National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (1)
- Adverse Events (1)
- Ambulatory Care and Surgery (1)
- Antibiotics (2)
- Antimicrobial Stewardship (3)
- Asthma (1)
- Caregiving (4)
- Care Management (1)
- Centers for Education and Research on Therapeutics (CERTs) (1)
- Children/Adolescents (3)
- Chronic Conditions (2)
- Clinician-Patient Communication (1)
- Communication (4)
- Comparative Effectiveness (1)
- (-) Education: Patient and Caregiver (22)
- Elderly (3)
- Electronic Health Records (EHRs) (2)
- Guidelines (1)
- Health Information Technology (HIT) (3)
- Health Literacy (6)
- Health Promotion (1)
- Hospital Discharge (1)
- Lifestyle Changes (1)
- (-) Medication (22)
- Medication: Safety (3)
- Opioids (1)
- Osteoporosis (1)
- Pain (1)
- Palliative Care (1)
- Patient-Centered Healthcare (3)
- Patient-Centered Outcomes Research (2)
- Patient Adherence/Compliance (2)
- Patient and Family Engagement (3)
- Patient Experience (1)
- Patient Safety (3)
- Patient Self-Management (1)
- Practice Patterns (1)
- Provider: Pharmacist (1)
- Public Health (1)
- Quality of Life (1)
- Respiratory Conditions (1)
- Shared Decision Making (3)
- Sickle Cell Disease (1)
- Social Determinants of Health (1)
- Tools & Toolkits (1)
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 22 of 22 Research Studies DisplayedCarroll AR, Schlundt D, Bonnet K
Caregiver and clinician perspectives on discharge medication counseling: a qualitative study.
This study’s objective was to explore the perspectives of multidisciplinary clinicians and caregivers regarding discharge medication counseling for children and to develop a conceptual model to inform intervention efforts to reduce discharge medication dosing errors. The authors conducted a qualitative analysis using results from focus groups and individual interviews with 17 caregivers and 16 clinicians. Domains and subthemes included: (1) infrastructure of healthcare delivery, including supplies for counseling, content and organization of discharge instructions, clinician training and education, roles and responsibilities of team members, and hospital pharmacy delivery and counseling program; (2) processes of healthcare delivery, including medication reconciliation, counseling content, counseling techniques, and language barriers and health literacy; and (3) measurable outcomes, including medication dosing accuracy and caregiver understanding and adherence to discharge instructions. The conceptual model that resulted from this analysis can be applied to the development and evaluation of interventions to reduce discharge medication dosing errors following a hospitalization.
AHRQ-funded; HS026122.
Citation: Carroll AR, Schlundt D, Bonnet K .
Caregiver and clinician perspectives on discharge medication counseling: a qualitative study.
Hosp Pediatr 2023 Apr; 13(4):325-42. doi: 10.1542/hpeds.2022-006937..
Keywords: Children/Adolescents, Medication, Hospital Discharge, Education: Patient and Caregiver, Caregiving
Martin BA, Breslow RM, Sims A
Identifying over-the-counter information to prioritize for the purpose of reducing adverse drug reactions in older adults: a national survey of pharmacists.
This study’s objective was to determine which information on over-the-counter (OTC) Drug Facts Labels (DFS) is most critical in reducing adverse drug reactions (ADRs) among older adults and should be placed in front of the label. A national survey of practicing pharmacists knowledgeable about OTC medication use by older adults asked respondents to rank order the importance of the DFL sections to reduce ADRs. A total of 318 responses were analyzed. There was high consensus that uses and purposes, active ingredient, warnings, and directions for use were the most important sections on the label. Two specific warnings “Do not use” and “Ask a doctor or pharmacist” were deemed most important in the warnings section.
AHRQ-funded; HS025386.
Citation: Martin BA, Breslow RM, Sims A .
Identifying over-the-counter information to prioritize for the purpose of reducing adverse drug reactions in older adults: a national survey of pharmacists.
J Am Pharm Assoc 2022 Jan-Feb;62(1):167-75.e1. doi: 10.1016/j.japh.2021.08.019..
Keywords: Elderly, Medication: Safety, Medication, Adverse Drug Events (ADE), Adverse Events, Patient Safety, Health Literacy, Education: Patient and Caregiver
Miller BJ, Carson KA, Keller S
Educating patients on unnecessary antibiotics: personalizing potential harm aids patient understanding.
Antibiotic resistance is a public health emergency fueled by inappropriate antibiotic use. Public education campaigns often focus on global antibiotic resistance or societal harm of antibiotic misuse. In this study, the investigators administered a survey at a primary care clinic in Baltimore, MD. A total of 250 participants rated 18 statements about potential harm from antibiotics on how each statement changed their likelihood to request antibiotics for an upper respiratory tract infection.
AHRQ-funded; HS025782.
Citation: Miller BJ, Carson KA, Keller S .
Educating patients on unnecessary antibiotics: personalizing potential harm aids patient understanding.
J Am Board Fam Med 2020 Nov-Dec;33(6):969-77. doi: 10.3122/jabfm.2020.06.200210..
Keywords: Antimicrobial Stewardship, Antibiotics, Education: Patient and Caregiver, Medication, Respiratory Conditions, Health Literacy
Keller SC, Cosgrove SE, Arbaje AI
It's complicated: patient and informal caregiver performance of outpatient parenteral antimicrobial therapy-related tasks.
This study’s objective was to perform a patient-centered goal-directed task analysis to identify what is required for successful completion of outpatient parenteral antimicrobial therapy (OPAT) by patients and caregivers. The authors conducted 40 semi-structured patient interviews and also 20 observations of patients and caregivers performing OPAT. Six goals were identified. The authors concluded that patients and caregivers should use teach-back, take formal classes, and other forms of instruction to ensure safety and good outcomes for the patients.
AHRQ-funded; HS025782.
Citation: Keller SC, Cosgrove SE, Arbaje AI .
It's complicated: patient and informal caregiver performance of outpatient parenteral antimicrobial therapy-related tasks.
Am J Med Qual 2020 Mar/Apr;35(2):133-46. doi: 10.1177/1062860619853345..
Keywords: Caregiving, Patient-Centered Healthcare, Antimicrobial Stewardship, Medication, Education: Patient and Caregiver, Patient Safety
McCarthy DM, Curtis LM, Courtney DM
A multifaceted intervention to improve patient knowledge and safe use of opioids: results of the ED EMC(2) randomized controlled trial.
Despite increased focus on opioid prescribing, little is known about the influence of prescription opioid medication information given to patients in the emergency department (ED). The objective of this study was to evaluate the effect of an Electronic Medication Complete Communication (EMC(2)) Opioid Strategy on patients' safe use of opioids and knowledge about opioids. The study found that the EMC(2) tools improved demonstrated safe dosing, but these benefits did not translate into actual use based on medication dairies. The text-messaging intervention did result in improved patient knowledge.
AHRQ-funded; HS023459.
Citation: McCarthy DM, Curtis LM, Courtney DM .
A multifaceted intervention to improve patient knowledge and safe use of opioids: results of the ED EMC(2) randomized controlled trial.
Acad Emerg Med 2019 Dec;26(12):1311-25. doi: 10.1111/acem.13860..
Keywords: Opioids, Medication, Medication: Safety, Patient Safety, Health Literacy, Education: Patient and Caregiver, Clinician-Patient Communication, Communication, Health Information Technology (HIT)
RIchmond J, Mangrum R, Wang G
An informed public's views on reducing antibiotic overuse.
The purpose of this study was to understand public attitudes about and recommendations to address antibiotic overuse by employing public deliberation (a method for eliciting informed input on value-laden issues). The investigators concluded that when informed about individual and social consequences of antibiotic overuse, patients may be more receptive to antibiotic prescription limits. They suggest that community-physician-government partnerships are needed to create solutions.
AHRQ-funded; 290201000005C.
Citation: RIchmond J, Mangrum R, Wang G .
An informed public's views on reducing antibiotic overuse.
Health Serv Res 2019 Dec;54(6):1283-94. doi: 10.1111/1475-6773.13175..
Keywords: Antimicrobial Stewardship, Antibiotics, Medication, Health Literacy, Education: Patient and Caregiver
Volerman A, Fierstein J, Boon K
Factors associated with effective inhaler technique among children with moderate to severe asthma.
Guidelines recommend that children and families receive education about and demonstration of effective inhaler technique as part of asthma self-management education. For youth, improved inhaler technique is associated with better quality of life and decreased health care use, yet technique remains suboptimal. To understand potential reasons for differences in inhaler skills, this study examined individual- and health care-level factors associated with effective inhaler technique among children.
AHRQ-funded; HS026385.
Citation: Volerman A, Fierstein J, Boon K .
Factors associated with effective inhaler technique among children with moderate to severe asthma.
Ann Allergy Asthma Immunol 2019 Nov;123(5):511-12.e1. doi: 10.1016/j.anai.2019.08.017.
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Keywords: Children/Adolescents, Asthma, Chronic Conditions, Patient Self-Management, Education: Patient and Caregiver, Medication, Quality of Life
Crosby LE, Walton A, Shook LM
Development of a hydroxyurea decision aid for parents of children with sickle cell anemia.
This study developed a decision aid for use of hydroxyurea for parents of children with sickle cell anemia. There are national evidence-based guidelines, but they do not offer strategies for implementation. A multicomponent decision aid was developed via a needs assessment, clinic observations and iterative feedback. The decision aid was considered useful by the 75 parents and 28 clinicians who participated in all phases of the study.
AHRQ-funded; HS021114.
Citation: Crosby LE, Walton A, Shook LM .
Development of a hydroxyurea decision aid for parents of children with sickle cell anemia.
J Pediatr Hematol Oncol 2019 Jan;41(1):56-63. doi: 10.1097/mph.0000000000001257..
Keywords: Caregiving, Children/Adolescents, Chronic Conditions, Shared Decision Making, Education: Patient and Caregiver, Medication, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Sickle Cell Disease
Pandolfe F, Wright A, Slack WV
Rethinking the outpatient medication list: increasing patient activation and education while architecting for centralization and improved medication reconciliation.
The purpose of this study was to identify barriers impacting the time consuming and error fraught process of medication reconciliation and to design and implement an electronic medication management system where patient and trusted healthcare proxies can participate in establishing and maintaining an inclusive and up-to-date list of medications.
AHRQ-funded; HS021495.
Citation: Pandolfe F, Wright A, Slack WV .
Rethinking the outpatient medication list: increasing patient activation and education while architecting for centralization and improved medication reconciliation.
J Am Med Inform Assoc 2018 Aug;25(8):1047-53. doi: 10.1093/jamia/ocy047..
Keywords: Education: Patient and Caregiver, Health Information Technology (HIT), Medication, Ambulatory Care and Surgery, Patient and Family Engagement
Ancker JS, Send A, Hafeez B
Health IT usability focus section: adapting EHR-based medication instructions to comply with plain language guidance-a randomized experiment.
Using examples of clinician-written medication instructions from an electronic health record, the investigators conducted an experiment to determine whether parental misinterpretations would be reduced by instructions that followed best practices for plain language. The researchers found that a relatively simple intervention of revising text was associated with a modest reduction in frequency of misinterpretations of medication instructions.
AHRQ-funded; HS021531.
Citation: Ancker JS, Send A, Hafeez B .
Health IT usability focus section: adapting EHR-based medication instructions to comply with plain language guidance-a randomized experiment.
Appl Clin Inform 2017 Oct;8(4):1127-43. doi: 10.4338/aci-2017-06-ra-0111..
Keywords: Communication, Education: Patient and Caregiver, Electronic Health Records (EHRs), Health Information Technology (HIT), Medication
Marcum ZA, Hanlon JT, Murray MD
Improving medication adherence and health outcomes in older adults: an evidence-based review of randomized controlled trials.
The objective of this review was to provide an updated summary of evidence from randomized controlled studies to determine whether interventions aimed at improving medication adherence also improve the health outcomes of older adults residing in community-based settings. This evidence-based review of medication adherence interventions in older adults revealed promising strategies in the larger context of a largely mixed body of literature.
AHRQ-funded; HS022982; HS023779.
Citation: Marcum ZA, Hanlon JT, Murray MD .
Improving medication adherence and health outcomes in older adults: an evidence-based review of randomized controlled trials.
Drugs Aging 2017 Mar;34(3):191-201. doi: 10.1007/s40266-016-0433-7.
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Keywords: Elderly, Medication, Patient Adherence/Compliance, Patient-Centered Outcomes Research, Education: Patient and Caregiver
Kernodle AR, Frail CK, Gernant SA
Patients' experiences using a brief screening tool for medication-related problems in a community pharmacy setting.
The researchers explored patient perceptions and the practical implication of using a brief 9-item scale to screen for medication-related problems in community pharmacies. After interviewing 40 patients who completed the scale and reviewed its results with their pharmacist, they concluded that it may have value in increasing patients' understanding of and confidence in their medications, enhancing pharmacist-patient relationships, and identifying problems requiring additional interventions.
AHRQ-funded; HS022119.
Citation: Kernodle AR, Frail CK, Gernant SA .
Patients' experiences using a brief screening tool for medication-related problems in a community pharmacy setting.
J Pharm Pract 2017 Feb;30(1):49-57. doi: 10.1177/0897190015605015.
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Keywords: Medication, Patient Experience, Education: Patient and Caregiver, Provider: Pharmacist
Cram P, Wolinsky FD, Lou Y
Patient-activation and guideline-concordant pharmacological treatment after bone density testing: the PAADRN randomized controlled trial.
In a clinical trial of 7749 patients, the researchers tested whether usual care augmented by a tailored patient-activation DXA result letter accompanied by an educational brochure would improve guideline-concordant pharmacological treatment compared to usual care only. They found that treatment rates did not improve.
AHRQ-funded; HS023009.
Citation: Cram P, Wolinsky FD, Lou Y .
Patient-activation and guideline-concordant pharmacological treatment after bone density testing: the PAADRN randomized controlled trial.
Osteoporos Int 2016 Dec;27(12):3513-24. doi: 10.1007/s00198-016-3681-9.
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Keywords: Education: Patient and Caregiver, Guidelines, Medication, Osteoporosis, Patient and Family Engagement
Mathur MB, Gould M, Khazeni N
Direct-to-consumer drug advertisements can paradoxically increase intentions to adopt lifestyle changes.
The researchers aimed to assess whether priming with real direct-to-consumer (DTC) television advertisements elicited boomerang effects on perceptions of lifestyle change and whether these effects, if present, were moderated by individual problem status. They found that real television advertisements elicited only a weak boomerang effect on perceived effectiveness and elicited an unexpected reverse boomerang effect on personal intentions to use lifestyle change versus drugs.
AHRQ-funded; HS019816.
Citation: Mathur MB, Gould M, Khazeni N .
Direct-to-consumer drug advertisements can paradoxically increase intentions to adopt lifestyle changes.
Front Psychol 2016 Oct 3;7:1533. doi: 10.3389/fpsyg.2016.01533.
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Keywords: Medication, Lifestyle Changes, Lifestyle Changes, Education: Patient and Caregiver
Houser SH, Au DW, Miller MJ
Socio-demographic differences in risk information seeking sources for non-steroidal anti-inflammatory drugs (NSAIDS).
The authors examined the primary sources of non-steroidal anti-inflammatory drugs (NSAIDs) risk information and the associations with patient socio-demographic factors. They found that the primary patient source of information on NSAID risks was physician, followed by internet, pharmacist, and other sources, such as nurses and family/friends. They concluded that patients obtain information from a variety of sources, but primarily from health care providers.
AHRQ-funded; HS021110.
Citation: Houser SH, Au DW, Miller MJ .
Socio-demographic differences in risk information seeking sources for non-steroidal anti-inflammatory drugs (NSAIDS).
Int J Med Inform 2016 Oct;94:222-7. doi: 10.1016/j.ijmedinf.2016.07.017.
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Keywords: Education: Patient and Caregiver, Medication, Social Determinants of Health
Curtis LM, Mullen RJ, Russell A
An efficacy trial of an electronic health record-based strategy to inform patients on safe medication use: the role of written and spoken communication.
The researchers tested the feasibility and efficacy of an electronic health record (EHR) strategy that automated the delivery of print medication information at the time of prescribing. They found that written information and physician counseling were independently associated with patient understanding of risk information and that receiving both was most beneficial. They concluded that although an EHR can be a reliable means to deliver tangible, print medication education to patients, it cannot replace physician-patient communication, and that offering both written and spoken information resulted in a synergistic effect for informing patients.
AHRQ-funded; HS017220.
Citation: Curtis LM, Mullen RJ, Russell A .
An efficacy trial of an electronic health record-based strategy to inform patients on safe medication use: the role of written and spoken communication.
Patient Educ Couns 2016 Sep;99(9):1489-95. doi: 10.1016/j.pec.2016.07.004.
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Keywords: Electronic Health Records (EHRs), Communication, Education: Patient and Caregiver, Medication: Safety, Medication
Singh JA, Qu H, Yazdany J
Barriers to medication decision making in women with lupus nephritis: a formative study using nominal group technique.
The researchers assessed the perspectives of women with lupus nephritis on barriers to medication decision making. The most salient perceived barriers, as indicated by percent-weighted votes assigned, were known/anticipated side effects (15.6 percent), medication expense/ability to afford medications (8.2 percent), and the fear that the medication could cause other diseases (7.8 percent).
AHRQ-funded; HS021110.
Citation: Singh JA, Qu H, Yazdany J .
Barriers to medication decision making in women with lupus nephritis: a formative study using nominal group technique.
J Rheumatol 2015 Sep;42(9):1616-23. doi: 10.3899/jrheum.150168.
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Keywords: Centers for Education and Research on Therapeutics (CERTs), Shared Decision Making, Education: Patient and Caregiver, Medication, Patient and Family Engagement
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
Kuntz JL, Safford MM, Singh JA
Patient-centered interventions to improve medication management and adherence: a qualitative review of research findings.
This review reports the current state of scientific research around interventions to improve medication management through four patient-centered domains. Out of 60 studies, the authors found the following types of intervention: patient education, augmented pharmacy services, decision aids, shared decision-making, and clinical review of patient adherence. They were unable to determine whether these interventions were more effective than traditional medication adherence interventions.
AHRQ-funded; HS021107.
Citation: Kuntz JL, Safford MM, Singh JA .
Patient-centered interventions to improve medication management and adherence: a qualitative review of research findings.
Patient Educ Couns 2014 Dec;97(3):310-26. doi: 10.1016/j.pec.2014.08.021.
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Keywords: Education: Patient and Caregiver, Shared Decision Making, Medication, Patient Adherence/Compliance, Patient-Centered Healthcare
Shoemaker SJ, Staub-DeLong L, Wasserman M
Factors affecting adoption and implementation of AHRQ health literacy tools in pharmacies.
The purpose of this study is to understand the facilitators and barriers to the adoption and implementation of AHRQ’s health literacy tools, particularly a tool to assess a pharmacy’s health literacy practices. The study found facilitators including awareness of health literacy, a culture of innovation, and a change champion. It also identified barriers such as lack of leadership support and limited staff time.
AHRQ-funded; 290200600011I
Citation: Shoemaker SJ, Staub-DeLong L, Wasserman M .
Factors affecting adoption and implementation of AHRQ health literacy tools in pharmacies.
Res Social Adm Pharm. 2013 Sep-Oct;9(5):553-63. doi: 10.1016/j.sapharm.2013.05.003..
Keywords: Health Literacy, Education: Patient and Caregiver, Practice Patterns, Tools & Toolkits, Medication
Robertson J, Farris KB, Schultz SK
Older adults' views about "Managing Your Medications" booklet.
The objective of the study was to evaluate the Managing Your Medications (MYM) booklet to improve medication management. Older adults reported it was comprehensible and 17 percent reported behavioral intentions to change their current actions regarding medications. Overall, 12.7 percent of respondents agreed that MYM changed their opinion of the topic. The most popular means to dis¬seminate were doctors’ offices and senior citizens’ centers.
AHRQ-funded; HS016094.
Citation: Robertson J, Farris KB, Schultz SK .
Older adults' views about "Managing Your Medications" booklet.
J Appl Gerontol 2013 Apr;32(3):370-82. doi: 10.1177/0733464811421910..
Keywords: Elderly, Education: Patient and Caregiver, Health Literacy, Medication
Kravitz RL, Bell RA
Media, messages, and medication: strategies to reconcile what patients hear, what they want, and what they need from medications.
This analysis takes the form of a critical, integrative synthesis of research from the fields of medicine, marketing, public health, and health communications. The authors conclude that the problem is not a lack of information: rather, it is knowing what information to trust.
AHRQ-funded; 290200810015C
Citation: Kravitz RL, Bell RA .
Media, messages, and medication: strategies to reconcile what patients hear, what they want, and what they need from medications.
BMC Med Inform Decis Making 2013;13 Suppl 3:S5. doi: 10.1186/1472-6947-13-s3-s5..
Keywords: Communication, Education: Patient and Caregiver, Health Promotion, Medication, Public Health