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
1 to 25 of 53 Research Studies DisplayedSmith MA, Bednarz L, Nordby PA
Increasing consumer engagement by tailoring a public reporting website on the quality of diabetes care: a qualitative study.
The goal of this study was to determine if tailoring quality reports to persons with diabetes mellitus and co-occurring chronic conditions would increase user engagement with a website that publicly reports the quality of diabetes care. It concluded that tailoring can be used to improve public reporting sites for individuals with chronic conditions, ultimately allowing consumers to make more informed health care decisions.
AHRQ-funded; HS021899.
Citation: Smith MA, Bednarz L, Nordby PA .
Increasing consumer engagement by tailoring a public reporting website on the quality of diabetes care: a qualitative study.
J Med Internet Res 2016 Dec 21;18(12):e332. doi: 10.2196/jmir.6555.
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Keywords: Chronic Conditions, Shared Decision Making, Diabetes, Patient and Family Engagement, Web-Based
Bierman AS, Tinetti ME
AHRQ Author: Bierman AS
Precision medicine to precision care: managing multimorbidity.
Multimorbidity is the most common condition managed in practice. The authors argue that health-care delivery must be transformed to provide precision care to people with multimorbidity. Accomplishing this transition will require a change in practice, research, and policy from disease-specific to patient-centered models of care delivery.
AHRQ-authored.
Citation: Bierman AS, Tinetti ME .
Precision medicine to precision care: managing multimorbidity.
Lancet 2016 Dec 3;388(10061):2721-23. doi: 10.1016/s0140-6736(16)32232-2.
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Keywords: Healthcare Delivery, Chronic Conditions, Guidelines, Patient-Centered Healthcare, Primary Care, Primary Care: Models of Care
Kenzik KM, Kent EE, Martin MY
Chronic condition clusters and functional impairment in older cancer survivors: a population-based study.
The purpose of this study was to identify chronic condition clusters at pre- and post-cancer diagnosis, evaluate predictors of developing clusters post-cancer, and examine the impact on functional impairment among older cancer survivors. It found that distinct condition clusters of two or more chronic conditions are prevalent among older cancer survivors. Cluster prevalence increases from pre- to post-cancer diagnosis.
AHRQ-funded; HS023009; HS013852.
Citation: Kenzik KM, Kent EE, Martin MY .
Chronic condition clusters and functional impairment in older cancer survivors: a population-based study.
J Cancer Surviv 2016 Dec;10(6):1096-103. doi: 10.1007/s11764-016-0553-4.
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Keywords: Chronic Conditions, Cancer, Elderly, Research Methodologies, Health Status
Sohn MW, Kang H, Park JS
Disparities in recommended preventive care usage among persons living with diabetes in the Appalachian region.
This study examined disparities in the receipt of preventive care recommended by the American Diabetes Association (ADA) between Appalachian and non-Appalachian counties and within Appalachian counties. It concluded that there are significant disparities in the uptake of many recommended preventive services between less and more affluent counties in the Appalachian region.
AHRQ-funded; HS018542.
Citation: Sohn MW, Kang H, Park JS .
Disparities in recommended preventive care usage among persons living with diabetes in the Appalachian region.
BMJ Open Diabetes Res Care 2016 Dec;4(1):e000284. doi: 10.1136/bmjdrc-2016-000284.
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Keywords: Diabetes, Disparities, Prevention, Chronic Conditions, Social Determinants of Health
Merlin JS, Bulls HW, Vucovich LA
Pharmacologic and non-pharmacologic treatments for chronic pain in individuals with HIV: a systematic review.
The authors conducted a systematic review to identify clinical trials and observational studies examining the impact of pharmacologic or non-pharmacologic interventions on pain and/or functional outcomes among HIV-infected individuals with chronic pain in high-development countries. They found that the only included controlled studies with positive results were of capsaicin and cannabis. Among the seven studies of pharmacologic interventions, the authors determined that five had substantial pharmaceutical industry sponsorship. Their findings highlight several important gaps in the HIV/chronic pain literature requiring further research.
AHRQ-funded; HS019465.
Citation: Merlin JS, Bulls HW, Vucovich LA .
Pharmacologic and non-pharmacologic treatments for chronic pain in individuals with HIV: a systematic review.
AIDS Care 2016 Dec;28(12):1506-15. doi: 10.1080/09540121.2016.1191612.
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Keywords: Chronic Conditions, Comparative Effectiveness, Human Immunodeficiency Virus (HIV), Medication, Patient-Centered Outcomes Research
Gounder PP, Seeman SM, Holman RC
AHRQ Author: Steiner CA
Potentially preventable hospitalizations for acute and chronic conditions in Alaska, 2010-2012.
The Healthy Alaska 2020 initiative (HA2020) targeted reducing potentially preventable hospitalizations (PPH) for acute and chronic conditions among its health indicators. This study found that among 127,371 total hospitalizations, 4,911 and 6,721 were for acute and chronic PPH conditions, respectively. The overall crude PPH rate was 7.3 (3.1 for acute and 4.2 for chronic conditions).
AHRQ-authored.
Citation: Gounder PP, Seeman SM, Holman RC .
Potentially preventable hospitalizations for acute and chronic conditions in Alaska, 2010-2012.
Prev Med Rep 2016 Dec;4:614-21. doi: 10.1016/j.pmedr.2016.03.017.
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Keywords: Hospitalization, Healthcare Cost and Utilization Project (HCUP), Quality Indicators (QIs), Chronic Conditions, Quality of Care
Ware JE, Jr., Gandek B, Allison J
The validity of disease-specific quality of life attributions among adults with multiple chronic conditions.
The objective of this study was to evaluate the convergent and discriminant validity of QOL attributions to specific diseases among adults with multiple chronic conditions (MCC). It concluded that, collectively, convergent and discriminant test results support the construct validity of disease-specific QOL impact attributions across MCC within the eight pre-identified conditions.
AHRQ-funded; HS023117.
Citation: Ware JE, Jr., Gandek B, Allison J .
The validity of disease-specific quality of life attributions among adults with multiple chronic conditions.
Int J Stat Med Res 2016;5(1):17-40..
Keywords: Quality of Life, Chronic Conditions, Arthritis, Kidney Disease and Health, Heart Disease and Health
Sarkar U, Gourley GI, Lyles CR
Usability of commercially available mobile applications for diverse patients.
The objective of this study was to investigate the usability of existing mobile health applications ("apps") for diabetes, depression, and caregiving, in order to facilitate development and tailoring of patient-facing apps for diverse populations. Participants completed 43 percent of tasks across 11 apps without assistance. Three themes emerged from participant comments: lack of confidence with technology, frustration with design features and navigation, and interest in having technology to support their self-management.
AHRQ-funded; HS022408.
Citation: Sarkar U, Gourley GI, Lyles CR .
Usability of commercially available mobile applications for diverse patients.
J Gen Intern Med 2016 Dec;31(12):1417-26. doi: 10.1007/s11606-016-3771-6.
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Keywords: Chronic Conditions, Health Information Technology (HIT), Patient Self-Management, Telehealth, Vulnerable Populations
Lee SJ, Clark MA, Cox JV
Achieving coordinated care for patients with complex cases of cancer: a multiteam system approach.
The authors outlined challenges of care coordination in the context of a multiteam system (MTS), through the care experience of a patient in the Dallas County integrated safety-net system. A cancer diagnosis triggered an additional need for augmented coordination between his different provider teams. The authors recommend that further research and practice investigate the relationships of MTS coordination for shared care management, transfer to and from specialty care, treatment compliance, barriers to care, and health outcomes of chronic comorbid conditions, as well as cancer control and surveillance.
AHRQ-funded; HS022418.
Citation: Lee SJ, Clark MA, Cox JV .
Achieving coordinated care for patients with complex cases of cancer: a multiteam system approach.
J Oncol Pract 2016 Nov;12(11):1029-38. doi: 10.1200/jop.2016.013664.
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Keywords: Cancer, Care Coordination, Chronic Conditions, Patient-Centered Healthcare, Teams
Brody AM, Sharma VK, Singh A
Barriers to emergency physician diagnosis and treatment of uncontrolled chronic hypertension.
This study surveyed a national sample of emergency physicians on their perceived barriers in establishing an ED diagnosis of asymptomatic hypertension (HTN) and ED treatment of such patients. It found that the most common barriers to diagnosis of HTN were uncertainty regarding the validity of ED blood pressure measurements (92 percent)and reluctance to diagnose a condition which cannot be comprehensively managed in the ED setting (29 percent).
AHRQ-funded; HS000011.
Citation: Brody AM, Sharma VK, Singh A .
Barriers to emergency physician diagnosis and treatment of uncontrolled chronic hypertension.
Am J Emerg Med 2016 Nov;34(11):2241-42. doi: 10.1016/j.ajem.2016.08.050.
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Keywords: Blood Pressure, Emergency Department, Diagnostic Safety and Quality, Chronic Conditions
Rolfson O, Wissig S, van Maasakkers L
Defining an international standard set of outcome measures for patients with hip or knee osteoarthritis: consensus of the International Consortium for Health Outcomes Measurement Hip and Knee Osteoarthritis Working Group.
The researchers defined a minimum Standard Set of outcome measures and case-mix factors for monitoring, comparing, and improving healthcare for patients with clinically diagnosed hip or knee osteoarthritis (OA) with a focus on defining the outcomes that matter most to patients. The Working Group reached consensus on a concise set of outcome measures to evaluate patients' joint pain, physical functioning, health-related quality of life, work status, mortality, reoperations, readmissions, and overall satisfaction with treatment result.
AHRQ-funded; HS018910.
Citation: Rolfson O, Wissig S, van Maasakkers L .
Defining an international standard set of outcome measures for patients with hip or knee osteoarthritis: consensus of the International Consortium for Health Outcomes Measurement Hip and Knee Osteoarthritis Working Group.
Arthritis Care Res 2016 Nov;68(11):1631-39. doi: 10.1002/acr.22868.
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Keywords: Arthritis, Care Management, Chronic Conditions, Patient-Centered Outcomes Research
Cunha CB, D'Agata EM
Implementing an antimicrobial stewardship program in out-patient dialysis units.
The purpose of this review is to highlight the key elements and interventions of antimicrobial stewardship programs (ASP). The Infectious Disease Society of America and the Society of Healthcare Epidemiology of America have provided evidence-based guidelines for the development and implementation of an ASP. Many of their recommendations can be adapted to the out-patient dialysis setting.
AHRQ-funded; HS021666.
Citation: Cunha CB, D'Agata EM .
Implementing an antimicrobial stewardship program in out-patient dialysis units.
Curr Opin Nephrol Hypertens 2016 Nov;25(6):551-55. doi: 10.1097/mnh.0000000000000281.
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Keywords: Antimicrobial Stewardship, Antibiotics, Medication, Ambulatory Care and Surgery, Kidney Disease and Health, Chronic Conditions
Zullo AR, Dore DD, Gutman R
National glucose-lowering treatment complexity is greater in nursing home residents than community-dwelling adults.
This letter describes common glucose-lowering medication usage patterns for a national cross-section of U.S. adults aged 65 and older residing in nursing home (NH) and community settings from 2007 to 2010. The study results suggest that continued efforts are warranted to improve glucose-lowering medication management and simplify treatment regimens in the NH; that the relative importance of CER questions regarding specific glucose-lowering treatments may differ according to the care setting; and that CER studies of glucose-lowering treatments in older adults must address the combination use of medications, especially in NH residents.
AHRQ-funded; HS022998.
Citation: Zullo AR, Dore DD, Gutman R .
National glucose-lowering treatment complexity is greater in nursing home residents than community-dwelling adults.
J Am Geriatr Soc 2016 Nov;64(11):e233-e35. doi: 10.1111/jgs.14485.
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Keywords: Care Management, Chronic Conditions, Diabetes, Elderly, Medication, Nursing Homes
Naples JG, Gellad WF, Hanlon JT
The role of opioid analgesics in geriatric pain management.
This article reviews the epidemiology of opioid use and their effectiveness for chronic noncancer pain (CNCP) in older adults and summarizes important age-related changes in opioid pharmacokinetics and pharmacodynamics that increase the risks of adverse effects in the elderly. Finally, to assist clinicians with selecting appropriate therapy, the article concludes with an evidence-based approach to optimize opioid prescribing in older adults with CNCP.
AHRQ-funded; HS023779.
Citation: Naples JG, Gellad WF, Hanlon JT .
The role of opioid analgesics in geriatric pain management.
Clin Geriatr Med 2016 Nov;32(4):725-35. doi: 10.1016/j.cger.2016.06.006.
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Keywords: Chronic Conditions, Elderly, Medication, Opioids, Pain, Patient Safety
Reid MC, Eccleston C, Pillemer K
Management of chronic pain in older adults.
This review summarized recent evidence on the assessment and management of pain in older patients. Evidence is taken from systematic reviews, meta-analyses, individual trials, and clinical guidelines. Based on their review, the authors argue that all older adults with chronic pain should undergo a comprehensive geriatric pain assessment and that a comprehensive assessment can guide selection of treatments most likely to benefit the patient and identify targets for intervention besides pain relief.
AHRQ-funded; HS020648.
Citation: Reid MC, Eccleston C, Pillemer K .
Management of chronic pain in older adults.
BMJ 2015;350:h532. doi: 10.1136/bmj.h532..
Keywords: Care Management, Chronic Conditions, Elderly, Comparative Effectiveness, Evidence-Based Practice, Pain
Bishop TF, Ryan AM, Chen MA
A randomized, controlled trial of a shared panel management program for small practices.
This study’s objective was to determine whether a shared panel management program was effective at improving quality of care for patients with uncontrolled chronic disease. It found that a shared, low-intensity panel management program run by a city health department did not improve quality of care for patients with chronic illnesses and lapses in care.
AHRQ-funded; HS018546; HS018275.
Citation: Bishop TF, Ryan AM, Chen MA .
A randomized, controlled trial of a shared panel management program for small practices.
Health Serv Res 2016 Oct;51(5):1796-813. doi: 10.1111/1475-6773.12455.
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Keywords: Chronic Conditions, Quality Improvement, Quality of Care, Health Information Technology (HIT)
Kim JP, Chao LX, Simpson EL
Persistence of atopic dermatitis (AD): a systematic review and meta-analysis.
Previous studies found conflicting results about whether childhood atopic dermatitis (AD) persists into adulthood. The researchers sought to determine persistence rates and clinical factors associated with prolonged AD. They found that most childhood AD remitted by adulthood. However, children with already persistent disease, later onset, and/or more severe disease have increased persistence.
AHRQ-funded; HS023011.
Citation: Kim JP, Chao LX, Simpson EL .
Persistence of atopic dermatitis (AD): a systematic review and meta-analysis.
J Am Acad Dermatol 2016 Oct;75(4):681-87.e11. doi: 10.1016/j.jaad.2016.05.028.
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Keywords: Children/Adolescents, Chronic Conditions, Children/Adolescents
Darlow S, Wen KY
Development testing of mobile health interventions for cancer patient self-management: a review.
The purpose of the current study was to conduct a review of published articles that describe the development process of mobile health interventions for patients’ cancer care self-management. The following trends emerged: importance of stakeholder engagement during the development process, addressing the unique needs and experiences of cancer patients and care providers, ensuring user satisfaction with the system, and identifying perceived benefits and limitations of the system.
AHRQ-funded; HS019001.
Citation: Darlow S, Wen KY .
Development testing of mobile health interventions for cancer patient self-management: a review.
Health Informatics J 2016 Sep;22(3):633-50. doi: 10.1177/1460458215577994..
Keywords: Patient Self-Management, Cancer, Chronic Conditions, Telehealth, Health Information Technology (HIT)
Walley AY, Green TC
Mainstreaming naloxone through coprescription to patients receiving long-term opioid therapy for chronic pain.
This editorial comments on the Coffin and colleagues' report of the Naloxone for Opioid Safety Evaluation (NOSE) study. The authors concluded that the NOSE study is a substantial step forward in demonstrating the feasibility of coprescription of rescue kits in primary care settings. (Coffin et al., Ann Intern Med. 2016 Aug 16;165(4):245-52.)
AHRQ-funded; HS024021.
Citation: Walley AY, Green TC .
Mainstreaming naloxone through coprescription to patients receiving long-term opioid therapy for chronic pain.
Ann Intern Med 2016 Aug 16;165(4):292-3. doi: 10.7326/m16-1348.
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Keywords: Chronic Conditions, Medication, Patient Safety, Primary Care
Holtrop JS, Potworowski G, Fitzpatrick L
Effect of care management program structure on implementation: a normalization process theory analysis.
This study used normalization process theory (NPT) to understand how care management structure affected how well care management became routine in practice. It concluded that, although care management can introduce many new changes into delivery of clinical practice, implementing it successfully as a new complex intervention is possible. NPT can be helpful in explaining differences in implementing a new care management program.
AHRQ-funded; HS020108.
Citation: Holtrop JS, Potworowski G, Fitzpatrick L .
Effect of care management program structure on implementation: a normalization process theory analysis.
BMC Health Serv Res 2016 Aug 15;16(a):386. doi: 10.1186/s12913-016-1613-1.
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Keywords: Care Management, Chronic Conditions, Primary Care, Healthcare Delivery
Rivera-Hernandez M
Religiosity, social support and care associated with health in older Mexicans with diabetes.
This study examined the relationships between religiosity, social support, diabetes care and control, and self-rated health of people living in Mexico who have been diagnosed with diabetes. The author found that emotional support from one's spouse/partner directly affects diabetes care and control and health. No direct relationship between religiosity and health was found, but religiosity was positively associated with diabetes care and control.
AHRQ-funded; HS000011.
Citation: Rivera-Hernandez M .
Religiosity, social support and care associated with health in older Mexicans with diabetes.
J Relig Health 2016 Aug;55(4):1394-410. doi: 10.1007/s10943-015-0105-7.
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Keywords: Chronic Conditions, Diabetes, Elderly
Luo Z, Chen Q, Annis AM
A comparison of health plan- and provider-delivered chronic care management models on patient clinical outcomes.
Two contrasting strategies of chronic care management include provider-delivered care management (PDCM) and health plan-delivered care management (HPDCM). The researchers aimed to compare the effectiveness of PDCM vs. HPDCM on improving clinical outcomes for patients with chronic diseases. They found that in a commercially insured population, neither PDCM nor HPDCM resulted in substantial improvement in patients' clinical indicators in the first year.
AHRQ-funded; HS020108.
Citation: Luo Z, Chen Q, Annis AM .
A comparison of health plan- and provider-delivered chronic care management models on patient clinical outcomes.
J Gen Intern Med 2016 Jul;31(7):762-70. doi: 10.1007/s11606-016-3617-2.
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Keywords: Chronic Conditions, Care Management, Primary Care: Models of Care, Primary Care, Healthcare Delivery, Comparative Effectiveness, Patient-Centered Outcomes Research, Health Insurance
Wisk LE, Weitzman ER
Substance use patterns through early adulthood: results for youth with and without chronic conditions.
As there have been no nationally representative studies of substance use during this period for these medically vulnerable youth, the authors examined onset and intensification of these behaviors for a national sample of youth with and without chronic conditions. Youth with chronic medical conditions (YCMC) were more likely to engage in any and heavier substance use; transition years and early adulthood were periods of peak risk for YCMC compared with their healthy peers.
AHRQ-funded; HS000063.
Citation: Wisk LE, Weitzman ER .
Substance use patterns through early adulthood: results for youth with and without chronic conditions.
Am J Prev Med 2016 Jul;51(1):33-45. doi: 10.1016/j.amepre.2016.01.029.
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Keywords: Children/Adolescents, Children/Adolescents, Chronic Conditions, Substance Abuse, Young Adults
Kenzik KM, Kvale EA, Rocque GB
Treatment summaries and follow-up care instructions for cancer survivors: improving survivor self-efficacy and health care utilization.
The researchers examined the association of receiving summaries and care plans with cancer survivor self-efficacy for chronic illness management. They found that explanation of the follow-up care plan, beyond the written component, enhances survivor self-efficacy for managing cancer as a chronic condition-an important mediator for improving health care utilization outcomes.
AHRQ-funded; HS023009; HS013852.
Citation: Kenzik KM, Kvale EA, Rocque GB .
Treatment summaries and follow-up care instructions for cancer survivors: improving survivor self-efficacy and health care utilization.
Oncologist 2016 Jul;21(7):817-24. doi: 10.1634/theoncologist.2015-0517.
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Keywords: Cancer, Chronic Conditions, Education: Patient and Caregiver, Elderly, Patient Self-Management
Raval AD, Madhavan S, Mattes MD
Types of chronic conditions combinations and initial cancer treatment among elderly Medicare beneficiaries with localised prostate cancer.
The authors sought to examine the association between types of chronic conditions combinations and initial cancer treatment among elderly Medicare beneficiaries with localised prostate cancer. They found that a significant proportion of elderly men with chronic conditions have received aggressive initial cancer treatment, and they suggested a conservative approach for the initial prostate cancer treatment among elderly men with significant chronic conditions and localised prostate cancer.
AHRQ-funded; HS018622.
Citation: Raval AD, Madhavan S, Mattes MD .
Types of chronic conditions combinations and initial cancer treatment among elderly Medicare beneficiaries with localised prostate cancer.
Int J Clin Pract 2016 Jul;70(7):606-18. doi: 10.1111/ijcp.12838.
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Keywords: Cancer, Cancer: Prostate Cancer, Care Management, Chronic Conditions, Elderly, Men's Health