National Healthcare Quality and Disparities Report
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Topics
- Adverse Drug Events (ADE) (1)
- Back Health and Pain (1)
- Behavioral Health (2)
- Blood Pressure (2)
- Cancer (1)
- Cancer: Breast Cancer (2)
- Cancer: Colorectal Cancer (1)
- Cardiovascular Conditions (1)
- Caregiving (1)
- Care Management (2)
- Children/Adolescents (2)
- Chronic Conditions (3)
- Clinical Decision Support (CDS) (1)
- Clinician-Patient Communication (1)
- Colonoscopy (1)
- Communication (1)
- Comparative Effectiveness (1)
- Decision Making (1)
- Depression (2)
- Diabetes (5)
- Diagnostic Safety and Quality (1)
- Education: Patient and Caregiver (3)
- Elderly (5)
- Electronic Health Records (EHRs) (1)
- Electronic Prescribing (E-Prescribing) (1)
- Guidelines (1)
- Healthcare Costs (3)
- Healthcare Delivery (1)
- Healthcare Utilization (2)
- Health Information Technology (HIT) (5)
- Health Insurance (3)
- Health Literacy (1)
- Health Services Research (HSR) (1)
- Heart Disease and Health (3)
- Hepatitis (1)
- Home Healthcare (1)
- Hospital Discharge (2)
- Hospital Readmissions (1)
- Human Immunodeficiency Virus (HIV) (8)
- Kidney Disease and Health (1)
- Lifestyle Changes (1)
- Medicare (2)
- Medication (21)
- Medication: Safety (1)
- Nutrition (1)
- Patient-Centered Healthcare (4)
- Patient-Centered Outcomes Research (2)
- (-) Patient Adherence/Compliance (43)
- Patient and Family Engagement (1)
- Patient Safety (1)
- Patient Self-Management (4)
- Practice Patterns (1)
- Primary Care (1)
- Quality Measures (1)
- Racial and Ethnic Minorities (10)
- Respiratory Conditions (2)
- Screening (2)
- Sex Factors (1)
- Sickle Cell Disease (1)
- Social Determinants of Health (2)
- Social Stigma (2)
- Substance Abuse (1)
- Surgery (1)
- Telehealth (1)
- Tobacco Use (1)
- Treatments (1)
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 43 Research Studies DisplayedTuran B, Rogers AJ, Rice WS
Association between perceived discrimination in healthcare settings and HIV medication adherence: mediating psychosocial mechanisms.
There is insufficient research on the impact of perceived discrimination in healthcare settings on adherence to antiretroviral therapy (ART), particularly among women living with HIV, and even less is known about psychosocial mechanisms that may mediate this association. Cross-sectional analyses were conducted in a sample of diverse women living with HIV enrolled in the Women's Interagency HIV Study (WIHS), a multi-center cohort study to investigate these issues.
AHRQ-funded; HS013852.
Citation: Turan B, Rogers AJ, Rice WS .
Association between perceived discrimination in healthcare settings and HIV medication adherence: mediating psychosocial mechanisms.
AIDS Behav 2017 Dec;21(12):3431-39. doi: 10.1007/s10461-017-1957-5..
Keywords: Human Immunodeficiency Virus (HIV), Medication, Patient Adherence/Compliance, Social Stigma
Badawy SM, Morrone K, Thompson A
Computer and mobile technology interventions to promote medication adherence and disease management in people with thalassemia.
This study aims to identify and assess the effects of computer and mobile technology interventions designed to facilitate medication adherence and disease management in individuals with thalassemia.
AHRQ-funded; HS023011.
Citation: Badawy SM, Morrone K, Thompson A .
Computer and mobile technology interventions to promote medication adherence and disease management in people with thalassemia.
Cochrane Database Syst Rev 2017 Dec;2017(12)..
Keywords: Health Information Technology (HIT), Medication, Patient Adherence/Compliance, Patient-Centered Healthcare, Patient Self-Management
Crawford J, Beaton D, Almad F
AHRQ Author: Bierman AS
Cross-cultural survey development: the colon cancer screening behaviors survey for South Asian populations.
The objective of this work was to develop a survey that considered cultural relevance and diversity of South Asian populations, with the aim of describing or predicting factors that influence colorectal cancer screening intention and adherence. The initial development of the Colon Cancer Screening Behaviours Survey for South Asian populations was completed using a number of steps. This initial survey was later cross-culturally translated and adapted into the Urdu language.
AHRQ-authored.
Citation: Crawford J, Beaton D, Almad F .
Cross-cultural survey development: the colon cancer screening behaviors survey for South Asian populations.
BMC Res Notes 2017 Dec 28;10(1):770. doi: 10.1186/s13104-017-3098-3.
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Keywords: Cancer, Cancer: Colorectal Cancer, Colonoscopy, Patient Adherence/Compliance, Racial and Ethnic Minorities, Screening
Taira DA, Seto BK, Davis JW
Examining factors associated with nonadherence and identifying providers caring for nonadherent subgroups.
This study examined racial/ethnic and regional differences in medication adherence in patients with diabetes taking oral anti-diabetic, anti-hypertensive, and cholesterol lowering medications and to identify the pharmacies and prescribers who serve these communities. After adjustment for other factors, Filipinos, Native Hawaiians, and people of other race were significantly less adherent to anti-diabetic and anti-hypertensive medications than Japanese.
AHRQ-funded; HS023185.
Citation: Taira DA, Seto BK, Davis JW .
Examining factors associated with nonadherence and identifying providers caring for nonadherent subgroups.
J Pharm Health Serv Res 2017 Dec;8(4):247-53. doi: 10.1111/jphs.12193.
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Keywords: Diabetes, Medication, Patient Adherence/Compliance, Patient-Centered Healthcare, Racial and Ethnic Minorities
Rundell SD, Gold LS, Hansen RN
Impact of co-morbidities on resource use and adherence to guidelines among commercially insured adults with new visits for back pain.
The purpose of this study was to assess if co-morbidity is associated with higher use of back-related care and adherence to back pain guidelines. The investigators found that co-morbidity burden and the presence of specific chronic conditions, such as musculoskeletal conditions, were associated with high long-term use of back-related care and care inconsistent with guidelines.
AHRQ-funded; HS022982.
Citation: Rundell SD, Gold LS, Hansen RN .
Impact of co-morbidities on resource use and adherence to guidelines among commercially insured adults with new visits for back pain.
J Eval Clin Pract 2017 Dec;23(6):1218-26. doi: 10.1111/jep.12763..
Keywords: Back Health and Pain, Guidelines, Health Services Research (HSR), Healthcare Utilization, Patient Adherence/Compliance
Oates GR, Hamby BW, Stepanikova I
Social determinants of adherence to pulmonary rehabilitation for chronic obstructive pulmonary disease.
Adherence to pulmonary rehabilitation (PR) is low. Previous studies have focused on clinical predictors of PR completion. This study aimed to identify social determinants of adherence to PR. The findings showed that, relative to high adherence, low adherence is associated with limited functional capacity and current smoking, while moderate adherence is associated with socioeconomic disadvantage. The distinction highlights different pathways to suboptimal adherence and calls for tailored intervention approaches.
AHRQ-funded; HS023009.
Citation: Oates GR, Hamby BW, Stepanikova I .
Social determinants of adherence to pulmonary rehabilitation for chronic obstructive pulmonary disease.
Copd 2017 Dec;14(6):610-17. doi: 10.1080/15412555.2017.1379070..
Keywords: Respiratory Conditions, Racial and Ethnic Minorities, Patient Adherence/Compliance, Social Determinants of Health
Albrecht JS, Khokhar B, Huang TY
Adherence and healthcare utilization among older adults with COPD and depression.
The researchers quantified the independent effects of adherence to antidepressants and chronic obstructive pulmonary disease (COPD) maintenance medications on healthcare utilization among individuals co-diagnosed with COPD and depression. They found that, compared to no use,higher levels of adherence to COPD maintenance medications were associated with decreased risk of ED visits and hospitalizations. Similarly, higher levels of adherence to antidepressants resulted in decreased risk of ED visits and hospitalization.
AHRQ-funded; HS024560.
Citation: Albrecht JS, Khokhar B, Huang TY .
Adherence and healthcare utilization among older adults with COPD and depression.
Respir Med 2017 Aug;129:53-58. doi: 10.1016/j.rmed.2017.06.002.
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Keywords: Elderly, Healthcare Utilization, Respiratory Conditions, Depression, Patient Adherence/Compliance
Flory J, Gerhard T, Stempniewicz N
Comparative adherence to diabetes drugs: an analysis of electronic health records and claims data.
The objective of this brief report is to compare adherence rates for 6 major classes of diabetes medications: metformin, sulfonylurea, thiazolidinedione, basal insulin, DPP-4 inhibitors, and GLP-1 receptor agonists. The authors note that the rates at which diabetes drugs are prescribed, and the rates at which patients actually take them, differ substantially. The authors also note that the physicians should be aware of potentially significant challenges concerning adherence to newer agents.
AHRQ-funded; HS023898.
Citation: Flory J, Gerhard T, Stempniewicz N .
Comparative adherence to diabetes drugs: an analysis of electronic health records and claims data.
Diabetes Obes Metab 2017 Aug;19(8):1184-87. doi: 10.1111/dom.12931..
Keywords: Diabetes, Electronic Health Records (EHRs), Patient Adherence/Compliance, Practice Patterns, Medication
Bandi P, Goldmann E, Parikh NS
Age-related differences in antihypertensive medication adherence in Hispanics: a cross-sectional community-based survey in New York City, 2011-2012.
US Hispanics, particularly younger adults in New York City, have a higher prevalence of uncontrolled hypertension than do people of other racial/ethnic groups. This study found that in younger adults, heavy alcohol consumption, a longer duration of hypertension, and recent poor physical health were negatively associated with high adherence. In older adults, advancing age, higher education level, high knowledge of hypertension control, and insurance status were positively associated with high adherence.
AHRQ-funded; HS022961.
Citation: Bandi P, Goldmann E, Parikh NS .
Age-related differences in antihypertensive medication adherence in Hispanics: a cross-sectional community-based survey in New York City, 2011-2012.
Prev Chronic Dis 2017 Jul 13;14:E57. doi: 10.5888/pcd14.160512.
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Keywords: Blood Pressure, Medication, Patient Adherence/Compliance, Racial and Ethnic Minorities
Grove LR, Olesiuk WJ, Ellis AR
Evaluating the potential for primary care to serve as a mental health home for people with schizophrenia.
This study examined the annual primary care and specialty mental health service utilization of adult North Carolina Medicaid enrollees with schizophrenia and at least one comorbid chronic condition who were in a medical home during 2007-2010. It concluded that medical home enrollment was associated with increased use of primary care and specialty mental health care, as well as increased medication adherence.
AHRQ-funded; HS019659; HS000032.
Citation: Grove LR, Olesiuk WJ, Ellis AR .
Evaluating the potential for primary care to serve as a mental health home for people with schizophrenia.
Gen Hosp Psychiatry 2017 Jul;47:14-19. doi: 10.1016/j.genhosppsych.2017.03.002.
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Keywords: Medication, Behavioral Health, Patient-Centered Healthcare, Patient Adherence/Compliance, Primary Care
Turan B, Hatcher AM, Weiser SD
Framing mechanisms linking HIV-related stigma, adherence to treatment, and health outcomes.
The authors present a conceptual framework that highlights how unique dimensions of individual-level HIV-related stigma (perceived community stigma, experienced stigma, internalized stigma, and anticipated stigma) might differently affect the health of those living with HIV. Their conceptual framework posits that, in the context of intersectional and structural stigmas, individual-level dimensions of HIV-related stigma operate through interpersonal factors, mental health, psychological resources, and biological stress pathways.
AHRQ-funded; HS013852.
Citation: Turan B, Hatcher AM, Weiser SD .
Framing mechanisms linking HIV-related stigma, adherence to treatment, and health outcomes.
Am J Public Health 2017 Jun;107(6):863-69. doi: 10.2105/ajph.2017.303744.
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Keywords: Human Immunodeficiency Virus (HIV), Medication, Patient Adherence/Compliance, Patient-Centered Outcomes Research, Social Stigma
Maciejewski ML, Hammill BG, Bayliss EA
Prescriber continuity and disease control of older adults.
The objective of this study was to examine whether glycemic control or lipid control was associated with the number of prescribers of cardiometabolic medications. It concluded that multiple prescribers were associated with worse disease control, possibly because patients with more severe diabetes or dyslipidemia have multiple prescribers or because care fragmentation is associated with worse disease control.
AHRQ-funded; HS023085.
Citation: Maciejewski ML, Hammill BG, Bayliss EA .
Prescriber continuity and disease control of older adults.
Med Care 2017 Apr;55(4):405-10. doi: 10.1097/mlr.0000000000000658.
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Keywords: Elderly, Medication, Diabetes, Patient Adherence/Compliance, Healthcare Delivery
Cornelius T, Earnshaw VA, Menino D
Treatment motivation among caregivers and adolescents with substance use disorders.
The researchers used self-determination theory to examine intersecting motivational narratives among caregivers and adolescents in substance use disorder treatment. Relationships between motivation, interpretation of caregiver pressures, adolescent autonomy, and relatedness were also explored. Their results suggest the importance of intrinsically motivated treatment, and highlight autonomy support and relatedness as mechanisms that might facilitate treatment engagement.
AHRQ-funded; HS022986.
Citation: Cornelius T, Earnshaw VA, Menino D .
Treatment motivation among caregivers and adolescents with substance use disorders.
J Subst Abuse Treat 2017 Apr;75:10-16. doi: 10.1016/j.jsat.2017.01.003.
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Keywords: Caregiving, Children/Adolescents, Patient Adherence/Compliance, Patient and Family Engagement, Substance Abuse
Leonard S, Anderson LM, Jonassaint J
Utilizing a novel mobile health "selfie" application to improve compliance to iron chelation in pediatric patients receiving chronic transfusions.
Iron chelation therapy can prevent iron overload for pediatric patients with sickle cell disease and beta-thalassemia major; however, adherence is suboptimal. Therefore, the researchers developed an intensive training program (ITP), to improve medication management and disease knowledge. The objectives were to determine feasibility of the ITP and its preliminary impact on adherence, disease knowledge, and health outcomes. The mobile ITP was feasibly implemented in a clinical setting.
AHRQ-funded; HS022989.
Citation: Leonard S, Anderson LM, Jonassaint J .
Utilizing a novel mobile health "selfie" application to improve compliance to iron chelation in pediatric patients receiving chronic transfusions.
J Pediatr Hematol Oncol 2017 Apr;39(3):223-29. doi: 10.1097/mph.0000000000000743.
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Keywords: Children/Adolescents, Education: Patient and Caregiver, Patient Adherence/Compliance, Sickle Cell Disease
Yeung K, Basu A, Marcum ZA
Impact of a value-based formulary in three chronic disease cohorts.
This study assessed the impact of a value based formulary (VBF) on medication adherence and patient and health plan expenditures on 3 chronic disease states: diabetes, hypertension, and hyperlipidemia. The investigators measured medication expenditures from member, health plan, and member-plus-health plan (overall) perspectives and medication adherence as proportion of days covered. They conducted an exploratory analysis of medication utilization classifying medications according to whether co-payments moved up or down in the year following VBF implementation.
AHRQ-funded; HS022982.
Citation: Yeung K, Basu A, Marcum ZA .
Impact of a value-based formulary in three chronic disease cohorts.
Am J Manag Care 2017 Mar; 23(3 Suppl):S46-s53..
Keywords: Chronic Conditions, Health Insurance, Patient Adherence/Compliance, Medication, Healthcare Costs
Marcum ZA, Hanlon JT, Murray MD
Improving medication adherence and health outcomes in older adults: an evidence-based review of randomized controlled trials.
The objective of this review was to provide an updated summary of evidence from randomized controlled studies to determine whether interventions aimed at improving medication adherence also improve the health outcomes of older adults residing in community-based settings. This evidence-based review of medication adherence interventions in older adults revealed promising strategies in the larger context of a largely mixed body of literature.
AHRQ-funded; HS022982; HS023779.
Citation: Marcum ZA, Hanlon JT, Murray MD .
Improving medication adherence and health outcomes in older adults: an evidence-based review of randomized controlled trials.
Drugs Aging 2017 Mar;34(3):191-201. doi: 10.1007/s40266-016-0433-7.
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Keywords: Elderly, Medication, Patient Adherence/Compliance, Patient-Centered Outcomes Research, Education: Patient and Caregiver
Marcum ZA, Gellad WF
Improving medication adherence: keep your eyes on the prize.
In this commentary, the authors discuss a paper published by Reddy, et al. published in 2017 in the Journal of General Internal Medicine, entitled “Patient and partner feedback reports to improve statin medication adherence: a randomized control trial.”
AHRQ-funded; HS022982.
Citation: Marcum ZA, Gellad WF .
Improving medication adherence: keep your eyes on the prize.
J Gen Intern Med 2017 Mar;32(3):236-37. doi: 10.1007/s11606-016-3927-4..
Keywords: Medication, Patient Adherence/Compliance
Tucker JS, Shadel WG, Galvan FH
Pilot evaluation of a brief intervention to improve nicotine patch adherence among smokers living with HIV/AIDS.
This article presents results from a pilot evaluation of a brief smoking cessation treatment to improve adherence to the nicotine patch among Latino smokers living with HIV/AIDS. Although this small pilot was conducted to estimate effect sizes and was not powered to detect group differences, results were promising and suggested that adding a 10-min module focused on nicotine patch adherence to a standard 5 As protocol could increase abstinence rates.
AHRQ-funded; HS000062.
Citation: Tucker JS, Shadel WG, Galvan FH .
Pilot evaluation of a brief intervention to improve nicotine patch adherence among smokers living with HIV/AIDS.
Psychol Addict Behav 2017 Mar;31(2):148-53. doi: 10.1037/adb0000221.
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Keywords: Human Immunodeficiency Virus (HIV), Patient Adherence/Compliance, Racial and Ethnic Minorities, Tobacco Use
Schneider JA, Kozloski M, Michaels S
Criminal justice involvement history is associated with better HIV care continuum metrics among a population-based sample of young black MSM.
This study examined how history of criminal justice involvement (CJI) is related to HIV care continuum metrics among young black MSM 16-29 years of age. It found that having one CJI experience and detention for only 1 day was associated with better retention in care compared with no or more frequent CJI. Those with a previous history of CJI were more successful in achieving most HIV care continuum metrics.
AHRQ-funded; HS000084.
Citation: Schneider JA, Kozloski M, Michaels S .
Criminal justice involvement history is associated with better HIV care continuum metrics among a population-based sample of young black MSM.
AIDS 2017 Jan 2;31(1):159-65. doi: 10.1097/qad.0000000000001269.
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Keywords: Care Management, Human Immunodeficiency Virus (HIV), Patient Adherence/Compliance, Racial and Ethnic Minorities
Farias AJ, Du XL
Association between out-of-pocket costs, race/ethnicity, and adjuvant endocrine therapy adherence among Medicare patients with breast cancer.
This study aimed to determine whether there are racial/ethnic differences in 1-year adherence to adjuvant endocrine therapy (AET) and whether out-of-pocket costs explain the racial/ethnic disparities in adherence. It concluded that racial/ethnic disparities in AET adherence were largely explained by women's differences in socioeconomic status and out-of-pocket medication costs.
AHRQ-funded; HS018956.
Citation: Farias AJ, Du XL .
Association between out-of-pocket costs, race/ethnicity, and adjuvant endocrine therapy adherence among Medicare patients with breast cancer.
J Clin Oncol 2017 Jan;35(1):86-95.
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Keywords: Cancer: Breast Cancer, Healthcare Costs, Patient Adherence/Compliance, Racial and Ethnic Minorities, Social Determinants of Health
Cooper LB, Hammill BG, Peterson ED
Characterization of mineralocorticoid receptor antagonist therapy initiation in high-risk patients with heart failure.
Heart failure guidelines recommend routine monitoring of serum potassium, and renal function in patients treated with a mineralocorticoid receptor antagonist (MRA). This study found that patients initiated on MRA therapy as an outpatient had extremely poor rates of guideline indicated follow-up laboratory monitoring after drug initiation. In particular, patients with chronic kidney disease were at high risk for adverse events after MRA initiation.
AHRQ-funded; HS021092.
Citation: Cooper LB, Hammill BG, Peterson ED .
Characterization of mineralocorticoid receptor antagonist therapy initiation in high-risk patients with heart failure.
Circ Cardiovasc Qual Outcomes 2017 Jan;10(1):pii: e002946. doi: 10.1161/circoutcomes.116.002946.
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Keywords: Care Management, Heart Disease and Health, Kidney Disease and Health, Adverse Drug Events (ADE), Patient Adherence/Compliance
Zullo MD, Gathright EC, Dolansky MA
Influence of depression on utilization of cardiac rehabilitation postmyocardial infarction: A study of 158 991 Medicare beneficiaries.
The purpose of this study was to examine the association between depression diagnosis and participation in cardiac rehabilitation (CR) in a large sample of Medicare beneficiaries with recent myocardial infarction (MI). It concluded that diagnosis of depression in Medicare beneficiaries was strongly associated with attending CR and attending more sessions of CR compared with those without depression. Depression is not a barrier to CR participation after MI in Medicare beneficiaries.
AHRQ-funded; HS019795.
Citation: Zullo MD, Gathright EC, Dolansky MA .
Influence of depression on utilization of cardiac rehabilitation postmyocardial infarction: A study of 158 991 Medicare beneficiaries.
J Cardiopulm Rehabil Prev 2017 Jan;37(1):22-29. doi: 10.1097/hcr.0000000000000222.
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Keywords: Heart Disease and Health, Depression, Medicare, Patient Adherence/Compliance, Comparative Effectiveness
Dakwar E, Levin FR, Olfson M
First treatment contact for ADHD: predictors of and gender differences in treatment seeking.
The investigators aimed to estimate ADHD treatment-seeking probabilities over the lifetime and to identify predictors of treatment seeking for ADHD separately for males and females. They found that a large proportion of persons with ADHD do not seek treatment, and that treatment seeking by males was affected by a greater number of identifiable characteristics, suggesting that males might be more responsive to efforts directed toward expediting treatment entry.
AHRQ-funded; HS016097.
Citation: Dakwar E, Levin FR, Olfson M .
First treatment contact for ADHD: predictors of and gender differences in treatment seeking.
Psychiatr Serv 2014 Dec;65(12):1465-73. doi: 10.1176/appi.ps.201300298.
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Keywords: Behavioral Health, Sex Factors, Patient Adherence/Compliance
Schmittdiel J, Raebel M, Dyer W
Medicare Star excludes diabetes patients with poor CVD risk factor control.
This study is designed to improve understanding of novel CMS quality measures (adherence to antihypertensives, antihyperlipidemics, and oral antihyperglycemics) by assessing the proportion of Medicare patients with diabetes who are excluded from the Medicare Star medication adherence metrics due to early nonadherence and insulin use. Medicare’s STAR measures are used to evaluate the performance of Medicare Advantage plans.
AHRQ-funded; HS019859
Citation: Schmittdiel J, Raebel M, Dyer W .
Medicare Star excludes diabetes patients with poor CVD risk factor control.
Am J Manag Care. 2014 Dec; 20(12):e573-81..
Keywords: Medicare, Diabetes, Quality Measures, Patient Adherence/Compliance
Kuntz JL, Safford MM, Singh JA
Patient-centered interventions to improve medication management and adherence: a qualitative review of research findings.
This review reports the current state of scientific research around interventions to improve medication management through four patient-centered domains. Out of 60 studies, the authors found the following types of intervention: patient education, augmented pharmacy services, decision aids, shared decision-making, and clinical review of patient adherence. They were unable to determine whether these interventions were more effective than traditional medication adherence interventions.
AHRQ-funded; HS021107.
Citation: Kuntz JL, Safford MM, Singh JA .
Patient-centered interventions to improve medication management and adherence: a qualitative review of research findings.
Patient Educ Couns 2014 Dec;97(3):310-26. doi: 10.1016/j.pec.2014.08.021.
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Keywords: Education: Patient and Caregiver, Decision Making, Medication, Patient Adherence/Compliance, Patient-Centered Healthcare