National Healthcare Quality and Disparities Report
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Topics
- Adverse Drug Events (ADE) (3)
- Adverse Events (1)
- Ambulatory Care and Surgery (1)
- Arthritis (1)
- Blood Pressure (5)
- Cancer (1)
- Cancer: Prostate Cancer (1)
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- (-) Diabetes (92)
- Diagnostic Safety and Quality (5)
- Disparities (4)
- Education: Patient and Caregiver (6)
- Elderly (6)
- Electronic Health Records (EHRs) (10)
- Electronic Prescribing (E-Prescribing) (1)
- Eye Disease and Health (3)
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- Newborns/Infants (1)
- Obesity (6)
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- Outcomes (7)
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- Patient-Centered Outcomes Research (8)
- Patient Adherence/Compliance (7)
- Patient and Family Engagement (1)
- Patient Experience (1)
- Patient Safety (2)
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- Practice Patterns (4)
- Pregnancy (5)
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- Provider: Health Personnel (1)
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- Quality Indicators (QIs) (1)
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- Quality of Life (2)
- Racial and Ethnic Minorities (11)
- Research Methodologies (1)
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- Screening (3)
- Sex Factors (1)
- Shared Decision Making (1)
- Social Determinants of Health (3)
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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 92 Research Studies DisplayedMcCoy RG, Van Houten HK, Ross JS
HbA1c overtesting and overtreatment among US adults with controlled type 2 diabetes, 2001-13: observational population based study.
The researchers sought to determine the extent and effect of excessive testing for glycated hemoglobin (HbA1c) among adults with controlled type 2 diabetes. They found that in a US cohort of adults with stable and controlled type 2 diabetes, more than 60% received too many HbA1c tests, a practice associated with potential overtreatment with hypoglycemic drugs.
AHRQ-funded; HS018339.
Citation: McCoy RG, Van Houten HK, Ross JS .
HbA1c overtesting and overtreatment among US adults with controlled type 2 diabetes, 2001-13: observational population based study.
BMJ 2015 Dec 8;351:h6138. doi: 10.1136/bmj.h6138..
Keywords: Chronic Conditions, Diabetes, Healthcare Utilization, Medication, Patient-Centered Outcomes Research
Quan J, Lee AK, Handley MA
Automated telephone self-management support for diabetes in a low-income health plan: a health care utilization and cost analysis.
The objective was to determine whether automated telephone self-management support for low-income, linguistically diverse health plan members with diabetes affects health care utilization or cost. It found no significant differences in emergency department visits and hospitalizations or in costs.
AHRQ-funded; HS020684; HS017261; HS022561.
Citation: Quan J, Lee AK, Handley MA .
Automated telephone self-management support for diabetes in a low-income health plan: a health care utilization and cost analysis.
Popul Health Manag 2015 Dec;18(6):412-20. doi: 10.1089/pop.2014.0154.
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Keywords: Diabetes, Chronic Conditions, Patient Self-Management, Low-Income, Healthcare Costs
Pillay J, Armstrong MJ, Butalia S
Behavioral programs for type 1 diabetes mellitus: a systematic review and meta-analysis.
The purpose of this review and meta-analysis was to determine the effects of behavioral programs for patients with type 1 diabetes on behavioral, clinical, and health outcomes and to investigate factors that might moderate effect. It concluded that behavioral programs for type 1 diabetes offer some benefit for glycemic control, at least at short-term follow-up, but improvement for other outcomes has not been shown.
AHRQ-funded; 2902012000131.
Citation: Pillay J, Armstrong MJ, Butalia S .
Behavioral programs for type 1 diabetes mellitus: a systematic review and meta-analysis.
Ann Intern Med 2015 Dec 1;163(11):836-47. doi: 10.7326/m15-1399..
Keywords: Diabetes, Education: Patient and Caregiver, Patient Self-Management, Patient-Centered Outcomes Research, Lifestyle Changes, Chronic Conditions
Pillay J, Armstrong MJ, Butalia S
Behavioral programs for type 2 diabetes mellitus: a systematic review and network meta-analysis.
The purpose of this review was to identify factors moderating the effectiveness of behavioral programs for adults with type 2 diabetes. It concluded that diabetes self-management education offering 10 or fewer hours of contact with delivery personnel provided little benefit. Behavioral programs seem to benefit persons with suboptimal or poor glycemic control more than those with good control.
AHRQ-funded; 2902012000131.
Citation: Pillay J, Armstrong MJ, Butalia S .
Behavioral programs for type 2 diabetes mellitus: a systematic review and network meta-analysis.
Ann Intern Med 2015 Dec 1;163(11):848-60. doi: 10.7326/m15-1400..
Keywords: Diabetes, Education: Patient and Caregiver, Patient Self-Management, Patient-Centered Outcomes Research, Lifestyle Changes, Chronic Conditions
Graetz I, Huang J, Brand R
The impact of electronic health records and teamwork on diabetes care quality.
The researchers examined whether team cohesion among primary care team members changed the association between EHR use and changes in clinical outcomes for patients with diabetes. They found that patients cared for by higher cohesion primary care teams experienced modest but statistically significantly greater EHR-related health outcome improvements, compared with patients cared for by providers practicing in lower cohesion teams.
AHRQ-funded; HS015280; HS021082.
Citation: Graetz I, Huang J, Brand R .
The impact of electronic health records and teamwork on diabetes care quality.
Am J Manag Care 2015 Dec;21(12):878-84.
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Keywords: Diabetes, Electronic Health Records (EHRs), Quality of Care, Primary Care, Teams
Stuart BC, Davidoff AJ, Erten MZ
AHRQ Author: Davidoff AJ
Changes in medication management after a diagnosis of cancer among Medicare beneficiaries with diabetes.
The researchers sought to determine whether a new cancer diagnosis is associated with changes in medication adherence among Medicare beneficiaries with diabetes. They concluded that cancer diagnosis among patients with diabetes reduced adherence with evidence-based medications, particularly if patients’ life expectancy was short.
Citation: Stuart BC, Davidoff AJ, Erten MZ .
Changes in medication management after a diagnosis of cancer among Medicare beneficiaries with diabetes.
J Oncol Pract 2015 Nov;11(6):429-34. doi: 10.1200/jop.2014.003046..
Keywords: Medication, Medicare, Cancer, Diabetes, Patient Adherence/Compliance
Chao MT, Handley MA, Quan J
Disclosure of complementary health approaches among low income and racially diverse safety net patients with diabetes.
The authors identified sociodemographic and communication factors associated with disclosure of complementary health approaches to providers by low-income patients with diabetes. Disclosure was associated with language concordance, physicians' interpersonal communication scores, shared decision making, and explanatory-type communication.
AHRQ-funded; HS020684; HS017261; HS022561.
Citation: Chao MT, Handley MA, Quan J .
Disclosure of complementary health approaches among low income and racially diverse safety net patients with diabetes.
Patient Educ Couns 2015 Nov;98(11):1360-6. doi: 10.1016/j.pec.2015.06.011.
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Keywords: Low-Income, Diabetes, Complementary and Alternative Medicine, Racial and Ethnic Minorities, Healthcare Delivery
Miller GE, Sarpong EM, Hill SC
AHRQ Author: Miller GE, Sarpong EM, Hill SC
Does increased adherence to medications change health care financial burdens for adults with diabetes?
The aim of the present study was to investigate increased out-of-pocket drug costs and financial burdens of achieving adherence to oral antidiabetic medications and medications for prevalent comorbidities. The researchers found that the mean simulated additional out-of-pocket drug costs of achieving adherence were $310 for uninsured adults treated for diabetes. These additional drug costs would increase the percentage of uninsured adults with financial burden.
AHRQ-authored.
Citation: Miller GE, Sarpong EM, Hill SC .
Does increased adherence to medications change health care financial burdens for adults with diabetes?
J Diabetes 2015 Nov;7(6):872-80. doi: 10.1111/1753-0407.12292..
Keywords: Medical Expenditure Panel Survey (MEPS), Healthcare Costs, Diabetes, Patient Adherence/Compliance, Medication
Hahn EA, Burns JL, Jacobs EA
Health literacy and patient-reported outcomes: a cross-sectional study of underserved English- and Spanish-speaking patients with type 2 diabetes.
The investigators examined associations between patient characteristics, health behaviors, and health outcomes and explored the role of health literacy as a potential mediator of outcomes. They found that health literacy was not associated with diabetes self-care, health status, or satisfaction with communication, and it did not mediate the effects of other factors on these outcomes. Diabetes self-efficacy was significantly associated with health behaviors and outcomes. The association between Spanish language preference and poorer health was not mediated by this group's lower health literacy.
AHRQ-funded; HS019335.
Citation: Hahn EA, Burns JL, Jacobs EA .
Health literacy and patient-reported outcomes: a cross-sectional study of underserved English- and Spanish-speaking patients with type 2 diabetes.
J Health Commun 2015;20 Suppl 2:4-15. doi: 10.1080/10810730.2015.1061071.
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Keywords: Communication, Diabetes, Health Literacy, Patient-Centered Outcomes Research, Racial and Ethnic Minorities
Mansi I, Frei CR, Wang CP
Statins and new-onset diabetes mellitus and diabetic complications: a retrospective cohort study of US healthy adults.
The authors studied the long-term relationship between statin use and new-onset diabetes among Tricare beneficiaries. They found that diabetes, diabetic complications, and overweight/obesity were more commonly diagnosed among statin-users than similar nonusers in a healthy cohort of adults, demonstrating that short-term clinical trials might not fully describe the risk/benefit of long-term statin use for primary prevention.
AHRQ-funded; HS022418.
Citation: Mansi I, Frei CR, Wang CP .
Statins and new-onset diabetes mellitus and diabetic complications: a retrospective cohort study of US healthy adults.
J Gen Intern Med 2015 Nov;30(11):1599-610. doi: 10.1007/s11606-015-3335-1.
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Keywords: Adverse Drug Events (ADE), Diabetes, Medication, Obesity
Huang ES, Davis AM
Glycemic control in older adults with diabetes mellitus.
These comprehensive guidelines emphasize an individualized approach to diabetes care goals and treatment among adults. The glycemic control recommendations suggest a general goal for glycated hemoglobin (HbA1c) in older adults of 7.5 percent to 8.0 percent (level IA evidence). A target HbA1c level between 7.0 percent and 7.5 percent may be appropriate if it can be safely achieved in healthy older adults.
AHRQ-funded; HS018542.
Citation: Huang ES, Davis AM .
Glycemic control in older adults with diabetes mellitus.
JAMA 2015 Oct 13;314(14):1509-10. doi: 10.1001/jama.2015.8345..
Keywords: Diabetes, Guidelines, Patient-Centered Outcomes Research, Elderly, Quality Improvement
Cherrington AL, Agne AA, Lampkin Y
Diabetes Connect: developing a mobile health intervention to link diabetes community health workers with primary care.
The authors tested a model for the integration of a community health worker-delivered mobile health technology intervention to improve diabetes self-management. They found that the integration of mobile health technology into community health worker programs was successfully achieved and readily accepted.
AHRQ-funded; HS019465.
Citation: Cherrington AL, Agne AA, Lampkin Y .
Diabetes Connect: developing a mobile health intervention to link diabetes community health workers with primary care.
J Ambul Care Manage 2015 Oct-Dec;38(4):333-45. doi: 10.1097/jac.0000000000000110.
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Keywords: Education: Patient and Caregiver, Diabetes, Primary Care, Patient Self-Management, Telehealth
Kuo YF, Goodwin JS, Chen NW
Diabetes mellitus care provided by nurse practitioners vs primary care physicians.
The study objective was to compare processes and cost of care of older adults with diabetes mellitus cared for by nurse practitioners (NPs) with processes and cost of those cared for by primary care physicians (PCPs). It concluded that nurse practitioners were similar to PCPs or slightly lower in their rates of diabetes mellitus guideline–concordant care.
AHRQ-funded; HS020642; HS022134.
Citation: Kuo YF, Goodwin JS, Chen NW .
Diabetes mellitus care provided by nurse practitioners vs primary care physicians.
J Am Geriatr Soc 2015 Oct;63(10):1980-8. doi: 10.1111/jgs.13662..
Keywords: Chronic Conditions, Diabetes, Elderly, Primary Care, Practice Patterns
Huang ES
Potential overtreatment of older, complex adults with diabetes.
This study examined glycemic control levels among older adults with diabetes mellitus by health status and to estimate the prevalence of potential overtreatment of diabetes. Most older patients with complex/intermediate or very complex/poor health status, reached tight glycemic targets between 2001 and 2010. Most of them were treated with insulin or sulfonylureas. The findings suggest that a substantial proportion of older adults with diabetes were potentially over-treated.
AHRQ-funded; HS018542.
Citation: Huang ES .
Potential overtreatment of older, complex adults with diabetes.
JAMA 2015 Sep 22-29;314(12):1280-1. doi: 10.1001/jama.2015.9757..
Keywords: Diabetes, Elderly, Health Status
Lipton BJ, Decker SL
AHRQ Author: Decker SL
Association between diagnosed diabetes and trouble seeing, National Health Interview Survey, 2011-13.
This study used nationally representative 2011–2013 data from the United States to estimate the association between diagnosed diabetes and trouble seeing. Diagnosed diabetes was associated with approximately double the odds of self-reported trouble seeing. Older age, less education, and a history of comorbid conditions were positively correlated, while male sex, being married, and having health insurance were negatively correlated with trouble seeing.
AHRQ-authored.
Citation: Lipton BJ, Decker SL .
Association between diagnosed diabetes and trouble seeing, National Health Interview Survey, 2011-13.
J Diabetes 2015 Sep;7(5):743-6. doi: 10.1111/1753-0407.12311.
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Keywords: Chronic Conditions, Diabetes, Elderly, Eye Disease and Health, Risk
Powers C, Gabriel MH, Encinosa W
AHRQ Author: Encinosa W
Meaningful use stage 2 e-prescribing threshold and adverse drug events in the Medicare Part D population with diabetes.
The authors investigated whether physicians who meet the meaningful use stage 2 threshold for e-prescribing (50 percent of prescriptions e-prescribed) have lower rates of ADEs among their diabetic patients. They found that physician e-prescribing to Medicare beneficiaries was associated with reduced risk of ADEs among their diabetes patients, as were several prescriber and panel characteristics.
AHRQ-authored
Citation: Powers C, Gabriel MH, Encinosa W .
Meaningful use stage 2 e-prescribing threshold and adverse drug events in the Medicare Part D population with diabetes.
J Am Med Inform Assoc 2015 Sep;22(5):1094-8. doi: 10.1093/jamia/ocv036..
Keywords: Electronic Prescribing (E-Prescribing), Diabetes, Medication, Patient Safety
Kuo YF, Chen NW, Baillargeon J
Potentially preventable hospitalizations in Medicare patients with diabetes: a comparison of primary care provided by nurse practitioners versus physicians.
The researchers compared the rates of potentially preventable hospitalizations in older diabetic patients who received primary care from nurse practitioners (NPs) only versus those who received care from primary care physicians only. Using potentially preventable hospitalizations as a quality indicator, they found that primary care provided by NPs was at least comparable with that provided by generalist physicians.
AHRQ-funded; HS020642; HS022134.
Citation: Kuo YF, Chen NW, Baillargeon J .
Potentially preventable hospitalizations in Medicare patients with diabetes: a comparison of primary care provided by nurse practitioners versus physicians.
Med Care 2015 Sep;53(9):776-83. doi: 10.1097/mlr.0000000000000406..
Keywords: Hospitalization, Primary Care, Comparative Effectiveness, Diabetes
Pu J, Zhao B, Wang EJ
Racial/ethnic differences in gestational diabetes prevalence and contribution of common risk factors.
This study aimed to assess racial/ethnic differences in relative contribution of risk factors of gestational diabetes mellitus (GDM) among Asian subgroups (Asian Indian, Chinese, Filipino, Japanese, Korean, and Vietnamese), Hispanics, non-Hispanic blacks, and non-Hispanic whites. It found that GDM was most prevalent among Asian Indians (19.3 percent). Relative risks were similar across all race/ethnic groups.
AHRQ-funded; HS019815.
Citation: Pu J, Zhao B, Wang EJ .
Racial/ethnic differences in gestational diabetes prevalence and contribution of common risk factors.
Paediatr Perinat Epidemiol 2015 Sep;29(5):436-43. doi: 10.1111/ppe.12209.
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Keywords: Diabetes, Obesity, Pregnancy, Racial and Ethnic Minorities, Risk, Women
Desai JR, Vazquez-Benitez G, Xu Z
Who must we target now to minimize future cardiovascular events and total mortality? Lessons from the Surveillance, Prevention and Management of Diabetes Mellitus (SUPREME-DM) cohort study.
This report examined trends in cardiovascular events and mortality in US health systems to help guide the design of targeted clinical and public health strategies to reduce cardiovascular events and mortality rates. It concluded that in order to sustain improvements health systems that have successfully focused on care improvement in high-risk adults with diabetes or heart disease must broaden their improvement strategies to target lower risk adults who have not yet developed diabetes or hearat disease.
AHRQ-funded; HS019859.
Citation: Desai JR, Vazquez-Benitez G, Xu Z .
Who must we target now to minimize future cardiovascular events and total mortality? Lessons from the Surveillance, Prevention and Management of Diabetes Mellitus (SUPREME-DM) cohort study.
Circ Cardiovasc Qual Outcomes 2015 Sep;8(5):508-16. doi: 10.1161/circoutcomes.115.001717.
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Keywords: Cardiovascular Conditions, Diabetes, Mortality, Risk
Guo MW, Ahn HJ, Juarez DT
Length of stay and deaths in diabetes-related preventable hospitalizations among Asian American, Pacific Islander, and white older adults on Medicare, Hawai'i, December 2006-December 2010.
The objective of this study was to compare in-hospital deaths and length of stays for diabetes-related preventable hospitalizations (D-RPHs) in Hawai‘i for Asian American, Pacific Islander, and white Medicare recipients aged 65 years or older. It found that Native Hawaiians were more likely to die during a D-RPH and were hospitalized at a younger age for a D-RPH than other studied racial/ethnic groups.
AHRQ-funded; HS019990.
Citation: Guo MW, Ahn HJ, Juarez DT .
Length of stay and deaths in diabetes-related preventable hospitalizations among Asian American, Pacific Islander, and white older adults on Medicare, Hawai'i, December 2006-December 2010.
Prev Chronic Dis 2015 Aug 6;12:E124. doi: 10.5888/pcd12.150092..
Keywords: Mortality, Hospitalization, Diabetes, Racial and Ethnic Minorities, Elderly
Ratanawongsa N, Karter AJ, Quan J
Reach and validity of an objective medication adherence measure among safety net health plan members with diabetes: a cross-sectional study.
The objective of this study was to evaluate the performance of continuous medication gap (CMG) for diverse, low-income managed care members with diabetes. It concluded that CMG demonstrated acceptable inclusiveness and validity in a diverse, low-income safety net population, comparable with its performance in studies among other insured populations.
AHRQ-funded; HS020684; HS022561; HS017261.
Citation: Ratanawongsa N, Karter AJ, Quan J .
Reach and validity of an objective medication adherence measure among safety net health plan members with diabetes: a cross-sectional study.
J Manag Care Spec Pharm 2015 Aug;21(8):688-98. doi: 10.18553/jmcp.2015.21.8.688..
Keywords: Diabetes, Patient Adherence/Compliance, Patient Self-Management, Medication, Low-Income
Bartels CM, Wong JC, Johnson SL
Rheumatoid arthritis and the prevalence of diabetic retinopathy.
The objective of this study was to examine RA as a risk factor for diabetic retinopathy compared with other vascular risk factors. It found that compared with patients without RA, the adjusted model demonstrated that patients with diabetes and RA were 28 percent less likely to have diabetic retinopathy.
AHRQ-funded; HS018368.
Citation: Bartels CM, Wong JC, Johnson SL .
Rheumatoid arthritis and the prevalence of diabetic retinopathy.
Rheumatology 2015 Aug;54(8):1415-9. doi: 10.1093/rheumatology/kev012..
Keywords: Arthritis, Risk, Eye Disease and Health, Diabetes
Magnan EM, Palta M, Pandhi N
The relationship of individual comorbid chronic conditions to diabetes care quality.
The aim of this study was to determine which chronic conditions were related to lack of achievement or achievement of diabetes care quality goals to determine potential targets for future interventions. It found that 62 chronic conditions varied in their relationships to diabetes care goal achievement for specific care goals. For example, congestive heart failure was related to lack of achievement of cholesterol management goals.
AHRQ-funded; HS018368; HS021899.
Citation: Magnan EM, Palta M, Pandhi N .
The relationship of individual comorbid chronic conditions to diabetes care quality.
BMJ Open Diabetes Res Care 2015 Jul 23;3(1):e000080. doi: 10.1136/bmjdrc-2015-000080..
Keywords: Care Management, Chronic Conditions, Diabetes, Quality of Care
Scifres CM, Abebe KZ, Jones KA
Gestational diabetes diagnostic methods (GD2M) pilot randomized trial.
The researchers tested the feasibility of conducting a pragmatic randomized controlled trial (RCT) comparing the International Association of Diabetes in Pregnancy Study Groups (IADPSG) versus Carpenter-Coustan diagnostic criteria for gestational diabetes (GDM), and examined patient and provider views on GDM screening. They found that both pregnant women and providers value GDM screening, and pregnant women can be recruited to a blinded, randomized GDM screening trial with minimal attrition and missing data.
AHRQ-funded; HS019461.
Citation: Scifres CM, Abebe KZ, Jones KA .
Gestational diabetes diagnostic methods (GD2M) pilot randomized trial.
Matern Child Health J 2015 Jul;19(7):1472-80. doi: 10.1007/s10995-014-1651-4..
Keywords: Diabetes, Diagnostic Safety and Quality, Pregnancy, Screening, Women
Tung EL, Peek ME
Linking community resources in diabetes care: a role for technology?
This paper highlights several noteworthy innovations, which can enable physicians, health workers, researchers, community developers, and health departments to begin envisioning, designing, and implementing their own strategies to mobilize assets and improve health.
AHRQ-funded; HS000078.
Citation: Tung EL, Peek ME .
Linking community resources in diabetes care: a role for technology?
Curr Diab Rep 2015 Jul;15(7):45. doi: 10.1007/s11892-015-0614-5..
Keywords: Diabetes, Primary Care, Community-Based Practice, Chronic Conditions