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 61 Research Studies DisplayedGraham JL, Shahani L, Grimes RM
The influence of trust in physicians and trust in the healthcare system on linkage, retention, and adherence to HIV care.
The present study was designed to determine if trust in physicians and the healthcare system among persons newly diagnosed with HIV infection was predictive of patients' subsequent linkage, retention, and adherence to HIV care. No significant association was found between trust-in-physicians and linkage to care or adherence to antiretroviral therapy.
AHRQ-funded; HS016093.
Citation: Graham JL, Shahani L, Grimes RM .
The influence of trust in physicians and trust in the healthcare system on linkage, retention, and adherence to HIV care.
AIDS Patient Care STDS 2015 Dec;29(12):661-7. doi: 10.1089/apc.2015.0156..
Keywords: Human Immunodeficiency Virus (HIV), Patient Adherence/Compliance, Outcomes, Healthcare Utilization
Lee YJ, Boden-Albala B, Jia H
The association between online health information-seeking behaviors and health behaviors among Hispanics in New York City: a community-based cross-sectional study.
The specific aim of this study was to examine the association between online health information-seeking behaviors and health behaviors (physical activity, fruit and vegetable consumption, alcohol use, and hypertension medication adherence) among Hispanics. It concluded that given the promising, although modest, associations between online health information-seeking behaviors and some health behaviors, efforts are needed to improve Hispanics' ability to access and understand health information.
AHRQ-funded; HS022961; HS019853.
Citation: Lee YJ, Boden-Albala B, Jia H .
The association between online health information-seeking behaviors and health behaviors among Hispanics in New York City: a community-based cross-sectional study.
J Med Internet Res 2015 Nov 26;17(11):e261. doi: 10.2196/jmir.4368.
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Keywords: Education: Patient and Caregiver, Web-Based, Telehealth, Patient Adherence/Compliance, Racial and Ethnic Minorities
Zhou M, Chang HY, Segal JB
Adherence to a novel oral anticoagulant among patients with atrial fibrillation.
The researchers examined adherence and persistence to dabigatran among adults with atrial fibrillation. Among those using dabigatran alone (n = 2,713), 41 percent were nonadherent with therapy, and 32 percent had gaps of 60 days or greater. Among those observed for 9 months who used dabigatran alone, rates of nonadherence were 47 percent, whereas 48 percent discontinued therapy during follow-up.
AHRQ-funded; HS018960.
Citation: Zhou M, Chang HY, Segal JB .
Adherence to a novel oral anticoagulant among patients with atrial fibrillation.
J Manag Care Spec Pharm 2015 Nov;21(11):1054-62. doi: 10.18553/jmcp.2015.21.11.1054.
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Keywords: Blood Thinners, Patient Adherence/Compliance, Heart Disease and Health, Cardiovascular Conditions, Medication
Goyal A, de Lemos JA, Peng SA
Association of patient enrollment in Medicare Part D with outcomes after acute myocardial infarction.
The researchers investigated whether enrollment versus nonenrollment in Medicare's prescription drug plan (Part D) is associated with better outcomes after acute myocardial infarction (AMI). They found that only half of Medicare-insured patients with AMI were enrolled in Part D by hospital discharge, and their 30-day and 1-year adjusted outcomes did not differ substantially from nonenrollees.
AHRQ-funded; HS021092.
Citation: Goyal A, de Lemos JA, Peng SA .
Association of patient enrollment in Medicare Part D with outcomes after acute myocardial infarction.
Circ Cardiovasc Qual Outcomes 2015 Nov;8(6):567-75. doi: 10.1161/circoutcomes.115.001650.
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Keywords: Heart Disease and Health, Medicare, Patient-Centered Outcomes Research, Medication, Patient Adherence/Compliance
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
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
LaFleur J, Hoop R, Korner E
Predictors of early discontinuation of pegylated interferon for reasons other than lack of efficacy in United States veterans with chronic hepatitis C.
The researchers determined whether selected patient characteristics predicted discontinued therapy for reasons other than lack of efficcacy (non-LOE) using national databases of U.S. veterans. They found that predictors of greatest magnitude included comorbidities of myocardial infarction/congestive heart failure, renal disease, platelets 100/mm or more, Black race, albumin 3.5 mg/dl or more, sleep aid use, and poor persistence with antidepressants and antihypertensive agents.
AHRQ-funded; HS018582.
Citation: LaFleur J, Hoop R, Korner E .
Predictors of early discontinuation of pegylated interferon for reasons other than lack of efficacy in United States veterans with chronic hepatitis C.
Gastroenterol Nurs 2015 Nov-Dec;38(6):417-28. doi: 10.1097/sga.0000000000000214.
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Keywords: Chronic Conditions, Hepatitis, Medication, Patient Adherence/Compliance
Kahn B, Freeland Z, Gopal P
Predictors of guideline concordance for surveillance colonoscopy recommendations in patients at a safety-net health system.
The aim of this study was to quantify and identify predictors for guideline-concordant surveillance recommendations after adenoma polypectomy. It found that underuse recommendations were more likely in patients with C3 adenomas; overuse recommendations were more likely in patients with high-grade dysplasia or fair prep quality and less likely in those with piecemeal resection, C3 adenomas, age>65, or Hispanic ethnicity.
AHRQ-funded; HS022418.
Citation: Kahn B, Freeland Z, Gopal P .
Predictors of guideline concordance for surveillance colonoscopy recommendations in patients at a safety-net health system.
Cancer Causes Control 2015 Nov;26(11):1653-60. doi: 10.1007/s10552-015-0661-x..
Keywords: Cancer: Colorectal Cancer, Colonoscopy, Guidelines, Patient Adherence/Compliance, Patient-Centered Outcomes Research
Baker DW, Brown T, Goldman SN
Two-year follow-up of the effectiveness of a multifaceted intervention to improve adherence to annual colorectal cancer screening in community health centers.
After an earlier outreach intervention achieved 82 percent annual adherence to colorectal cancer (CRC) screening with fecal occult blood testing (FOBT), this study assessed adherence to FOBT after a second outreach. It found that a total of 88.7 percent of patients completed a fecal immunochemical test within 6 months of their second outreach.
AHRQ-funded; HS021141.
Citation: Baker DW, Brown T, Goldman SN .
Two-year follow-up of the effectiveness of a multifaceted intervention to improve adherence to annual colorectal cancer screening in community health centers.
Cancer Causes Control 2015 Nov;26(11):1685-90. doi: 10.1007/s10552-015-0650-0..
Keywords: Cancer, Cancer: Colorectal Cancer, Patient Adherence/Compliance, Prevention, Screening
Highfield L, Rajan SS, Valerio MA
A non-randomized controlled stepped wedge trial to evaluate the effectiveness of a multi-level mammography intervention in improving appointment adherence in underserved women.
This study evaluated a theoretically based, systematically designed implementation strategy to support adoption and implementation of a patient navigation-based intervention, called Peace of Mind Program (PMP), aimed at improving breast cancer screening among underserved women.. Any potential confounding or bias will be controlled in the analysis. Outcomes such as appointment adherence, patient referral to diagnostics, time to diagnostic referral, patient referral to treatment, time to treatment referral, and budget impact of the intervention will be assessed.
AHRQ-funded; HS023255.
Citation: Highfield L, Rajan SS, Valerio MA .
A non-randomized controlled stepped wedge trial to evaluate the effectiveness of a multi-level mammography intervention in improving appointment adherence in underserved women.
Implement Sci 2015 Oct 14;10:143. doi: 10.1186/s13012-015-0334-x.
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Keywords: Cancer: Breast Cancer, Cancer, Screening, Patient Adherence/Compliance, Women, Vulnerable Populations, Prevention, Imaging
Rosenberg SM, Partridge AH
New insights into nonadherence with adjuvant endocrine therapy among young women with breast cancer.
This editorial described endocrine therapy and reasons for nonadherence in young women with breast cancer, including side effects and fertility concerns.
AHRQ-funded; HS023680.
Citation: Rosenberg SM, Partridge AH .
New insights into nonadherence with adjuvant endocrine therapy among young women with breast cancer.
J Natl Cancer Inst 2015 Oct;107(10). doi: 10.1093/jnci/djv245.
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Keywords: Adverse Drug Events (ADE), Cancer: Breast Cancer, Medication, Patient Adherence/Compliance
Wiener ES, Mullins CD, Pincus KJ
A framework for pharmacist-assisted medication adherence in hard-to-reach patients.
This study aimed to create a model for use in patient-centered, pharmacist-led interactions to improve medication adherence. The Health Action Process Approach (HAPA), a behavioral change framework, was adapted to known barriers of medication adherence. The study concluded that the newly developed framework provides a patient centered approach to facilitate and improve pharmacist-patient conversations regarding medication adherence.
AHRQ-funded; HS022135.
Citation: Wiener ES, Mullins CD, Pincus KJ .
A framework for pharmacist-assisted medication adherence in hard-to-reach patients.
Res Social Adm Pharm 2015 Sep-Oct;11(5):595-601. doi: 10.1016/j.sapharm.2014.11.0.
Keywords: Medication, Patient Adherence/Compliance, Patient-Centered Outcomes Research, Access to Care, Provider: Pharmacist
Beach MC, Roter DL, Saha S
Impact of a brief patient and provider intervention to improve the quality of communication about medication adherence among HIV patients.
The authors designed this study to improve patient-provider communication about HIV medication adherence. They found that brief provider training, combined with patient coaching sessions, improved provider communication behaviors and increased dialogue regarding medication adherence.
AHRQ-funded; HS013903; 290010012.
Citation: Beach MC, Roter DL, Saha S .
Impact of a brief patient and provider intervention to improve the quality of communication about medication adherence among HIV patients.
Patient Educ Couns 2015 Sep;98(9):1078-83. doi: 10.1016/j.pec.2015.05.011.
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Keywords: Human Immunodeficiency Virus (HIV), Medication, Patient Adherence/Compliance, Patient and Family Engagement, Clinician-Patient Communication
Viswanathan S, Justice AC, Alexander GC
Adherence and HIV RNA suppression in the current era of highly active antiretroviral therapy.
The researchers examined trends in adherence to highly active antiretroviral therapy (HAART) and HIV RNA suppression. They found that, although all HIV-infected persons should be instructed to achieve perfect adherence, concerns of slightly lower adherence should not hinder prescribing new HAART regimens early in HIV infection.
AHRQ-funded; HS018372.
Citation: Viswanathan S, Justice AC, Alexander GC .
Adherence and HIV RNA suppression in the current era of highly active antiretroviral therapy.
J Acquir Immune Defic Syndr 2015 Aug 1;69(4):493-8. doi: 10.1097/qai.0000000000000643..
Keywords: Human Immunodeficiency Virus (HIV), Patient Adherence/Compliance, Medication
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
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
Skolasky RL, Maggard AM, Li D
Health behavior change counseling in surgery for degenerative lumbar spinal stenosis. Part I: improvement in rehabilitation engagement and functional outcomes.
This study examined whether a brief motivational interviewing-based health behavior change counseling (HBCC) intervention increased patient participation in physical therapy and/or home exercise programs (HEPs), reduced disability, and improved health status after surgery for degenerative lumbar spinal stenosis. It found that HBCC can improve outcomes after spine surgery through improved rehabilitation participation.
AHRQ-funded; HS017990.
Citation: Skolasky RL, Maggard AM, Li D .
Health behavior change counseling in surgery for degenerative lumbar spinal stenosis. Part I: improvement in rehabilitation engagement and functional outcomes.
Arch Phys Med Rehabil 2015 Jul;96(7):1200-7. doi: 10.1016/j.apmr.2015.03.009..
Keywords: Back Health and Pain, Surgery, Patient Adherence/Compliance
Skolasky RL, Maggard AM, Li D
Health behavior change counseling in surgery for degenerative lumbar spinal stenosis. Part II: Patient activation mediates the effects of health behavior change counseling on rehabilitation engagement.
This study sought to determine the effect of health behavior change counseling (HBCC) on patient activation and the influence of patient activation on rehabilitation engagement, and to identify common barriers to engagement among individuals undergoing surgery for degenerative lumbar spinal stenosis. It found that the influence of HBCC on rehabilitation engagement was mediated by patient activation. Despite improvements in patient activation, one-third of patients reported low rehabilitation engagement.
AHRQ-funded; HS017990.
Citation: Skolasky RL, Maggard AM, Li D .
Health behavior change counseling in surgery for degenerative lumbar spinal stenosis. Part II: Patient activation mediates the effects of health behavior change counseling on rehabilitation engagement.
Arch Phys Med Rehabil 2015 Jul;96(7):1208-14. doi: 10.1016/j.apmr.2015.02.031..
Keywords: Back Health and Pain, Surgery, Patient Adherence/Compliance
Roberts MC, Wheeler SB, Reeder-Hayes K
Racial/Ethnic and socioeconomic disparities in endocrine therapy adherence in breast cancer: a systematic review.
The authors sought to understand factors that influence endocrine therapy (ET) adherence among racial/ethnic and socioeconomic subpopulations of breast cancer patients. They found significant underuse of ET among minority and low-income women. They further noted that both race/ethnicity and socioeconomic status are associated with ET use in most settings.
AHRQ-funded; HS021282.
Citation: Roberts MC, Wheeler SB, Reeder-Hayes K .
Racial/Ethnic and socioeconomic disparities in endocrine therapy adherence in breast cancer: a systematic review.
Am J Public Health 2015 Jul;105 Suppl 3:e4-e15. doi: 10.2105/ajph.2014.302490.
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Keywords: Cancer: Breast Cancer, Medication, Patient Adherence/Compliance, Racial and Ethnic Minorities, Social Determinants of Health
Samples H, Mojtabai R
Antidepressant self-discontinuation: results from the collaborative psychiatric epidemiology surveys.
The authors examined the extent and correlates of self-discontinuation of antidepressant medications without physician advice using the Collaborative Psychiatric Epidemiology Surveys. They concluded that physicians prescribing antidepressants need to communicate clearly about the expected benefits of treatment, the minimum duration of use required to experience benefits, and the potential side effects of these medications, particularly to younger patients, those with anxiety disorders, and patients treated in general medical settings, all of whom have increased odds of self-discontinuation.
AHRQ-funded; HS000029.
Citation: Samples H, Mojtabai R .
Antidepressant self-discontinuation: results from the collaborative psychiatric epidemiology surveys.
Psychiatr Serv 2015 May;66(5):455-62. doi: 10.1176/appi.ps.201400021.
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Keywords: Medication, Depression, Medication: Safety, Behavioral Health, Patient Adherence/Compliance
Slota C, Sayner R, Vitko M
Glaucoma patient expression of medication problems and nonadherence.
The purpose of this article was to evaluate what patient characteristics led patients to express (1) medication problems, including difficulty with side effects and eye drop administration, and (2) problems with nonadherence to glaucoma medications. It found that patients with lower health literacy are less likely to express medication-related problems and patients who express medication problems often express nonadherence.
AHRQ-funded; HS023054.
Citation: Slota C, Sayner R, Vitko M .
Glaucoma patient expression of medication problems and nonadherence.
Optom Vis Sci 2015 May;92(5):537-43. doi: 10.1097/opx.0000000000000574..
Keywords: Eye Disease and Health, Patient Adherence/Compliance, Medication, Health Literacy
Wang X, Du XL
Socio-demographic and geographic variations in the utilization of hormone therapy in older women with breast cancer after Medicare Part-D coverage.
The researchers assessed socio-demographic, geographic, and other variations in the receipt of hormone therapy among patients with hormone receptor-positive breast cancer as well as adherence to hormone therapy within 1-year follow-up. They found that found that increasing age was significantly associated with a decreased receipt of hormone therapy and aromatase inhibitors in all hormone receptor-positive breast cancer patients after adjusting for other factors regardless of whether chemotherapy was received.
AHRQ-funded; HS018956.
Citation: Wang X, Du XL .
Socio-demographic and geographic variations in the utilization of hormone therapy in older women with breast cancer after Medicare Part-D coverage.
Med Oncol 2015 May;32(5):154. doi: 10.1007/s12032-015-0599-6..
Keywords: Cancer: Breast Cancer, Healthcare Utilization, Patient Adherence/Compliance, Patient-Centered Outcomes Research, Social Determinants of Health
Schmittdiel JA, Nichols GA, Dyer W
Health care system-level factors associated with performance on Medicare STAR adherence metrics in a large, integrated delivery system.
The researchers examined the association of Medicare STAR adherence metrics with system-wide factors for patients with diabetes. They found that the strongest predictor of achieving STAR-defined medication adherence for patients with diabetes was a greater days’ supply of medications. Other important factors were use of a mail order pharmacy, lower copayments and lower annual individual out-of-pocket maximums.
AHRQ-funded; HS019859
Citation: Schmittdiel JA, Nichols GA, Dyer W .
Health care system-level factors associated with performance on Medicare STAR adherence metrics in a large, integrated delivery system.
Med Care. 2015 Apr;53(4):332-7. doi: 10.1097/mlr.0000000000000328..
Keywords: Medicare, Diabetes, Patient Adherence/Compliance, Quality Measures
Kestenbaum LA, Feemster KA
Identifying and addressing vaccine hesitancy.
Despite, and perhaps because of, their public health impact, an increasing number of parents and patients are choosing to delay or refuse vaccines. These individuals are described as “vaccine hesitant.” This review explores the history of vaccine hesitancy, its causes, and suggests approaches for reducing hesitancy and strengthening vaccine acceptance.
AHRQ-funded; HS020939.
Citation: Kestenbaum LA, Feemster KA .
Identifying and addressing vaccine hesitancy.
Pediatr Ann 2015 Apr;44(4):e71-5. doi: 10.3928/00904481-20150410-07..
Keywords: Vaccination, Health Literacy, Patient Adherence/Compliance
Predmore ZS, Mattke S, Horvitz-Lennon M
Improving antipsychotic adherence among patients with schizophrenia: savings for states.
The authors presented findings of an analysis conducted to quantify the potential net savings to state budgets from interventions to improve adherence to antipsychotic drugs among patients with schizophrenia. Their financial model estimated an annual cost of $21.4 billion (in 2013 dollars) to Medicaid programs and other state agencies for people with schizophrenia. They concluded that better adherence could yield annual net savings of $3.28 billion to states and recommended that states consider interventions shown to increase medication adherence in this patient group.
AHRQ-funded; HS000029.
Citation: Predmore ZS, Mattke S, Horvitz-Lennon M .
Improving antipsychotic adherence among patients with schizophrenia: savings for states.
Psychiatr Serv 2015 Apr;66(4):343-5. doi: 10.1176/appi.ps.201400506.
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Keywords: Healthcare Costs, Medication, Behavioral Health, Patient Adherence/Compliance