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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
1 to 25 of 58 Research Studies DisplayedCherrington AL, Khodneva Y, Richman JS
Impact of peer support on acute care visits and hospitalizations for individuals with diabetes and depressive symptoms: a cluster-randomized controlled trial.
This study examined the impact of peer support on the number of acute care visits and hospitalizations for individuals with diabetes with and without depressive symptoms. This randomized controlled trial was conducted from 2010-2012. One year of peer support was given to intervention participants, and the usual care to control participants. A Patient Health Questionnaire (PHQ-8) was given to participants to assess depression symptoms at the beginning of the trial, at 6 months and then at 12 months. There was a lower rate of acute care visits and hospitalizations in those patients with depressive symptoms in the intervention group, but it made no difference for individuals without depressive symptoms.
AHRQ-funded; HS013852.
Citation: Cherrington AL, Khodneva Y, Richman JS .
Impact of peer support on acute care visits and hospitalizations for individuals with diabetes and depressive symptoms: a cluster-randomized controlled trial.
Diabetes Care 2018 Dec;41(12):2463-70. doi: 10.2337/dc18-0550..
Keywords: Ambulatory Care and Surgery, Chronic Conditions, Depression, Diabetes, Hospitalization, Behavioral Health, Patient Self-Management
McKernan LC, Clayton EW, Walsh CG
Protecting life while preserving liberty: ethical recommendations for suicide prevention with artificial intelligence.
This paper discusses the ethical considerations for suicide prevention using artificial intelligence. The authors provide recommendations in three areas-communication, consent, and controls-for both providers and researchers.
AHRQ-funded; HS022990.
Citation: McKernan LC, Clayton EW, Walsh CG .
Protecting life while preserving liberty: ethical recommendations for suicide prevention with artificial intelligence.
Front Psychiatry 2018 Dec 3;9:650. doi: 10.3389/fpsyt.2018.00650..
Keywords: Communication, Behavioral Health, Prevention
Musci RJ, Kharrazi H, Wilson RF
The study of effect moderation in youth suicide-prevention studies.
A systematic review was conducted focusing on identifying youth suicide-prevention studies within the United States. This paper reports on the methods utilized for understanding possible moderators of suicide-prevention program outcomes. The investigators found that only a small percentage of the reviewed articles assessed moderation effects. They assert that this is a substantial research gap driven by sample size or other limitations which have impeded the identification of intervention effect heterogeneity.
AHRQ-funded; 29020150000XI.
Citation: Musci RJ, Kharrazi H, Wilson RF .
The study of effect moderation in youth suicide-prevention studies.
Soc Psychiatry Psychiatr Epidemiol 2018 Dec;53(12):1303-10. doi: 10.1007/s00127-018-1574-2..
Keywords: Children/Adolescents, Behavioral Health, Prevention
Moise N, Falzon L, Obi M
Interventions to increase depression treatment initiation in primary care patients: a systematic review.
Researchers investigated interventions for increasing depression treatment initiation in primary care settings. They found that collaborative/integrated care, preference treatment matching, and case management strategies had the best evidence for improving depression treatment initiation, but none of the strategies had high strength of evidence. While primary care settings can consider using some of these strategies when referring depressed patients to treatment, their review highlights the need for further rigorous research in this area.
AHRQ-funded; HS025198.
Citation: Moise N, Falzon L, Obi M .
Interventions to increase depression treatment initiation in primary care patients: a systematic review.
J Gen Intern Med 2018 Nov;33(11):1978-89. doi: 10.1007/s11606-018-4554-z..
Keywords: Patient-Centered Healthcare, Depression, Primary Care, Behavioral Health, Patient and Family Engagement
Burnett-Zeigler IE, Waldron EM, Hong S
Accessibility and feasibility of using technology to support mindfulness practice, reduce stress and promote long term mental health.
In this study the investigators evaluated the feasibility of using an activity monitor to support mindfulness practice, reduce self-reported stress and physiological indicators of stress. They found that there were no significant changes in self-reported stress, depression, post-traumatic stress and mindfulness from baseline to eight-weeks; pulse pressure and standard deviation of pulse pressure increased over time; and those who were high on the non-judge mindfulness subscale had a lower standard deviation pulse pressure and spent less time stressed.
AHRQ-funded; HS023011.
Citation: Burnett-Zeigler IE, Waldron EM, Hong S .
Accessibility and feasibility of using technology to support mindfulness practice, reduce stress and promote long term mental health.
Complement Ther Clin Pract 2018 Nov;33:93-99. doi: 10.1016/j.ctcp.2018.09.001..
Keywords: Depression, Health Information Technology (HIT), Behavioral Health, Patient-Centered Outcomes Research, Stress
Annapureddy A, Valero-Elizondo J, Khera R
Association between financial burden, quality of life, and mental health among those with atherosclerotic cardiovascular disease in the United States.
Currently, there is little information about the relationship between the financial burden of healthcare for patients with atherosclerotic cardiovascular disease (ASCVD) and their health-related quality of life (HRQoL), well-being, and psychological health. Accordingly, the authors of this study, determined the relationship between healthcare financial burden and patient-reported HRQoL, self-perception of health, psychological distress, and risk of depression in a nationally representative US adult population with established ASCVD.
AHRQ-funded; HS023000.
Citation: Annapureddy A, Valero-Elizondo J, Khera R .
Association between financial burden, quality of life, and mental health among those with atherosclerotic cardiovascular disease in the United States.
Circ Cardiovasc Qual Outcomes 2018 Nov;11(11):e005180. doi: 10.1161/circoutcomes.118.005180..
Keywords: Cardiovascular Conditions, Healthcare Costs, Behavioral Health, Quality of Life
Fox AB, Earnshaw VA, Taverna EC
Conceptualizing and measuring mental illness stigma: the Mental Illness Stigma Framework and critical review of measures.
In this article, the authors bring together the different foci of mental illness stigma research with the Mental Illness Stigma Framework (MISF). The MISF provides a common framework and set of terminology for understanding mechanisms of mental illness stigma that are relevant to the study of both the stigmatized and the stigmatizer. The investigators apply this framework to systematically review and classify stigma measures used in the past decade according to their corresponding stigma mechanisms.
AHRQ-funded; HS022986.
Citation: Fox AB, Earnshaw VA, Taverna EC .
Conceptualizing and measuring mental illness stigma: the Mental Illness Stigma Framework and critical review of measures.
Stigma Health 2018 Nov;3(4):348-76. doi: 10.1037/sah0000104.
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Keywords: Behavioral Health, Social Stigma
Fry CE, Sommers BD
Effect of Medicaid expansion on health insurance coverage and access to care among adults with depression.
This quasi-experimental study sought to determine the relationship between Medicaid expansion and various health and financial outcomes among low-income adults with depression. The investigators found that Medicaid expansion was associated with a significant reduction in the proportion of adults with depression who lacked health insurance. Medicaid expansion was also associated with significant reductions in delaying care and medications because of cost.
AHRQ-funded; HS021291.
Citation: Fry CE, Sommers BD .
Effect of Medicaid expansion on health insurance coverage and access to care among adults with depression.
Psychiatr Serv 2018 Nov;69(11):1146-52. doi: 10.1176/appi.ps.201800181..
Keywords: Access to Care, Depression, Health Insurance, Medicaid, Behavioral Health
Lapham GT, Lee AK, Caldeiro RM
Prevalence of behavioral health conditions across frequency of cannabis use among adult primary care patients in Washington state.
This population-based study of primary care patients reports on the prevalence of common behavioral health conditions across cannabis use frequency. The investigators concluded that their study found a strong association between the frequency of cannabis use and tobacco use, depression symptoms, and other drug use, and as well as diagnosed mental health and substance use disorders.
AHRQ-funded; HS023173.
Citation: Lapham GT, Lee AK, Caldeiro RM .
Prevalence of behavioral health conditions across frequency of cannabis use among adult primary care patients in Washington state.
J Gen Intern Med 2018 Nov;33(11):1833-35. doi: 10.1007/s11606-018-4558-8..
Keywords: Behavioral Health, Depression, Primary Care, Substance Abuse, Tobacco Use
Moulin A, Evans EJ, Xing G
Substance use, homelessness, mental illness and Medicaid coverage: a set-up for high emergency department utilization.
The objective of this study was to identify characteristics unique to patients with psychiatric illness who are frequent emergency department (ED) users for mental health care. The authors suggest that understanding unique features of this population could lead to better care and lower healthcare costs. The authors concluded that patients with substance use disorders, homelessness and public healthcare coverage were more likely to be frequent users of EDs for mental illness.
AHRQ-funded; HS022236.
Citation: Moulin A, Evans EJ, Xing G .
Substance use, homelessness, mental illness and Medicaid coverage: a set-up for high emergency department utilization.
West J Emerg Med 2018 Nov;19(6):902-06. doi: 10.5811/westjem.2018.9.38954..
Keywords: Emergency Department, Medicaid, Healthcare Utilization, Behavioral Health, Substance Abuse, Vulnerable Populations
Lifland B, Wright DR, Mangione-Smith R
The impact of an adolescent depressive disorders clinical pathway on healthcare utilization.
The purpose of this study was to examine the association between level of adherence to an adolescent depressive disorders inpatient clinical pathway with psychiatric patients’ length of stay (LOS), cost, and readmissions. Patients in the high-adherence category were found to have significantly longer LOS and higher costs when compared to those in the low-adherence category. The authors conclude that understanding which of the care processes within the pathway are most cost-effective for improving patient-centered outcomes requires further investigation.
AHRQ-funded; HS024299.
Citation: Lifland B, Wright DR, Mangione-Smith R .
The impact of an adolescent depressive disorders clinical pathway on healthcare utilization.
Adm Policy Ment Health 2018 Nov;45(6):979-87. doi: 10.1007/s10488-018-0878-6..
Keywords: Care Management, Children/Adolescents, Depression, Healthcare Costs, Healthcare Utilization, Hospital Readmissions, Hospitalization, Inpatient Care, Behavioral Health, Outcomes, Patient-Centered Outcomes Research
Moise N, Shah RN, Essock S
Sustainability of collaborative care management for depression in primary care settings with academic affiliations across New York State.
This study examined sustainability of collaborative care management for depression in primary care settings with academic affiliations across New York State. The investigators used descriptive statistics to assess implementation metrics in sustaining vs. opt-out clinics and trends in implementation fidelity 1 and 2 years into the sustainability phase among sustaining clinics.
AHRQ-funded; HS025198
Citation: Moise N, Shah RN, Essock S .
Sustainability of collaborative care management for depression in primary care settings with academic affiliations across New York State.
Implement Sci 2018 Oct 12;13(1):128. doi: 10.1186/s13012-018-0818-6..
Keywords: Care Coordination, Depression, Behavioral Health, Primary Care
Bauer NS, Azer N, Sullivan PD
Acceptability of group visits for attention-deficit hyperactivity disorder in pediatric clinics.
The objective of the study was to describe the acceptability of ADHD group visits in busy pediatric clinics based on caregivers, child participants and facilitators. The authors found that the majority of comments from families and facilitators highlighted a variety of benefits of the use of a group visit model for ADHD chronic care. Despite systems-level barriers to implementation, families and facilitators felt the benefits outweighed the challenges.
AHRQ-funded; HS022434.
Citation: Bauer NS, Azer N, Sullivan PD .
Acceptability of group visits for attention-deficit hyperactivity disorder in pediatric clinics.
J Dev Behav Pediatr 2017 Oct;38(8):565-72. doi: 10.1097/dbp.0000000000000492..
Keywords: Children/Adolescents, Behavioral Health, Patient-Centered Outcomes Research, Chronic Conditions
Blumenthal KG, Li Y, Acker WW
Multiple drug intolerance syndrome and multiple drug allergy syndrome: epidemiology and associations with anxiety and depression.
In this study, the authors used electronic health record (EHR) data to describe prevalences of MDIS and MDAS and to examine associations with anxiety and depression. The investigators concluded that: 1.) while 6% of patients had MDIS, only 1% had MDAS; 2.) MDIS was associated with both anxiety and depression; 3.) patients with both anxiety and depression had an almost twofold increased odds of MDIS; 4.) MDAS was associated with a 40% increased odds of depression, but there was no significant association with anxiety.
AHRQ-funded; HS022728.
Citation: Blumenthal KG, Li Y, Acker WW .
Multiple drug intolerance syndrome and multiple drug allergy syndrome: epidemiology and associations with anxiety and depression.
Allergy 2018 Oct;73(10):2012-23. doi: 10.1111/all.13440..
Keywords: Adverse Drug Events (ADE), Adverse Events, Anxiety, Depression, Electronic Health Records (EHRs), Health Information Technology (HIT), Medication, Behavioral Health, Patient Safety
Davis MM, Gunn R, Gowen LK
A qualitative study of patient experiences of care in integrated behavioral health and primary care settings: more similar than different.
In this study, the authors examined, using qualitative methods, patients' experiences of care in integrated settings. The study included 24 patients receiving care across five practices participating in Advancing Care Together (ACT)-a 4-year demonstration project (2010-2014) of primary care and community mental health centers (CMHCs) integrating care. The investigators found that patients in both primary care and CMHCs perceived similar benefits from integrated care related to personal growth, improved quality, and access to care.
AHRQ-funded; HS022981.
Citation: Davis MM, Gunn R, Gowen LK .
A qualitative study of patient experiences of care in integrated behavioral health and primary care settings: more similar than different.
Transl Behav Med 2018 Sep 8;8(5):649-59. doi: 10.1093/tbm/ibx001..
Keywords: Community-Based Practice, Healthcare Delivery, Behavioral Health, Patient Experience, Primary Care
Katz RB, Toprak M, Wilkinson ST
Concurrent use of ketamine and monoamine oxidase inhibitors in the treatment of depression: a letter to the editor.
This research letter describes the implications of concurrent use of ketamine and monoamine oxidase inhibitors (MAO-Is) in the treatment of depression. There have not been many studies examining this. A literature review was conducted and eight cases total were found. All but one did not experience cardiovascular adverse events and that on patient had comorbid cardiac history. While these results were promising, the authors stressed that it is still unknown if concurrent use is safe and further research is needed.
AHRQ-funded; HS023000.
Citation: Katz RB, Toprak M, Wilkinson ST .
Concurrent use of ketamine and monoamine oxidase inhibitors in the treatment of depression: a letter to the editor.
Gen Hosp Psychiatry 2018 Sep - Oct;54:62-64. doi: 10.1016/j.genhosppsych.2018.05.007..
Keywords: Adverse Drug Events (ADE), Medication, Depression, Behavioral Health
Zuckerman KE, Lindly OJ, Reyes NM
Parent perceptions of community autism spectrum disorder stigma: measure validation and associations in a multi-site sample.
In this study, the investigators developed a brief, English/Spanish bilingual parent-reported scale of perceived community autism spectrum disorder (ASD) stigma and tested it in a multi-site sample of Latino and non-Latino white parents of children with ASD.
AHRQ-funded; HS000063.
Citation: Zuckerman KE, Lindly OJ, Reyes NM .
Parent perceptions of community autism spectrum disorder stigma: measure validation and associations in a multi-site sample.
J Autism Dev Disord 2018 Sep;48(9):3199-209. doi: 10.1007/s10803-018-3586-x..
Keywords: Autism, Disabilities, Social Stigma, Social Determinants of Health, Behavioral Health
Friedman SA, Azocar F, Xu H
The Mental Health Parity and Addiction Equity Act (MHPAEA) evaluation study: did parity differentially affect substance use disorder and mental health benefits offered by behavioral healthcare carve-out and carve-in plans?
The purpose of the stud was to assess whether implementation of the Mental Health Parity and Addiction Equity Act (MHPAEA) was associated with: 1. Reduced differences in financial requirements (i.e., copayments and coinsurance) for substance use disorder (SUD) versus specialty mental health (MH) care and 2. Reductions in the level of cost-sharing for SUD-specific services.
AHRQ-funded; HS024866.
Citation: Friedman SA, Azocar F, Xu H .
The Mental Health Parity and Addiction Equity Act (MHPAEA) evaluation study: did parity differentially affect substance use disorder and mental health benefits offered by behavioral healthcare carve-out and carve-in plans?
Drug Alcohol Depend 2018 Sep 1;190:151-58. doi: 10.1016/j.drugalcdep.2018.06.008..
Keywords: Behavioral Health, Health Insurance, Policy, Substance Abuse
Shaffer JA, Kronish IM, Falzon L
N-of-1 randomized intervention trials in health psychology: a systematic review and methodology critique.
The purpose of this study was to assess the quality of the methods and statistics, to describe interventions and outcomes, and to explore the heterogeneity of treatment effect of health psychology N-of-1, or single-case randomized clinical trials. Researchers conducted a systematic review of N-of-1 trials by searching numerous databases from their respective inception up to June 2015; studies were included if they had health behavior or psychological outcomes and the order of interventions was randomized. Study characteristics and analytic methods were then abstracted. The results of the study indicate that N-of-1 randomized trials could become the next major advance in health psychology for precision therapeutics, but they must be conducted with more methodologic and statistical rigor as well as be transparently and fully reported.
AHRQ-funded; HS024262.
Citation: Shaffer JA, Kronish IM, Falzon L .
N-of-1 randomized intervention trials in health psychology: a systematic review and methodology critique.
Ann Behav Med 2018 Aug 16;52(9):731-42. doi: 10.1093/abm/kax026..
Keywords: Behavioral Health, Health Services Research (HSR), Research Methodologies
Yonek JC, Jordan N, Dunlop D
Patient-centered medical home care for adolescents in need of mental health treatment.
The patient-centered medical home (PCMH) has emerged as an optimal primary care model for all youth; however, little is known about the extent to which adolescents in need of mental health (MH) treatment receive care consistent with the PCMH. This study assessed (1) 10-year trends in PCMH care among U.S. adolescents according to MH need and (2) variations in PCMH care and its subcomponents among adolescents with MH need, by individual and family characteristics.
AHRQ-funded; HS024183.
Citation: Yonek JC, Jordan N, Dunlop D .
Patient-centered medical home care for adolescents in need of mental health treatment.
J Adolesc Health 2018 Aug;63(2):172-80. doi: 10.1016/j.jadohealth.2018.02.006..
Keywords: Medical Expenditure Panel Survey (MEPS), Children/Adolescents, Behavioral Health, Patient-Centered Healthcare, Primary Care: Models of Care, Primary Care
Simpkin AL, Khan A, West DC
Stress from uncertainty and resilience among depressed and burned out residents: a cross-sectional study.
This study examined how stress from uncertainty is related to resilience among medical residents and whether those attributes are related to depression and burnout. The investigators surveyed 86 residents in pediatric residency programs from 4 urban freestanding children’s hospitals in North America in 2015. They used the Physicians’ Reaction to Uncertainty Scale to measure stress from uncertainty, the 14-item Resilience Scale to measure uncertainty, the Harvard National Depression Scale for depression, and the Maslach Burnout Inventory for burnout. There was a response rate of 58.1%. Five residents met depression criteria, and 15 residents met the burnout criteria. Depressed and burned out residents both had higher mean levels of stress compared to residents who neither depressed nor burned out.
AHRQ-funded; HS022986.
Citation: Simpkin AL, Khan A, West DC .
Stress from uncertainty and resilience among depressed and burned out residents: a cross-sectional study.
Acad Pediatr 2018 Aug;18(6):698-704. doi: 10.1016/j.acap.2018.03.002..
Keywords: Burnout, Stress, Depression, Provider: Physician, Behavioral Health, Provider, Education: Continuing Medical Education, Hospitals
Egorova NN, Pincus HA, Shemesh E
Behavioral health diagnoses among children and adolescents hospitalized in the United States: observations and implications.
The study described rates and characteristics of U.S. children hospitalized with a behavioral (mental or substance use) disorder. The study concluded that nearly 500,000 pediatric admissions in 2012 included behavioral disorders. Comorbidities were associated with longer stays and an estimated $1.36 billion additional annual costs, which were disproportionately borne by public insurance.
AHRQ-funded; HS20518; HS024433.
Citation: Egorova NN, Pincus HA, Shemesh E .
Behavioral health diagnoses among children and adolescents hospitalized in the United States: observations and implications.
Psychiatr Serv 2018 Aug;69(8):910-18. doi: 10.1176/appi.ps.201700389..
Keywords: Behavioral Health, Children/Adolescents, Diagnostic Safety and Quality, Healthcare Cost and Utilization Project (HCUP)
Olfson M, Crystal S, Wall M
Causes of death after nonfatal opioid overdose.
The purpose of this study was to describe all-cause mortality rates, selected cause-specific mortality rates, and standardized mortality rate ratios (SMRs) of adults during their first year after nonfatal opioid overdose. In a US national cohort of adults who had experienced a nonfatal opioid overdose, a marked excess of deaths was attributable to a wide range of substance use-associated, mental health, and medical conditions, underscoring the importance of closely coordinating the substance use, mental health, and medical care of this patient population.
AHRQ-funded; HS021112.
Citation: Olfson M, Crystal S, Wall M .
Causes of death after nonfatal opioid overdose.
JAMA Psychiatry 2018 Aug;75(8):820-27. doi: 10.1001/jamapsychiatry.2018.1471..
Keywords: Behavioral Health, Mortality, Opioids, Patient-Centered Healthcare, Substance Abuse
Adrian M, Lyon AR, Nicodimos S
Enhanced "train and hope" for scalable, cost-effective professional development in youth suicide prevention.
This study examined the impact of a 6-hr continuing education training, and the effect of a post-training reminder system, on mental health practitioners' knowledge, attitudes, and behavior surrounding suicide assessment and intervention. All practitioners, involved in the study, demonstrated increase in suicide assessment knowledge and attitudes for engaging in suicide risk assessments from pre- to posttest, and gains were maintained at the 3-month follow-up. The use of e-mail reminders was not associated with any additional changes.
AHRQ-funded; HS022982.
Citation: Adrian M, Lyon AR, Nicodimos S .
Enhanced "train and hope" for scalable, cost-effective professional development in youth suicide prevention.
Crisis 2018 Jul;39(4):235-46. doi: 10.1027/0227-5910/a000489..
Keywords: Education: Continuing Medical Education, Behavioral Health, Patient-Centered Healthcare, Prevention, Training
Andrews CM, Grogan CM, Smith BT
Medicaid benefits for addiction treatment expanded after implementation of the Affordable Care Act.
This study looked at the effects the Affordable Care Act (ACA) had on Medicaid benefits for addiction treatment. The ACA established a minimum standard of benefits and required state Medicaid programs to make changes to their treatment benefits. Researchers surveyed all 50 states and the District of Columbia in 2014 and 2017 when the ACA requirements came into effect. There was a substantial increase in benefits with a decrease in annual service limits of over 50 percent. There was a large reduction in preauthorization requirements for medications to treat opioid use disorder as well as other reductions in preauthorizations.
AHRQ-funded; HS000084.
Citation: Andrews CM, Grogan CM, Smith BT .
Medicaid benefits for addiction treatment expanded after implementation of the Affordable Care Act.
Health Aff 2018 Aug;37(8):1216-22. doi: 10.1377/hlthaff.2018.0272..
Keywords: Access to Care, Behavioral Health, Health Insurance, Medicaid, Policy, Substance Abuse