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 (3)
- Antibiotics (2)
- Arthritis (1)
- Behavioral Health (2)
- Blood Pressure (1)
- Blood Thinners (1)
- Cancer: Prostate Cancer (1)
- Cardiovascular Conditions (2)
- Catheter-Associated Urinary Tract Infection (CAUTI) (2)
- Children/Adolescents (4)
- Clinical Decision Support (CDS) (1)
- Clinician-Patient Communication (1)
- Clostridium difficile Infections (1)
- Communication (2)
- Diabetes (1)
- Diagnostic Safety and Quality (1)
- Disparities (1)
- Education: Patient and Caregiver (1)
- Electronic Health Records (EHRs) (1)
- Emergency Department (1)
- Emergency Medical Services (EMS) (1)
- Evidence-Based Practice (2)
- Guidelines (2)
- Healthcare-Associated Infections (HAIs) (3)
- Healthcare Cost and Utilization Project (HCUP) (1)
- Health Information Exchange (HIE) (1)
- Health Information Technology (HIT) (3)
- Health Status (1)
- Heart Disease and Health (2)
- Imaging (3)
- Maternal Care (1)
- Medicaid (1)
- Medical Devices (1)
- Medical Expenditure Panel Survey (MEPS) (1)
- Medication (10)
- Opioids (1)
- Pain (1)
- Patient-Centered Outcomes Research (2)
- Patient Experience (1)
- Patient Safety (4)
- Policy (2)
- (-) Practice Patterns (24)
- Pregnancy (2)
- Prevention (3)
- Primary Care (3)
- Provider: Health Personnel (1)
- Quality Improvement (1)
- Quality of Care (1)
- Racial and Ethnic Minorities (1)
- Registries (1)
- Risk (1)
- Screening (1)
- Shared Decision Making (3)
- U.S. Preventive Services Task Force (USPSTF) (1)
- Women (2)
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 24 of 24 Research Studies DisplayedMcCullagh LJ, Sofianou A, Kannry J
User centered clinical decision support tools: adoption across clinician training level.
This study examined the differences in adoption of CDS tools across providers’ training level. It found that the completion rates of the CDS calculator and medication order sets were higher among first year residents compared to all other training levels. Attending physicians were the less likely to accept the initial step of the CDS tool (29.3 percent) or complete the medication order sets (22.4 percent) that guided their prescription decisions.
AHRQ-funded; HS018491.
Citation: McCullagh LJ, Sofianou A, Kannry J .
User centered clinical decision support tools: adoption across clinician training level.
Appl Clin Inform 2014 Dec 17;5(4):1015-25. doi: 10.4338/aci-2014-05-ra-0048.
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Keywords: Clinical Decision Support (CDS), Shared Decision Making, Practice Patterns
Lee JL, Dy SM, Kravet SJ
Patient satisfaction and provider use of electronic communication: a cross-sectional analysis.
This cross sectional analysis examined provider patterns of communication with patients outside of the clinic setting via cellphone, email and text messaging and the relationship between communication behaviors and patient satisfaction. Among other conclusions, the investigators found that providers who made their email addresses available to patients had significantly higher overall satisfaction scores than those who did not, although there were no statistically significant differences in individual satisfaction domains.
AHRQ-funded; HS000029.
Citation: Lee JL, Dy SM, Kravet SJ .
Patient satisfaction and provider use of electronic communication: a cross-sectional analysis.
European Journal for Person Centered Healthcare 2014;5(4)..
Keywords: Communication, Health Information Technology (HIT), Patient Experience, Practice Patterns, Clinician-Patient Communication
Finnerty M, Neese-Todd S, Bilder S
Best practices: MEDNET: a multistate policy maker-researcher collaboration to improve prescribing practices.
The authors describe the Medicaid/ Mental Health Network for Evidence-Based Treatment (MEDNET), the first multistate Medicaid QI collaborative to focus on improving psychotropic prescribing. In particular, this article includes the development, infrastructure challenges, and early evidence of success of this public-academic partnership.
AHRQ-funded; HSO19937; HS021112.
Citation: Finnerty M, Neese-Todd S, Bilder S .
Best practices: MEDNET: a multistate policy maker-researcher collaboration to improve prescribing practices.
Psychiatr Serv 2014 Nov 1;65(11):1297-9. doi: 10.1176/appi.ps.201400343..
Keywords: Behavioral Health, Evidence-Based Practice, Medication, Medicaid, Practice Patterns
Kruger JF, Chen AH, Rybkin A
Clinician perspectives on considering radiation exposure to patients when ordering imaging tests: a qualitative study.
The authors examined outpatient clinician attitudes towards considering radiation exposure when ordering CT scans and clinician reactions to displaying radiation exposure information for CT scans at clinician electronic order entry. They found that displaying clinically relevant radiation exposure information at order entry may improve clinician knowledge and inform patient-clinician discussions regarding risks and benefits of imaging.
AHRQ-funded; HS018090.
Citation: Kruger JF, Chen AH, Rybkin A .
Clinician perspectives on considering radiation exposure to patients when ordering imaging tests: a qualitative study.
BMJ Qual Saf 2014 Nov;23(11):893-901. doi: 10.1136/bmjqs-2013-002773.
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Keywords: Shared Decision Making, Provider: Health Personnel, Imaging, Patient Safety, Practice Patterns
Kilaru AS, Gadsden SM, Perrone J
How do physicians adopt and apply opioid prescription guidelines in the emergency department? A qualitative study.
This qualitative study of emergency physicians attempted to gain insight into the adoption, use, and perceived relevance of opioid-prescribing guidelines. Most of the 61 participants interviewed in a convenience sample had a positive perspective on the intent and role of such guidelines and used them most commonly as communication tools with patients.
AHRQ-funded; HS021956.
Citation: Kilaru AS, Gadsden SM, Perrone J .
How do physicians adopt and apply opioid prescription guidelines in the emergency department? A qualitative study.
Ann Emerg Med 2014 Nov;64(5):482-89.e1. doi: 10.1016/j.annemergmed.2014.03.015.
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Keywords: Emergency Medical Services (EMS), Opioids, Pain, Guidelines, Practice Patterns
Yeh JS, Austad KE, Franklin JM
Association of medical students' reports of interactions with the pharmaceutical and medical device industries and medical school policies and characteristics: a cross-sectional study.
The study’s goal was to determine which medical school characteristics and which conflict of interest policy dimensions were most predictive of students’ reported behaviors. It found that students at schools with the highest ranked interaction policies based on the American Medical Student Association (AMSA) score were 63 percent less likely to accept gifts as students at the lowest ranked schools.
AHRQ-funded; HS018465.
Citation: Yeh JS, Austad KE, Franklin JM .
Association of medical students' reports of interactions with the pharmaceutical and medical device industries and medical school policies and characteristics: a cross-sectional study.
PLoS Med 2014 Oct;11(10):e1001743. doi: 10.1371/journal.pmed.1001743..
Keywords: Medical Devices, Medication, Policy, Practice Patterns
Fakih MG, Krein SL, Edson B
AHRQ Author: Battles JB
Engaging health care workers to prevent catheter-associated urinary tract infection and avert patient harm.
This article discusses catheter-associated urinary tract infection (CAUTI) prevention efforts, describes the national collaboration between different organizations, briefly reviews the technical and socio-adaptive components of the program, and specifically describes an approach to engaging health care workers as an essential part of CAUTI prevention and averting patient harm.
AHRQ-authored; AHRQ-funded; 290201000025I; 29032001T
Citation: Fakih MG, Krein SL, Edson B .
Engaging health care workers to prevent catheter-associated urinary tract infection and avert patient harm.
Am J Infect Control. 2014 Oct;42(10 Suppl):S223-9. doi: 10.1016/j.ajic.2014.03.355..
Keywords: Adverse Events, Catheter-Associated Urinary Tract Infection (CAUTI), Healthcare-Associated Infections (HAIs), Patient Safety, Prevention, Practice Patterns, Quality Improvement
Fakih MG, Krein SL, Edson B
AHRQ Author: Battles JB
Engaging health care workers to prevent catheter-associated urinary tract infection and avert patient harm.
The "On the CUSP: Stop CAUTI" initiative represents the single largest national effort to mitigate urinary catheter risk. The program brings together key organizations to assist hospitals by providing education and coaching support. Continuity is secured by integrating the process into the health care worker's daily routine activities.
AHRQ-authored; AHRQ-funded; 290201000025I; 29032001T.
Citation: Fakih MG, Krein SL, Edson B .
Engaging health care workers to prevent catheter-associated urinary tract infection and avert patient harm.
Am J Infect Control 2014 Oct;42(10 Suppl):S223-9. doi: 10.1016/j.ajic.2014.03.355.
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Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Healthcare-Associated Infections (HAIs), Patient Safety, Prevention, Practice Patterns
Cea Soriano L, Bateman BT, Garcia Rodriguez LA
Prescription of antihypertensive medications during pregnancy in the UK.
The authors aimed to describe the management of antihypertensive medications in pregnancy by general practitioners in the UK and compare it with current guidelines. Using electronic medical records from The Health Improvement Network database, they found that, in this population of UK pregnant women, prescription patterns of antihypertensive medications were dominated by recommended treatments, although some patients continued on contraindicated drugs throughout pregnancy or switched to preferred agents in a delayed fashion.
AHRQ-funded; HS018533.
Citation: Cea Soriano L, Bateman BT, Garcia Rodriguez LA .
Prescription of antihypertensive medications during pregnancy in the UK.
Pharmacoepidemiol Drug Saf 2014 Oct;23(10):1051-8. doi: 10.1002/pds.3641.
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Keywords: Blood Pressure, Pregnancy, Medication, Women, Practice Patterns
Mannion ML, Xie F, Curtis JR
Recent trends in medication usage for the treatment of juvenile idiopathic arthritis and the influence of tumor necrosis factor inhibitors.
The researchers investigated temporal trends in medication use among children diagnosed with juvenile idiopathic arthritis (JIA). They found that the use of tumor necrosis factor inhibitors (TNFi) in the treatment of JIA increased 2- to 3-fold from 2005 to 2012. New TNFi use was associated with decreased NSAID and oral glucocorticoids use. TNFi may be replacing, rather than complementing, methotrexate in the treatment of many patients.
AHRQ-funded; HS018517.
Citation: Mannion ML, Xie F, Curtis JR .
Recent trends in medication usage for the treatment of juvenile idiopathic arthritis and the influence of tumor necrosis factor inhibitors.
J Rheumatol 2014 Oct;41(10):2078-84. doi: 10.3899/jrheum.140012.
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Keywords: Children/Adolescents, Medication, Patient-Centered Outcomes Research, Practice Patterns, Arthritis
Fierro JL, Prasad PA, Localio AR
Variability in the diagnosis and treatment of group a streptococcal pharyngitis by primary care pediatricians.
The researchers compared practice patterns regarding the diagnosis and management of streptococcal pharyngitis across 25 pediatric primary care practices sharing an electronic health record. They found that only 18 of 222 clinicians wrote 50 percent of all broad-spectrum antibiotic prescriptions for children with group a streptococcus pharyngitis. They suggested targeted interventions to improve adherence to prescribing guidelines.
AHRQ-funded; 290200710013
Citation: Fierro JL, Prasad PA, Localio AR .
Variability in the diagnosis and treatment of group a streptococcal pharyngitis by primary care pediatricians.
Infect Control Hosp Epidemiol. 2014 Oct;35 Suppl 3:S79-85. doi: 10.1086/677820..
Keywords: Antibiotics, Children/Adolescents, Diagnostic Safety and Quality, Primary Care, Practice Patterns
Goodwin JS, Jaramillo E, Yang L
Is anyone listening? Variation in PSA screening among providers for men 75+ before and after United States Preventive Services Task Force recommendations against it: a retrospective cohort study.
The authors assessed prostate specific antigen (PSA) screening by primary care physicians (PCPs) before and after the 2008 United States Preventive Services Task Force (USPSTF) recommendations. They found that the USPSTF recommendation did not increase consensus among PCPs regarding PSA screening of older men.
AHRQ-funded; HS022134.
Citation: Goodwin JS, Jaramillo E, Yang L .
Is anyone listening? Variation in PSA screening among providers for men 75+ before and after United States Preventive Services Task Force recommendations against it: a retrospective cohort study.
PLoS One 2014 Sep 10;9(9):e107352. doi: 10.1371/journal.pone.0107352.
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Keywords: Cancer: Prostate Cancer, Practice Patterns, Primary Care, Screening, U.S. Preventive Services Task Force (USPSTF)
Pakyz AL, Ozcan YA
Use of data envelopment analysis to quantify opportunities for antibacterial targets for reduction of health care-associated Clostridium difficile infection.
The authors conducted a cross-sectional study using claims data from 58 hospitals to create a benchmark strategy targeting high-risk antibacterials for C difficile. Seventeen hospitals were identified as best-practice hospitals. They found that the antibacterial classes requiring the greatest percentage reduction in use in non-best-practice hospitals versus best-practice hospitals were clindamycin, β-lactam/β-lactamase combinations, and carbapenems.
AHRQ-funded; HS018578.
Citation: Pakyz AL, Ozcan YA .
Use of data envelopment analysis to quantify opportunities for antibacterial targets for reduction of health care-associated Clostridium difficile infection.
Am J Med Qual 2014 Sep-Oct;29(5):437-44. doi: 10.1177/1062860613502520.
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Keywords: Antibiotics, Clostridium difficile Infections, Guidelines, Healthcare-Associated Infections (HAIs), Practice Patterns
Goldsweig AM, Reid KJ, Gosch K
Contemporary use of dual antiplatelet therapy for preventing cardiovascular events.
The authors examined dual antiplatelet therapy (DAPT) use in contemporary clinical practice after publication of the results of the landmark randomized clinical trial CHARISMA. They found that use of DAPT is modest in patients with established cardiovascular disease, for whom the CHARISMA trial suggested decreased major adverse cardiovascular events (MACEs), and prescription rates have remained stable over time; use of DAPT in patients with multiple risk factors only, for whom CHARISMA suggested that DAPT may lead to increased MACEs, was low and decreased over time.
AHRQ-funded; HS018781.
Citation: Goldsweig AM, Reid KJ, Gosch K .
Contemporary use of dual antiplatelet therapy for preventing cardiovascular events.
Am J Manag Care 2014 Aug;20(8):659-65.
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Keywords: Cardiovascular Conditions, Medication, Prevention, Practice Patterns, Risk
Hollingsworth JM, Sakshaug JW, Zhang Y
In-office imaging capabilities among procedure-based specialty practices.
The authors sought to determine whether arrangements tailored to fit Stark law spur utilization. They found that the availability of in-office advanced imaging is associated with increased imaging use.
AHRQ-funded; HS020927; HS018726.
Citation: Hollingsworth JM, Sakshaug JW, Zhang Y .
In-office imaging capabilities among procedure-based specialty practices.
Surg Innov 2014 Aug;21(4):403-8. doi: 10.1177/1553350613505715.
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Keywords: Ambulatory Care and Surgery, Quality of Care, Imaging, Practice Patterns
Johnson EK, Graham DA, Chow JS
Nationwide emergency department imaging practices for pediatric urolithiasis: room for improvement.
The researchers describe the national use of computed tomography (CT) versus ultrasound imaging for pediatric patients seen at emergency departments (EDs) for suspected urolithiasis (SU) during the period 2006-2010. Use of CT was much higher than use of ultrasound, although it dropped off after 2007. Lowest CT use was seen at EDs that care for more children.
AHRQ-funded; HS019485
Citation: Johnson EK, Graham DA, Chow JS .
Nationwide emergency department imaging practices for pediatric urolithiasis: room for improvement.
J Urol. 2014 Jul;192(1):200-6. doi: 10.1016/j.juro.2014.01.028..
Keywords: Children/Adolescents, Emergency Department, Healthcare Cost and Utilization Project (HCUP), Imaging, Children/Adolescents, Practice Patterns
Larkin I, Ang D, Avorn J
Restrictions on pharmaceutical detailing reduced off-label prescribing of antidepressants and antipsychotics in children.
The researchers estimated the effect of anti-detailing policies on off-label prescribing of antidepressants and antipsychotics by pediatricians and by child and adolescent psychiatrists in the period January 2006-June 2009. They found that prescriptions for off-label use of promoted drugs fell by 11 percent and that prescriptions for on-label use of promoted drugs fell by 34 percent. Conversely, prescriptions for on-label use of nonpromoted drugs rose by 14 percent, and those for off-label use of nonpromoted drugs rose by 35 percent. They concluded that these results suggest that pharmaceutical sales representatives promoted drugs not approved for pediatric use and that policies that restrict detailing by those representatives reduced such off-label prescribing.
AHRQ-funded; HS018465.
Citation: Larkin I, Ang D, Avorn J .
Restrictions on pharmaceutical detailing reduced off-label prescribing of antidepressants and antipsychotics in children.
Health Aff 2014 Jun;33(6):1014-23. doi: 10.1377/hlthaff.2013.0939.
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Keywords: Medication, Children/Adolescents, Communication, Policy, Practice Patterns
Camelo Castillo W, Boggess K, Stürmer T
Trends in glyburide compared with insulin use for gestational diabetes treatment in the United States, 2000-2011.
The researchers sought to characterize pharmacologic treatment of women with gestational diabetes (GDM) by describing trends in the use of glyburide compared with insulin over the past decade (2000-2011) and identifying predictors of initial choice of pharmacotherapy. They found that glyburide has replaced insulin as the more common pharmacotherapy for GDM among those privately insured.
AHRQ-funded; HS017950
Citation: Camelo Castillo W, Boggess K, Stürmer T .
Trends in glyburide compared with insulin use for gestational diabetes treatment in the United States, 2000-2011.
Obstet Gynecol. 2014 Jun;123(6):1177-84. doi: 10.1097/AOG.0000000000000285..
Keywords: Diabetes, Maternal Care, Medication, Practice Patterns, Pregnancy, Women
Del Fiol G, Workman TE, Gorman PN
Clinical questions raised by clinicians at the point of care: a systematic review.
The researchers conducted a systematic review of studies examining the questions that clinicians raise in the context of patient care decisionmaking. They concluded that clinicians frequently raise questions about patient care in their practice. Although they are effective at finding answers to questions they pursue, roughly half of the questions are never pursued.
AHRQ-funded; HS018352.
Citation: Del Fiol G, Workman TE, Gorman PN .
Clinical questions raised by clinicians at the point of care: a systematic review.
JAMA Intern Med. 2014 May;174(5):710-8. doi: 10.1001/jamainternmed.2014.368..
Keywords: Education: Patient and Caregiver, Shared Decision Making, Health Information Exchange (HIE), Health Information Technology (HIT), Practice Patterns
Armstrong EP, Wang SM, Hines LE
Prescriber perceptions of a near real-time fax alert program for potential drug-drug interactions.
The purpose of this study was to determine whether prescribers thought that near real-time fax alerts for potential drug-drug interactions (PDDIs) were a good way to communicate with them. The researchers found that physician perceptions of the value of the fax alerts were dependent on which combination of drugs was involved.
AHRQ-funded; HS017001
Citation: Armstrong EP, Wang SM, Hines LE .
Prescriber perceptions of a near real-time fax alert program for potential drug-drug interactions.
J Manag Care Spec Pharm. 2014 May;20(5):494-500a..
Keywords: Adverse Drug Events (ADE), Health Information Technology (HIT), Medication, Patient Safety, Practice Patterns
O'Brien EC, Holmes DN, Ansell JE
Physician practices regarding contraindications to oral anticoagulation in atrial fibrillation: findings from the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF) registry.
This study describes the frequencies of and factors associated with oral anticoagulation (OAC) contraindications in clinical practice for patients with atrial fibrillation (AF). Contraindications to OAC therapy among patients with AF are common but subjective. Many patients with reported contraindications were receiving OAC, suggesting that the perceived benefits outweighed the potential harm posed by the relative contraindication.
AHRQ-funded; HS021092
Citation: O'Brien EC, Holmes DN, Ansell JE .
Physician practices regarding contraindications to oral anticoagulation in atrial fibrillation: findings from the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF) registry.
Am Heart J. 2014 Apr;167(4):601-609.e1. doi: 10.1016/j.ahj.2013.12.014..
Keywords: Heart Disease and Health, Blood Thinners, Medication, Registries, Cardiovascular Conditions, Patient-Centered Outcomes Research, Evidence-Based Practice, Practice Patterns
Cook BL, Zuvekas SH, Carson N
AHRQ Author: Zuvekas SH
Assessing racial/ethnic disparities in treatment across episodes of mental health care.
The authors investigated disparities in mental health care episodes, aligning their analyses with decisions to start or drop treatment, and choices made during treatment. Using MEPS data, they found that, compared with whites, blacks and Latinos had less initiation and adequacy of care. Black and Latino episodes were shorter and had fewer psychotropic drug fills; black episodes had a greater proportion of specialist visits and Latino episodes had a greater proportion of primary care physician visits. Blacks were more likely to have an episode with acute psychiatric care.
AHRQ-authored.
Citation: Cook BL, Zuvekas SH, Carson N .
Assessing racial/ethnic disparities in treatment across episodes of mental health care.
Health Serv Res 2014 Feb;49(1):206-29. doi: 10.1111/1475-6773.12095.
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Keywords: Disparities, Medical Expenditure Panel Survey (MEPS), Behavioral Health, Practice Patterns, Racial and Ethnic Minorities
Goldberger ZD, Alexander GC
Digitalis use in contemporary clinical practice: refitting the foxglove.
The researchers hypothesized that digoxin use for systolic heart failure (HF) has decreased during the past 15 years, despite clinical guidelines supporting its use. They fund that there has been a marked reduction in ambulatory digoxin use in the United States since 1997, with the largest declines in use observed from 1997 through 2001, and especially for patients with HF.
AHRQ-funded; HS018960.
Citation: Goldberger ZD, Alexander GC .
Digitalis use in contemporary clinical practice: refitting the foxglove.
JAMA Intern Med 2014 Jan;174(1):151-4. doi: 10.1001/jamainternmed.2013.10432..
Keywords: Heart Disease and Health, Medication, Ambulatory Care and Surgery, Practice Patterns
James KA, Fernald DH, Huff J
AHRQ Author: Ricciardi R
GAPS in implementing health assessments in primary care: a literature review.
The authors conducted a systematic review of literature about health assessments in ambulatory and primary care. They found that training and standardization of practice workflows improves implementation of health assessments, but gaps remain on identification and selection of health assessments, integration with electronic health records, and optimal intervals of health assessments administration.
AHRQ-authored; AHRQ-funded; 29020071008.
Citation: James KA, Fernald DH, Huff J .
GAPS in implementing health assessments in primary care: a literature review.
J Ambul Care Manage 2014 Jan-Mar;37(1):2-10. doi: 10.1097/jac.0000000000000000.
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Keywords: Electronic Health Records (EHRs), Health Status, Ambulatory Care and Surgery, Primary Care, Practice Patterns