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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 29 Research Studies DisplayedHolcomb J, Ferguson GM, Sun J
Stakeholder engagement in adoption, implementation, and sustainment of an evidence-based intervention to increase mammography adherence among low-income women.
The purpose of this document review study was to create a conceptual framework to guide stakeholder engagement in an evidence-based intervention to increase mammography appointment adherence in underserved and low-income women. The document review results were aligned with the constructs of the conceptual framework and an application of stakeholder engagement in an evidence-based mammography intervention. The researchers concluded that both the conceptual framework constructs and the stakeholder engagement strategies can be utilized across a range of organizations, programs, and settings.
AHRQ-funded; HS023255.
Citation: Holcomb J, Ferguson GM, Sun J .
Stakeholder engagement in adoption, implementation, and sustainment of an evidence-based intervention to increase mammography adherence among low-income women.
J Cancer Educ 2022 Oct;37(5):1486-95. doi: 10.1007/s13187-021-01988-2..
Keywords: Evidence-Based Practice, Screening, Imaging, Women, Low-Income, Patient Adherence/Compliance
Oke I, Badami A, Kosteva KL
Systemic barriers in receiving electronically prescribed glaucoma medications.
The purpose of this cross-sectional study was to quantify glaucoma medication treatment interruptions attributable to electronically prescribed medications and recommend interventions to reduce this barrier. The researchers reviewed Glaucoma medication refill requests received over a 6-week interval, and then contacted patient pharmacies 1 month after the request date to determine whether the medication was picked up by the patient. Patients who did not pick up the prescriptions were contacted and consented to participate in a survey to identify the barriers to getting the medications. The study found that a prior authorization requirement was significantly associated with patients not obtaining their medication, as well as insurance coverage (32.2%) and availability of the medication at the pharmacy (22.6%). The study concluded that due to the need for prior authorization, insurance coverage, and pharmacy availability, approximately one third of electronically prescribed glaucoma medications were not picked up by patients within one month of the refill request.
AHRQ-funded; HS000063.
Citation: Oke I, Badami A, Kosteva KL .
Systemic barriers in receiving electronically prescribed glaucoma medications.
J Glaucoma 2022 Oct;31(10):812-15. doi: 10.1097/ijg.0000000000002100..
Keywords: Medication, Patient Adherence/Compliance, Electronic Prescribing (E-Prescribing), Health Information Technology (HIT)
Roddy MK, Mayberry LS, Nair D
Exploring mHealth potential to improve kidney function: secondary analysis of a randomized trial of diabetes self-care in diverse adults.
This study examined whether REACH, a text message-delivered self-management support intervention, which focuses on medication adherence, diet, and exercise can significantly improve glycemic control in 506 chronic kidney disease (CKD) patients with Type 2 Diabetes (T2D). The authors used data from the trial to explore the intervention’s effect on change in estimated glomerular filtration rate (eGR) at 12 months in a subsample of 271 patients. Patients with proteinuria at baseline who received REACH had less worsening of eGFR.
AHRQ-funded; HS026395.
Citation: Roddy MK, Mayberry LS, Nair D .
Exploring mHealth potential to improve kidney function: secondary analysis of a randomized trial of diabetes self-care in diverse adults.
BMC Nephrol 2022 Aug 10;23(1):280. doi: 10.1186/s12882-022-02885-6..
Keywords: Telehealth, Health Information Technology (HIT), Patient Self-Management, Diabetes, Chronic Conditions, Kidney Disease and Health, Patient Adherence/Compliance
Creary SE, Beeman C, Stanek J
Impact of hydroxyurea dose and adherence on hematologic outcomes for children with sickle cell anemia.
The purpose of this study was to quantify the contributions of hydroxyurea dose and medication adherence to the association between hydroxyurea exposure and hematologic parameters in children with sickle cell anemia (SCA.) Using data from children with SCA who were enrolled in two prospective hydroxyurea adherence studies, the researchers assessed the association by video of directly observed therapy or electronic pill bottle and medication administration record. Forty-five participants were included in the analysis. The study reported that higher exposure was related with higher fetal hemoglobin and mean corpuscular volume. The researchers concluded that higher hydroxyurea dose was related with improved hematologic parameters and is affected by level of prescribed dose and adherence.
AHRQ-funded; HS023011.
Citation: Creary SE, Beeman C, Stanek J .
Impact of hydroxyurea dose and adherence on hematologic outcomes for children with sickle cell anemia.
Pediatr Blood Cancer 2022 Jun;69(6):e29607. doi: 10.1002/pbc.29607..
Keywords: Children/Adolescents, Medication, Sickle Cell Disease, Chronic Conditions, Outcomes, Patient Adherence/Compliance
Hunter KB, Glickman ME, Campos LF
Inferring medication adherence from time-varying health measures.
The purpose of this study was to explore an approach to infer medication adherence rates based on longitudinally recorded health measures that are likely impacted by time-varying adherence behaviors. A modular inferential approach was utilized, which included fitting a two-component model on a training set of patients with detailed adherence data. The researchers assessed the method on a cohort of hypertensive patients, using baseline socio-demographic measures, health comorbidities, and blood pressure measured over time to infer patients' adherence to antihypertensive medication.
AHRQ-funded; HS022112.
Citation: Hunter KB, Glickman ME, Campos LF .
Inferring medication adherence from time-varying health measures.
Stat Med 2022 May 30;41(12):2205-26. doi: 10.1002/sim.9351..
Keywords: Medication, Patient Adherence/Compliance, Blood Pressure
Mason M, Cho Y, Rayo J
Technologies for medication adherence monitoring and technology assessment criteria: narrative review.
This narrative review summarizes the technical features, data capture methods, and various advantages and limitations of medication adherence monitoring technology along with proposed criteria for assessing medication adherence monitoring technologies. Technology assessment criteria were identified and organized into the following five categories: development information, technology features, adherence to data collection and management, feasibility and implementation, and acceptability and usability.
AHRQ-funded; R01 HS027846.
Citation: Mason M, Cho Y, Rayo J .
Technologies for medication adherence monitoring and technology assessment criteria: narrative review.
JMIR Mhealth Uhealth 2022 Mar 10;10(3):e35157. doi: 10.2196/35157..
Keywords: Medication, Patient Adherence/Compliance, Telehealth, Health Information Technology (HIT)
Cochran G, Cole ES, Sharbaugh M
Provider and patient-panel characteristics associated with initial adoption and sustained prescribing of medication for opioid use disorder.
This study examined primary care provider (PCP) and patient-panel characteristics associated with initial adoption and sustained prescribing of medication for opioid use disorder (MOUD). The authors assessed a retrospective cohort from 2015 to 2018 within the Pennsylvania Medicaid Program. Participants included PCPs who were Medicaid providers, with no history of MOUD provision, and who treated 10 or more Medicaid enrollees annually. The authors identified 113 rural and 782 urban PCPs who engaged in initial adoption and 36 rural and 288 urban PCPs who engaged in sustained prescribing. Rural/urban PCPs who prescribed increasing larger numbers of antidepressant and antipsychotic medications had greater odds of initial adoption and sustained prescribing compared to those that did not prescribe these medications. Each additional patient out of 100 with opioid use disorder diagnosed before MOUD adoption increased the adjusted odds for initial adoption 2% to 4% and sustained prescribing by 4% to 7%. New Medicaid providers in rural areas were 2.52 and in urban areas were 2.66 more likely to engage in initial MOUD adoption compared to established PCPs.
AHRQ-funded; HS025072.
Citation: Cochran G, Cole ES, Sharbaugh M .
Provider and patient-panel characteristics associated with initial adoption and sustained prescribing of medication for opioid use disorder.
J Addict Med 2022 Mar-Apr;16(2):e87-e96. doi: 10.1097/adm.0000000000000859..
Keywords: Opioids, Medication, Substance Abuse, Patient Adherence/Compliance, Behavioral Health
Wickwire EM, Bailey MD, Somers VK
CPAP adherence is associated with reduced inpatient utilization among older adult Medicare beneficiaries with pre-existing cardiovascular disease.
The purpose of this study was to examine the impact of adherence to continuous positive airway pressure (CPAP) therapy on health care utilization among a nationally representative and sample of older adults with multiple morbidities and pre-existing cardiovascular disease and subsequently diagnosed with obstructive sleep apnea in the United States. The investigators concluded that in this nationally representative sample of older Medicare beneficiaries with multiple morbidities and relative to low adherers, high adherers demonstrated reduced inpatient utilization.
AHRQ-funded; HS024560.
Citation: Wickwire EM, Bailey MD, Somers VK .
CPAP adherence is associated with reduced inpatient utilization among older adult Medicare beneficiaries with pre-existing cardiovascular disease.
J Clin Sleep Med 2022 Jan;18(1):39-45. doi: 10.5664/jcsm.9478..
Keywords: Elderly, Medicare, Sleep Problems, Cardiovascular Conditions, Patient Adherence/Compliance, Hospitalization, Healthcare Utilization, Respiratory Conditions
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
Kendall L, Eschler J, Lozano P
Engineering for reliability in at-home chronic disease management.
The researchers examined how individuals responsible for managing their own or others’ chronic conditions integrate reminders and notification systems into their daily routines. Based on the participants’ experiences, they contend that many self-management failures should be viewed as systems failures, rather than individual failures and non-compliance.
AHRQ-funded; HS021590.
Citation: Kendall L, Eschler J, Lozano P .
Engineering for reliability in at-home chronic disease management.
AMIA Annu Symp Proc 2014 Nov 14;2014:777-86..
Keywords: Chronic Conditions, Patient Self-Management, Home Healthcare, Patient Adherence/Compliance
Albrecht JS, Gruber-Baldini AL, Hirshon JM
Hospital discharge instructions: comprehension and compliance among older adults.
The purpose of this prospective cohort study was to quantify the prevalence of non-comprehension and non-compliance with discharge instructions and to identify associated patient characteristics. The investigators concluded that non-comprehension of discharge instructions among older adults was prevalent, multi-factorial, and varies by domain.
AHRQ-funded; HS021068.
Citation: Albrecht JS, Gruber-Baldini AL, Hirshon JM .
Hospital discharge instructions: comprehension and compliance among older adults.
J Gen Intern Med 2014 Nov;29(11):1491-8. doi: 10.1007/s11606-014-2956-0..
Keywords: Elderly, Health Literacy, Hospital Discharge, Patient Adherence/Compliance
Zhang Y, Kaplan CM, Baik SH
Medication adherence and readmission after myocardial infarction in the Medicare population.
This study examines the relationship between 6-month medication adherence following a hospitalization for heart attack and a subsequent readmission occurring between 6 and 12 months after the heart attack. It found that the probability of having a preventable readmission 6 to 12 months after a heart attack discharge was much lower for Medicare beneficiaries with good adherence to all heart attack-related medications, compared to those with poor adherence.
AHRQ-funded; HS018657
Citation: Zhang Y, Kaplan CM, Baik SH .
Medication adherence and readmission after myocardial infarction in the Medicare population.
Am J Manag Care 2014 Nov; 20(11):e498-505..
Keywords: Heart Disease and Health, Medication, Patient Adherence/Compliance, Hospital Readmissions
Starner CI, Alexander GC, Bowen K
Specialty drug coupons lower out-of-pocket costs and may improve adherence at the risk of increasing premiums.
The investigators examined insurers' role in maintaining the affordability and accessibility of specialty drugs while maximizing their value. They found that drug coupons accounted for $21.2 million of patients' $35.3 million annual out-of-pocket costs. In the vast majority of cases, coupons reduced monthly cost sharing to less than $250, a point at which patients were far less likely to abandon therapy with biologic anti-inflammatory drugs or with drugs for multiple sclerosis. They highlighted that, by reducing cost sharing, coupons may also circumvent efforts to encourage patients to use the most cost-effective drugs.
AHRQ-funded; HS018960.
Citation: Starner CI, Alexander GC, Bowen K .
Specialty drug coupons lower out-of-pocket costs and may improve adherence at the risk of increasing premiums.
Health Aff 2014 Oct;33(10):1761-9. doi: 10.1377/hlthaff.2014.0497.
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Keywords: Healthcare Costs, Health Insurance, Medication, Patient Adherence/Compliance
Mixon AS, Neal E, Bell S
Care transitions: a leverage point for safe and effective medication use in older adults--a mini-review.
The authors discuss medication adherence in older adults across the continuum of care, describing reasons for nonadherence, methods to assess adherence, and tools to improve adherence, with particular focus on emerging techniques and technologies.
AHRQ-funded; HS019598.
Citation: Mixon AS, Neal E, Bell S .
Care transitions: a leverage point for safe and effective medication use in older adults--a mini-review.
Gerontology 2015;61(1):32-40. doi: 10.1159/000363765.
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Keywords: Elderly, Hospital Discharge, Medication: Safety, Medication, Patient Adherence/Compliance
Checchi KD, Huybrechts KF, Avorn J
Electronic medication packaging devices and medication adherence: a systematic review.
The authors conducted a systematic review of studies testing the effectiveness of electronic medication packaging (EMP) devices. From the 37 studies included in the review, they determined that although many varieties of EMP devices exist, data supporting their use are limited, with variability in the quality of studies testing EMP devices.
AHRQ-funded; HS18465
Citation: Checchi KD, Huybrechts KF, Avorn J .
Electronic medication packaging devices and medication adherence: a systematic review.
JAMA. 2014 Sep 24;312(12):1237-47. doi: 10.1001/jama.2014.10059..
Keywords: Medication, Health Information Technology (HIT), Patient Safety, Patient Adherence/Compliance
Kelly JD, Hartman C, Graham J
Social support as a predictor of early diagnosis, linkage, retention, and adherence to HIV care: results from the steps study.
The researchers studied 168 persons newly diagnosed with AIDS to determine if social support contributes to various aspects of HIV care. They found that higher social support scores were associated with earlier HIV diagnosis, linkage to care, and adherence to antiretroviral therapy (ART). However, social support did not contribute to use of ART or retention in HIV care.
AHRQ-funded; HS016093
Citation: Kelly JD, Hartman C, Graham J .
Social support as a predictor of early diagnosis, linkage, retention, and adherence to HIV care: results from the steps study.
J Assoc Nurses AIDS Care. 2014 Sep-Oct;25(5):405-13. doi: 10.1016/j.jana.2013.12.002..
Keywords: Human Immunodeficiency Virus (HIV), Patient Adherence/Compliance, Diagnostic Safety and Quality
Kesselheim AS, Bykov K, Avorn J
Burden of changes in pill appearance for patients receiving generic cardiovascular medications after myocardial infarction: cohort and nested case-control studies.
This study sought to determine whether nonpersistent use of generic drugs among patients with cardiovascular disease after a heart attack is associated with the different shapes or colors of generic medications. It found that patients who subsequently discontinued treatment with their cardiovascular medications were 30 percent more likely to have had a change in pill shape or color preceding the discontinuation.
AHRQ-funded; HS018465
Citation: Kesselheim AS, Bykov K, Avorn J .
Burden of changes in pill appearance for patients receiving generic cardiovascular medications after myocardial infarction: cohort and nested case-control studies.
Ann Intern Med. 2014 Jul 15;161(2):96-103. doi: 10.7326/M13-2381..
Keywords: Cardiovascular Conditions, Medication, Chronic Conditions, Patient Adherence/Compliance
Laws MB, Lee Y, Rogers WH
Provider-patient communication about adherence to anti-retroviral regimens differs by patient race and ethnicity.
This study directly examined differences in provider–patient communication about anti-retroviral therapy (ART) adherence by patient race or ethnicity. It found more ART adherence dialogue with Black and Hispanic patients than with White patients, even after controlling for indications, and a tendency for adherence dialogue to be more directive in Hispanics than in Whites.
AHRQ-funded; 290010012.
Citation: Laws MB, Lee Y, Rogers WH .
Provider-patient communication about adherence to anti-retroviral regimens differs by patient race and ethnicity.
AIDS Behav 2014 Jul;18(7):1279-87. doi: 10.1007/s10461-014-0697-z..
Keywords: Human Immunodeficiency Virus (HIV), Clinician-Patient Communication, Patient Adherence/Compliance, Racial and Ethnic Minorities
Voils CI, Gierisch JM, Yancy WS, Jr.
Differentiating behavior initiation and maintenance: theoretical framework and proof of concept.
The authors posited that health behavior initiation and maintenance require separate psychological processes and skills. They found evidence of improvement in dietary intake and of maintenance of physical activity and low-density lipoprotein cholesterol during the 4-month maintenance study. Participants found it helpful to plan for relapses, self-monitor, and obtain social support, but they had mixed reactions about reflecting on satisfaction with outcomes.
AHRQ-funded; HS000079.
Citation: Voils CI, Gierisch JM, Yancy WS, Jr. .
Differentiating behavior initiation and maintenance: theoretical framework and proof of concept.
Health Educ Behav 2014 Jun;41(3):325-36. doi: 10.1177/1090198113515242.
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Keywords: Nutrition, Patient Adherence/Compliance, Patient Self-Management, Lifestyle Changes
Singh JA
Facilitators and barriers to adherence to urate-lowering therapy in African-Americans with gout: a qualitative study.
The study aim was to assess the facilitators and barriers to adherence to urate-lowering therapy (ULT) in African-Americans with gout. It found that facilitators to ULT adherence included recognition of the need to take ULT regularly to prevent gout flares and the desire to have less dietary restriction. Barriers to optimal ULT adherence included doubts about effectiveness of ULT and concerns about cost and side effects.
AHRQ-funded; HS021110.
Citation: Singh JA .
Facilitators and barriers to adherence to urate-lowering therapy in African-Americans with gout: a qualitative study.
Arthritis Res Ther 2014 Mar 29;16(2):R82. doi: 10.1186/ar4524..
Keywords: Patient Adherence/Compliance, Medication, Racial and Ethnic Minorities
Yehia BR, French B, Fleishman JA
AHRQ Author: Fleishman JA
Retention in care is more strongly associated with viral suppression in HIV-infected patients with lower versus higher CD4 counts.
The investigators evaluated whether the association between retention in care and viral suppression differed by HIV disease severity. They found that retention in care is more strongly associated with viral suppression in patients with lower CD4 counts. They concluded that their results have important implications for improving the health of patients with advanced HIV disease and for test and treat approaches to HIV prevention.
AHRQ-authored; AHRQ-funded; 290201100007C.
Citation: Yehia BR, French B, Fleishman JA .
Retention in care is more strongly associated with viral suppression in HIV-infected patients with lower versus higher CD4 counts.
J Acquir Immune Defic Syndr 2014 Mar;65(3):333-9. doi: 10.1097/qai.0000000000000023.
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Keywords: Human Immunodeficiency Virus (HIV), Medication, Patient Adherence/Compliance
Nundy S, Dick JJ, Chou CH
Mobile phone diabetes project led to improved glycemic control and net savings for Chicago plan participants.
Mobile phones are a promising tool to use in engaging patients in behavior change and facilitating self-care between visits. The researchers examined the impact of a six-month mobile health (mHealth) demonstration project among adults with diabetes. In addition to pre-post improvements in glycemic control and patients’ satisfaction with overall care, they observed a net cost savings of 8.8 percent.
AHRQ-funded; HS000084.
Citation: Nundy S, Dick JJ, Chou CH .
Mobile phone diabetes project led to improved glycemic control and net savings for Chicago plan participants.
Health Aff 2014 Feb;33(2):265-72. doi: 10.1377/hlthaff.2013.0589..
Keywords: Diabetes, Health Information Technology (HIT), Patient Adherence/Compliance, Patient Self-Management, Telehealth
Norton BL, Person AK, Castillo C
Barriers to using text message appointment reminders in an HIV clinic.
The researchers conducted a randomized, controlled trial of text message reminders in a large HIV clinic. They found that there were no differences in clinic attendance rates between the group that received text reminders versus the group that did not (72 versus 81 percent). They concluded that barriers must be addressed before they are used as a universal approach to improve clinic attendance.
AHRQ-funded; HS000079.
Citation: Norton BL, Person AK, Castillo C .
Barriers to using text message appointment reminders in an HIV clinic.
Telemed J E Health 2014 Jan;20(1):86-9. doi: 10.1089/tmj.2012.0275..
Keywords: Communication, Health Information Technology (HIT), Human Immunodeficiency Virus (HIV), Patient Adherence/Compliance