pharmacotherapy 2014 Oct;34(10):1022-32. doi: 10.1002/phar.1462..
Keywords: Adverse Drug Events (ADE), Care Management, Community-Based Practice, Medicaid, Medication, Provider: Pharmacist
Makris UE, Abrams RC, Gurland B
Management of persistent pain in the older patient: a clinical review.
The purpose of this study was to 1.) Describe barriers to the management of persistent pain among older adults; 2.) Summarize current management approaches, including pharmacologic and nonpharmacologic modalities; 3.) Present rehabilitative approaches; and 4.) Highlight aspects of the patient-physician relationship that can help to improve treatment outcomes.
AHRQ-funded; HS020648.
Citation: Makris UE, Abrams RC, Gurland B .
Management of persistent pain in the older patient: a clinical review.
JAMA 2014 Aug 27;312(8):825-36. doi: 10.1001/jama.2014.9405..
Keywords: Care Management, Chronic Conditions, Elderly, Medication, Treatments
Gawron AJ, French DD, Pandolfino JE
Economic evaluations of gastroesophageal reflux disease medical management.
This article systematically evaluated the existing literature to identify economic evaluations of GERD medical management strategies and assess the scientific quality of these reports using the CHEERS guidelines. It concluded that initial empiric PPI therapy is likely the most cost-effective initial strategy for patients with typical GERD symptoms. Surgery may be cost effective in patients with chronic GERD symptoms at time horizons of 3–10 years.
AHRQ-funded; HS000078.
Citation: Gawron AJ, French DD, Pandolfino JE .
Economic evaluations of gastroesophageal reflux disease medical management.
Pharmacoeconomics 2014 Aug;32(8):745-58. doi: 10.1007/s40273-014-0164-8..
Keywords: Care Management, Chronic Conditions, Healthcare Costs
Cottrell EK, O'Brien K, Curry M
Understanding safety in prehospital emergency medical services for children.
This paper adds to the qualitative understanding of the nature of and contributors to safety events in the prehospital emergency care of children. The findings of this study suggest that factors at the systems, team, child/family, and individual provider level system contribute to errors in prehospital emergency care. These factors may be modifiable through interventions and systems improvements.
AHRQ-funded; HS019456.
Citation: Cottrell EK, O'Brien K, Curry M .
Understanding safety in prehospital emergency medical services for children.
Prehosp Emerg Care 2014 Jul-Sep;18(3):350-8. doi: 10.3109/10903127.2013.869640.
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Keywords: Care Management, Children/Adolescents, Emergency Medical Services (EMS), Quality of Care, Patient Safety
Halbert CH, Briggs V, Bowman M
Acceptance of a community-based navigator program for cancer control among urban African Americans.
The researchers evaluated acceptance of a community-based navigator program for cancer control and identified factors having significant independent associations with navigation acceptance in an urban sample of African Americans. They found that age and perceived risk of developing cancer had a significant independent association with navigation acceptance. Participants who believed that they were at high risk for developing cancer had a lower likelihood of completing navigation.
AHRQ-funded; HS019339.
Citation: Halbert CH, Briggs V, Bowman M .
Acceptance of a community-based navigator program for cancer control among urban African Americans.
Health Educ Res 2014 Feb;29(1):97-108. doi: 10.1093/her/cyt098..
Keywords: Cancer, Care Coordination, Care Management, Community-Based Practice, Racial and Ethnic Minorities, Urban Health
Taliani CA, Bricker PL, Adelman AM
Implementing effective care management in the patient-centered medical home.
The investigators explored how a disparate group of patient-centered medical homes (PCMHs) embedded care management in their team care environment to identify best practices. They concluded that PCMHs may want to ensure that care managers are available to meet with patients during visits, support patient self-management, fully leverage the electronic medical record for team messaging and patient tracking, and ensure integration into the care team with office huddles and ongoing communication.
AHRQ-funded; HS019150.
Citation: Taliani CA, Bricker PL, Adelman AM .
Implementing effective care management in the patient-centered medical home.
Am J Manag Care 2013 Dec;19(12):957-64.
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Keywords: Care Management, Diabetes, Healthcare Delivery, Patient-Centered Healthcare, Quality Improvement, Teams