National Healthcare Quality and Disparities Report
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Topics
- Adverse Drug Events (ADE) (1)
- Adverse Events (1)
- Antibiotics (1)
- Arthritis (1)
- Asthma (1)
- Back Health and Pain (2)
- Blood Thinners (1)
- Cardiovascular Conditions (4)
- Care Management (2)
- (-) Chronic Conditions (22)
- Community-Based Practice (1)
- (-) Comparative Effectiveness (22)
- Complementary and Alternative Medicine (2)
- Diabetes (1)
- Education: Patient and Caregiver (1)
- Elderly (2)
- Evidence-Based Practice (8)
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- Health Information Technology (HIT) (2)
- Health Insurance (1)
- Heart Disease and Health (2)
- Home Healthcare (1)
- Human Immunodeficiency Virus (HIV) (1)
- Injuries and Wounds (1)
- Medical Devices (1)
- Medicare (1)
- Medication (8)
- Opioids (1)
- Outcomes (10)
- Pain (2)
- Patient-Centered Outcomes Research (11)
- Patient Adherence/Compliance (2)
- Patient Self-Management (1)
- Primary Care (1)
- Primary Care: Models of Care (1)
- Racial and Ethnic Minorities (1)
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- Risk (1)
- Social Media (1)
- Surgery (2)
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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 22 of 22 Research Studies DisplayedBrown CS, Obi AT, Cronenwett JL
Outcomes after truncal ablation with or without concomitant phlebectomy for isolated symptomatic varicose veins (C2 disease).
This study looked outcomes of patients with varicose veins (C2 disease) who were treated with venous ablation alone or ablation plus phlebectomy using the Vascular Quality Initiative Varicose Vein Registry. Data between January 2015 and March 2015 was used to investigate postoperative as well as long-term clinical and patient-reported outcomes among patients with documented symptomatic C2 disease undergoing truncal endovenous ablations alone and combined ablation and phlebectomy. Out of 3375 patients, 40.1% underwent isolated truncal ablation and the rest had the combined procedure of ablation and phlebectomy. Complications were low for both procedures (8.4% and 8.7%). Overall, improvement in symptoms was experienced by 94.4% of patients with more increases in patients undergoing ablation and phlebectomy than ablation alone. Both procedures are recommended by the authors to be covered by insurance.
AHRQ-funded; HS000053.
Citation: Brown CS, Obi AT, Cronenwett JL .
Outcomes after truncal ablation with or without concomitant phlebectomy for isolated symptomatic varicose veins (C2 disease).
J Vasc Surg Venous Lymphat Disord 2021 Mar;9(2):369-76. doi: 10.1016/j.jvsv.2020.05.016..
Keywords: Cardiovascular Conditions, Chronic Conditions, Surgery, Outcomes, Patient-Centered Outcomes Research, Comparative Effectiveness, Evidence-Based Practice
Brown CS, Osborne NH, Kim GY
Comparison of unilateral vs bilateral and staged bilateral vs concurrent bilateral truncal endovenous ablation in the Vascular Quality Initiative.
This study compares outcomes in patients who have undergone unilateral vs bilateral venous ablation procedures or between staged and concurrent bilateral procedures. Data from the Vascular Quality Initiative from 2015 to 2019 was used to investigate immediate postoperative as well as long-term clinical and patient-reported outcomes. A total of 5029 patients were included, of whom 75.2% underwent unilateral procedures. Follow-up was conducted with a median of 227 days after. Unilateral patients were less likely to be female and white and had lower BMI compared with patients undergoing bilateral procedures. In addition, unilateral patients had fewer prior varicose vein treatments and had higher Venous Clinical Severity Scores (VCSS). There were no differences in complications in patients undergoing unilateral vs bilateral procedures. Systemic complications were rare in both groups.
AHRQ-funded; HS000053.
Citation: Brown CS, Osborne NH, Kim GY .
Comparison of unilateral vs bilateral and staged bilateral vs concurrent bilateral truncal endovenous ablation in the Vascular Quality Initiative.
J Vasc Surg Venous Lymphat Disord 2021 Jan;9(1):113-21.e3. doi: 10.1016/j.jvsv.2020.05.008..
Keywords: Cardiovascular Conditions, Chronic Conditions, Surgery, Outcomes, Patient-Centered Outcomes Research, Comparative Effectiveness, Evidence-Based Practice
Presley C, Agne A, Shelton T
Mobile-enhanced peer support for African Americans with Type 2 diabetes: a randomized controlled trial.
This study compared the effectiveness of a community-based diabetes self-management education (DSME) plus mobile health (mHealth)-enhanced peer support intervention to community-based DSME alone for African American adults with poorly controlled type 2 diabetes. This randomized controlled trial took place in Jefferson County, Alabama within a safety-net healthcare system with a group diagnosed with type 2 diabetes and hemoglobin A1C ≥ 7.5%. The intervention group reviewed community-based DSME plus 6 months of mHealth-enhanced peer support, including 12 weekly phone calls, then 3 monthly calls from community health workers. The control group received community based DSME only. Primary outcomes were lower A1C and secondary outcomes were lower diabetes distress, depressive symptoms, self-efficacy or confidence in their ability to manage diabetes, and social support. Of 120 participants selected, 97 completed the study. Both groups experienced clinical meaning reduction in A1C. Participants in the intervention group experienced a significantly larger reduction in diabetes distress compared to the control group.
AHRQ-funded; HS019465.
Citation: Presley C, Agne A, Shelton T .
Mobile-enhanced peer support for African Americans with Type 2 diabetes: a randomized controlled trial.
J Gen Intern Med 2020 Oct;35(10):2889-96. doi: 10.1007/s11606-020-06011-w..
Keywords: Telehealth, Health Information Technology (HIT), Patient Self-Management, Diabetes, Chronic Conditions, Racial and Ethnic Minorities, Community-Based Practice, Comparative Effectiveness, Patient-Centered Outcomes Research, Evidence-Based Practice, Outcomes, Education: Patient and Caregiver
Dobler CC, Morrow AS, Beuschel B
Pharmacologic therapies in patients with exacerbation of chronic obstructive pulmonary disease: a systematic review with meta-analysis.
The authors evaluated the comparative effectiveness and adverse events of pharmacologic interventions for adults with exacerbation of COPD. Sixty-eight randomized controlled trials were selected for evaluation and data extraction. They found that antibiotics and systemic corticosteroids reduced treatment failure in adults with mild to severe exacerbation of COPD.
AHRQ-funded.
Citation: Dobler CC, Morrow AS, Beuschel B .
Pharmacologic therapies in patients with exacerbation of chronic obstructive pulmonary disease: a systematic review with meta-analysis.
Ann Intern Med 2020 Mar 17;172(6):413-23. doi: 10.7326/m19-3007..
Keywords: Respiratory Conditions, Chronic Conditions, Evidence-Based Practice, Patient-Centered Outcomes Research, Comparative Effectiveness, Medication, Antibiotics, Treatments, Adverse Drug Events (ADE), Adverse Events
Mentias A, Shantha G, Chaudhury P
Assessment of outcomes of treatment with oral anticoagulants in patients with atrial fibrillation and multiple chronic conditions: a comparative effectiveness analysis.
The purpose of this retrospective comparative effectiveness analysis was to determine whether there are differences in efficacy and safety of dabigatran, rivaroxaban, and warfarin regarding stroke prevention and bleeding rates, respectively, in elderly patients with atrial fibrillation (AF) with multiple chronic conditions (MCC). The investigators concluded that oral anticoagulants were similarly effective in stroke prevention among patients with AF with MCC. However, the indicate that dabigatran and rivaroxaban use may be associated with lower rates of mortality in patients with MCC.
AHRQ-funded; HS023104.
Citation: Mentias A, Shantha G, Chaudhury P .
Assessment of outcomes of treatment with oral anticoagulants in patients with atrial fibrillation and multiple chronic conditions: a comparative effectiveness analysis.
JAMA Netw Open 2018 Sep 7;1(5):e182870. doi: 10.1001/jamanetworkopen.2018.2870..
Keywords: Blood Thinners, Heart Disease and Health, Cardiovascular Conditions, Outcomes, Patient-Centered Outcomes Research, Medication, Evidence-Based Practice, Comparative Effectiveness, Chronic Conditions
Chou R, Deyo R, Friedly J
Nonpharmacologic therapies for low back pain: a systematic review for an American College of Physicians clinical practice guideline.
The researchers systematically reviewed the current evidence on nonpharmacologic therapies for acute or chronic nonradicular or radicular low back pain. They found that several nonpharmacologic therapies for primarily chronic low back pain are associated with small to moderate, usually short-term effects on pain; findings include new evidence on mind-body interventions.
AHRQ-funded; 290201200014I.
Citation: Chou R, Deyo R, Friedly J .
Nonpharmacologic therapies for low back pain: a systematic review for an American College of Physicians clinical practice guideline.
Ann Intern Med 2017 Apr 4;166(7):493-505. doi: 10.7326/m16-2459.
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Keywords: Back Health and Pain, Chronic Conditions, Comparative Effectiveness, Outcomes, Evidence-Based Practice
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
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
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
Chou R, Hashimoto R, Friedly J
Epidural corticosteroid injections for radiculopathy and spinal stenosis: a systematic review and meta-analysis.
The researchers reviewed evidence on the benefits and harms of epidural corticosteroid injections in adults with radicular low back pain or spinal stenosis of any duration. They concluded that epidural corticosteroid injections for radiculopathy were associated with immediate reductions in pain and function. However, benefits were small and not sustained, and there was no effect on long-term surgery risk.
AHRQ-funded; 290201200014I.
Citation: Chou R, Hashimoto R, Friedly J .
Epidural corticosteroid injections for radiculopathy and spinal stenosis: a systematic review and meta-analysis.
Ann Intern Med 2015 Sep 1;163(5):373-81. doi: 10.7326/m15-0934.
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Keywords: Medication, Back Health and Pain, Chronic Conditions, Comparative Effectiveness, Evidence-Based Practice
Shah ED, Siegel CA, Chong K
Patients with Crohn's disease are more likely to remain on biologics than immunomodulators: a meta-analysis of treatment durability.
The researchers aimed to clarify treatment durability by assessing subject discontinuations from clinical trials in the context of treatment efficacy. They found that for patients with Crohn’s disease, biologic therapies had higher durability than immunomodulators for induction and maintenance therapy.
AHRQ-funded; HS021747.
Citation: Shah ED, Siegel CA, Chong K .
Patients with Crohn's disease are more likely to remain on biologics than immunomodulators: a meta-analysis of treatment durability.
Dig Dis Sci 2015 Aug;60(8):2408-18. doi: 10.1007/s10620-015-3618-8..
Keywords: Patient Adherence/Compliance, Medication, Chronic Conditions, Comparative Effectiveness
Rhee SM, Valle MF, Wilson LM
Negative pressure wound therapy technologies for chronic wound care in the home setting: a systematic review.
The researchers conducted a systematic review on the efficacy and safety of negative pressure wound therapy (NPWT) for the treatment of chronic wounds in the home setting. Data were limited by variability in the types of comparator groups, methodological limitations, and poor reporting of outcomes. The researchers were unable to draw conclusions about the efficacy or safety of NPWT for the treatment of chronic wounds in the home setting due to the insufficient evidence.
AHRQ-funded; 290201200007I.
Citation: Rhee SM, Valle MF, Wilson LM .
Negative pressure wound therapy technologies for chronic wound care in the home setting: a systematic review.
Wound Repair Regen 2015 Jul-Aug;23(4):506-17. doi: 10.1111/wrr.12295..
Keywords: Injuries and Wounds, Home Healthcare, Comparative Effectiveness, Treatments, Chronic Conditions
Guillory J, Chang P, Henderson CR
Piloting a text message-based social support intervention for patients with chronic pain: establishing feasibility and preliminary efficacy.
This pilot study examined the effectiveness of a short message service (SMS) text message–based social support intervention through mobile technology for pain attenuation and improving positive affect in a sample of patients with chronic noncancer pain. Findings show that this novel social support intervention reduced perceptions of pain and pain interference and improved positive affect among patients randomized to the intervention condition.
AHRQ-funded; HS020648.
Citation: Guillory J, Chang P, Henderson CR .
Piloting a text message-based social support intervention for patients with chronic pain: establishing feasibility and preliminary efficacy.
Clin J Pain 2015 Jun;31(6):548-56. doi: 10.1097/ajp.0000000000000193..
Keywords: Comparative Effectiveness, Chronic Conditions, Health Information Technology (HIT), Social Media
Chou R, Turner JA, Devine EB
The effectiveness and risks of long-term opioid therapy for chronic pain: a systematic review for a National Institutes of Health Pathways to Prevention Workshop.
This systematic review evaluated evidence on the effectiveness and harms of long-term (more than 3 months) opiod therapy for chronic pain in adults. It concluded that evidence is insufficient to determine the effectiveness of this therapy for improving chronic pain and function.
AHRQ-funded; 290201200014I
Citation: Chou R, Turner JA, Devine EB .
The effectiveness and risks of long-term opioid therapy for chronic pain: a systematic review for a National Institutes of Health Pathways to Prevention Workshop.
Ann Intern Med. 2015 Feb 17;162(4):276-86. doi: 10.7326/M14-2559..
Keywords: Chronic Conditions, Comparative Effectiveness, Medication, Opioids, Outcomes, Pain, Patient-Centered Outcomes Research
Mowrer JL, Tapp H, Ludden T
Patients' and providers' perceptions of asthma and asthma care: a qualitative study.
The primary goal of this qualitative study was to further explore patient and provider perceptions of asthma and asthma care as part of a larger Asthma Comparative Effectiveness Study. Three overarching themes, with a variety of subthemes, emerged as the main findings of this study. The three main themes were Cost/Economic Barriers/Process, Self-Governance/Adherence and Education.
AHRQ-funded; HS019946.
Citation: Mowrer JL, Tapp H, Ludden T .
Patients' and providers' perceptions of asthma and asthma care: a qualitative study.
J Asthma 2015;52(9):949-56. doi: 10.3109/02770903.2015.1010731..
Keywords: Asthma, Comparative Effectiveness, Patient Adherence/Compliance, Chronic Conditions
Friedly JL, Comstock BA, Turner JA
A randomized trial of epidural glucocorticoid injections for spinal stenosis.
The researchers designed the Lumbar Epidural Steroid Injections for Spinal Stenosis trial to compare the effectiveness of epidural injections of glucocorticoids plus anesthetic with injections of anesthetic alone in patients with lumbar spinal stenosis. They found that epidural injection of glucocorticoids plus lidocaine offered minimal or no short-term benefit as compared with lidocaine alone.
AHRQ-funded; HS019222
Citation: Friedly JL, Comstock BA, Turner JA .
A randomized trial of epidural glucocorticoid injections for spinal stenosis.
N Engl J Med. 2014 Jul 3;371(1):11-21. doi: 10.1056/NEJMoa1313265..
Keywords: Comparative Effectiveness, Chronic Conditions, Elderly, Outcomes
Thacker EL, Muntner P, Zhao H
Claims-based algorithms for identifying Medicare beneficiaries at high estimated risk for coronary heart disease events: a cross-sectional study.
The researchers sought to develop claims-based algorithms to identify individuals at high risk for coronary artery disease (CHD) and to identify low-density lipoprotein (LDL) cholesterol among statin users at high risk for CHD events. They found that despite low sensitivity, the high predictive value of their algorithm for high risk for CHD events supports the use of claims to identify Medicare beneficiaries at high risk for CHD events.
AHRQ-funded; HS018517
Citation: Thacker EL, Muntner P, Zhao H .
Claims-based algorithms for identifying Medicare beneficiaries at high estimated risk for coronary heart disease events: a cross-sectional study.
BMC Health Serv Res. 2014 Apr 29;14:195. doi: 10.1186/1472-6963-14-195..
Keywords: Comparative Effectiveness, Medicare, Risk, Cardiovascular Conditions, Chronic Conditions
Bannuru RR, Flavin NE, Vaysbrot E
High-energy extracorporeal shock-wave therapy for treating chronic calcific tendinitis of the shoulder: a systematic review.
Calcific and noncalcific tendinitis of the shoulder can be unresponsive to conventional therapies. Extracorporeal shock-wave therapy (ESWT) has been suggested as an alternative treatment. The purpose of this study was to assess the efficacy of ESWT in patients with calcific and noncalcific tendinitis. The investigators found that high-energy ESWT was effective for improving pain and shoulder function in chronic calcific shoulder tendinitis and can result in complete resolution of calcifications.
AHRQ-funded; HS017960.
Citation: Bannuru RR, Flavin NE, Vaysbrot E .
High-energy extracorporeal shock-wave therapy for treating chronic calcific tendinitis of the shoulder: a systematic review.
Ann Intern Med 2014 Apr 15;160(8):542-9. doi: 10.7326/m13-1982..
Keywords: Chronic Conditions, Comparative Effectiveness, Complementary and Alternative Medicine, Patient-Centered Outcomes Research
Bannuru RR, Flavin NE, Vaysbrot E
High-energy extracorporeal shock-wave therapy for treating chronic calcific tendinitis of the shoulder: a systematic review.
Calcific and noncalcific tendinitis of the shoulder can be unresponsive to conventional therapies. Extracorporeal shock-wave therapy (ESWT) has been suggested as an alternative treatment. The purpose of this study was to assess the efficacy of ESWT in patients with calcific and noncalcific tendinitis. The investigators found that high-energy ESWT was effective for improving pain and shoulder function in chronic calcific shoulder tendinitis and can result in complete resolution of calcifications.
AHRQ-funded; HS017960.
Citation: Bannuru RR, Flavin NE, Vaysbrot E .
High-energy extracorporeal shock-wave therapy for treating chronic calcific tendinitis of the shoulder: a systematic review.
Ann Intern Med 2014 Apr 15;160(8):542-9. doi: 10.7326/m13-1982..
Keywords: Chronic Conditions, Comparative Effectiveness, Complementary and Alternative Medicine, Patient-Centered Outcomes Research
Bressler B, Siegel CA
Beware of the swinging pendulum: anti-tumor necrosis factor monotherapy vs combination therapy for inflammatory bowel disease.
An editorial commenting on a study in the same issue by Osterman, et al. in the context of related studies concludes that it is more reasonable to consider slightly modifying the approach to anti-tumor necrosis factor combination therapy as opposed to a full pendulum swing back to monotherapy.
AHRQ-funded; HS021747
Citation: Bressler B, Siegel CA .
Beware of the swinging pendulum: anti-tumor necrosis factor monotherapy vs combination therapy for inflammatory bowel disease.
Gastroenterolog.y 2014 Apr;146(4):884-7. doi: 10.1053/j.gastro.2014.02.018..
Keywords: Comparative Effectiveness, Outcomes, Patient-Centered Outcomes Research, Medication, Chronic Conditions
Al-Khatib SM, Han JY, Edwards R
Do patients with a left ventricular ejection fraction between 30% and 35% benefit from a primary prevention implantable cardioverter defibrillator?
The researchers used data from randomized clinical trials involving patients with systolic heart failure who had received implantable cardioverter-defibrillators and compared outcomes for those whose left ventricular ejection fractions (LVEFs) was between 30 percent and 35 percent with those whose LVEF was less than 30 percent. The sample size was too small to permit any important conclusions.
AHRQ-funded; HS018505
Citation: Al-Khatib SM, Han JY, Edwards R .
Do patients with a left ventricular ejection fraction between 30% and 35% benefit from a primary prevention implantable cardioverter defibrillator?
Int J Cardiol. 2014 Mar 1;172(1):253-4. doi: 10.1016/j.ijcard.2013.12.278..
Keywords: Comparative Effectiveness, Outcomes, Medical Devices, Heart Disease and Health, Chronic Conditions
Navarro-Millán I, Sattui SE, Curtis JR
Systematic review of tumor necrosis factor inhibitor discontinuation studies in rheumatoid arthritis.
The objective of this article is to conduct a systematic review of the available literature on discontinuation of anti-tumor necrosis factor (anti-TNF) agents in rheumatoid arthritis (RA) patients and the associated features of study designs, including eligibility criteria, outcome definitions, and outcomes of discontinuation. The authors concluded that discontinuation of anti-TNF therapy is achievable for many RA patients who start in clinical remission or low disease activity.
AHRQ-funded; HS018517
Citation: Navarro-Millán I, Sattui SE, Curtis JR .
Systematic review of tumor necrosis factor inhibitor discontinuation studies in rheumatoid arthritis.
Clin Ther. 2013 Nov;35(11):1850-61.e1. doi: 10.1016/j.clinthera.2013.09.015..
Keywords: Comparative Effectiveness, Outcomes, Arthritis, Medication, Chronic Conditions