National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Ambulatory Care and Surgery (1)
- Arthritis (2)
- Asthma (4)
- Blood Pressure (1)
- Care Coordination (1)
- Care Management (2)
- Children/Adolescents (3)
- Chronic Conditions (12)
- Clinical Decision Support (CDS) (1)
- Clinician-Patient Communication (2)
- Communication (1)
- Decision Making (1)
- Diabetes (12)
- Digestive Disease and Health (1)
- Education: Patient and Caregiver (8)
- Electronic Health Records (EHRs) (3)
- Evidence-Based Practice (2)
- Healthcare Costs (1)
- Health Information Technology (HIT) (11)
- Health Literacy (2)
- Health Promotion (1)
- Home Healthcare (2)
- Human Immunodeficiency Virus (HIV) (1)
- Kidney Disease and Health (1)
- Lifestyle Changes (3)
- Low-Income (3)
- Medication (3)
- Nursing (1)
- Orthopedics (1)
- Pain (1)
- Patient-Centered Healthcare (3)
- Patient-Centered Outcomes Research (2)
- Patient Adherence/Compliance (3)
- Patient and Family Engagement (2)
- (-) Patient Self-Management (27)
- Primary Care (2)
- Provider: Pharmacist (1)
- Racial and Ethnic Minorities (1)
- Rural Health (1)
- Social Determinants of Health (1)
- Telehealth (6)
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 27 Research Studies DisplayedNair D, Cukor D, Taylor WD
Applying a biopsychosocial framework to achieve durable behavior change in kidney disease.
This scoping review uses the biopsychological model of health to identify individual, interpersonal, and systems-level drivers of kidney disease self-management behaviors. The authors also highlight factors that may serve as novel, impactful targets of theory-based behavioral interventions to understand and sustain behavior change in kidney disease.
AHRQ-funded; HS026395.
Citation: Nair D, Cukor D, Taylor WD .
Applying a biopsychosocial framework to achieve durable behavior change in kidney disease.
Semin Nephrol 2021 Nov;41(6):487-504. doi: 10.1016/j.semnephrol.2021.10.002..
Keywords: Kidney Disease and Health, Chronic Conditions, Patient Self-Management
Fuji KT, Abbott AA, Galt KA
A mixed-methods evaluation of standalone personal health record use by patients with type 2 diabetes.
The purpose of this study was to compare use of a standalone personal health records (PHRs) by patients with Type 2 diabetes to usual care through assessment of self-care behaviors, and short-term impact on social cognitive outcomes and hemoglobin A1c (HbA1c). Five themes emerged from the qualitative analysis describing participants' experiences with the PHR and identifying reasons for lack of engagement. Study findings revealed low PHR uptake and minimal impact on study outcomes, including lack of communication and information-sharing between patients and providers.
AHRQ-funded; HS018625.
Citation: Fuji KT, Abbott AA, Galt KA .
A mixed-methods evaluation of standalone personal health record use by patients with type 2 diabetes.
Perspect Health Inf Manag 2021 Fall;18(4):1e..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Diabetes, Patient Self-Management, Chronic Conditions, Patient and Family Engagement
Lopez-Olivo MA, Lin H, Rizvi T
Randomized controlled trial of patient education tools for patients with rheumatoid arthritis.
This randomized controlled trial compared results of patient education tools for patients with rheumatoid arthritis using a written booklet or a written booklet along with a newly developed video tool. Outcomes were measured immediately before and after review of the materials, and 3 and 6 months later. One-hundred eleven participants received an educational video and booklet and one-hundred ten a booklet alone. Mean age of participants was 50.8 years, mean disease duration 4.8 years, 85% were female, and 24% had limited health literacy levels. Both groups had improved outcomes up to 6 months after educational materials were delivered and used, with no statistically significant difference between the two groups. Patients receiving the video and booklet were more likely to rate the presentation as “excellent".
AHRQ-funded; HS0193554.
Citation: Lopez-Olivo MA, Lin H, Rizvi T .
Randomized controlled trial of patient education tools for patients with rheumatoid arthritis.
Arthritis Care Res 2021 Oct;73(10):1470-78. doi: 10.1002/acr.24362..
Keywords: Education: Patient and Caregiver, Health Literacy, Arthritis, Patient Self-Management
Smith BM, Sharma R, Das A
Patient and family engagement strategies for children and adolescents with chronic diseases: a review of systematic reviews.
Patient and family engagement is important for family-centered care, particularly for children and adolescents with chronic disease. In this study the investigators aimed to 1) identify available evidence from systematic reviews on engagement strategies used to help children, adolescents, and their caregivers manage chronic conditions, and 2) identify gaps in the literature. They searched PubMed and CINAHL from January 2015 to January 2020 for systematic reviews on patient and family engagement strategies in the pediatrics population (<18 years).
AHRQ-funded; 290201500006I.
Citation: Smith BM, Sharma R, Das A .
Patient and family engagement strategies for children and adolescents with chronic diseases: a review of systematic reviews.
Patient Educ Couns 2021 Sep;104(9):2213-23. doi: 10.1016/j.pec.2021.02.026..
Keywords: Children/Adolescents, Patient and Family Engagement, Chronic Conditions, Patient-Centered Healthcare, Evidence-Based Practice, Patient Self-Management
Oikonomidi T, Ravaud P, James A
AHRQ Author: Montori V
An international, mixed-methods study of the perceived intrusiveness of remote digital diabetes monitoring.
This paper describes an international online vignette-based survey to assess the relationship between remote digital monitoring (RDM) modalities for diabetes and intrusiveness in patients’ lives. The survey was conducted from February-June 2019 in 30 countries with 1010 participants. A total of 2680 vignette-assessments were completed with 52% on type 1 diabetes. Increased intrusiveness was associated with food monitoring compared with glucose- and PA-monitoring alone and permanent monitoring with real-time physician-generated feedback compared with monitoring for a week with feedback. Public-sector data handling was associated with decreased intrusiveness as compared with the private sector.
AHRQ-authored.
Citation: Oikonomidi T, Ravaud P, James A .
An international, mixed-methods study of the perceived intrusiveness of remote digital diabetes monitoring.
Mayo Clin Proc 2021 May;96(5):1236-47. doi: 10.1016/j.mayocp.2020.07.040..
Keywords: Telehealth, Health Information Technology (HIT), Diabetes, Chronic Conditions, Lifestyle Changes, Patient Self-Management
Lopez-Olivo MA, des Bordes JK, Lin H
A randomized controlled trial comparing two self-administered educational strategies for patients with knee osteoarthritis.
The authors conducted a randomized clinical trial in patients with knee osteoarthritis to assess the efficacy of providing a video for entertainment education, in combination with two booklets, compared with providing the booklets alone. They found that, although both education strategies were associated with improved knowledge and reduced decisional conflict at 6 months, receiving the video + booklets in combination, compared with receiving the booklets alone, proved to be more effective in changing behaviors and appeared to have some advantages for Spanish speakers and those who were less educated.
AHRQ-funded; HS019354.
Citation: Lopez-Olivo MA, des Bordes JK, Lin H .
A randomized controlled trial comparing two self-administered educational strategies for patients with knee osteoarthritis.
ACR Open Rheumatol 2021 Mar;3(3):185-95. doi: 10.1002/acr2.11222..
Keywords: Arthritis, Orthopedics, Education: Patient and Caregiver, Patient Self-Management, Patient Adherence/Compliance, Decision Making, Health Promotion
Ozkaynak M, Valdez R, Hannah K
Understanding gaps between daily living and clinical settings in chronic disease management: qualitative study.
This study’s objective was to characterize gaps from the patient’s perspective between health-related activities across home-based and clinical settings in the management of chronic conditions. Patients were recruited from an anticoagulation clinic of an urban, western mountain system and primary interviews were conducted with 39 patients and 4 providers. The causes of gaps included clinician recommendations not fitting into patients’ daily routines; recommendations not fitting into a patients’ living contexts; and no information transfer across settings. Consequences of these gaps included increased cognitive and physical workload on the patient, poor patient satisfaction, and compromised adherence to the therapy plan.
AHRQ-funded; HS024092.
Citation: Ozkaynak M, Valdez R, Hannah K .
Understanding gaps between daily living and clinical settings in chronic disease management: qualitative study.
J Med Internet Res 2021 Feb 25;23(2):e17590. doi: 10.2196/17590..
Keywords: Chronic Conditions, Care Management, Care Coordination, Patient Self-Management, Health Information Technology (HIT)
Oikonomidi T, Ravaud P, Cosson E
AHRQ Author: Montori V
Evaluation of patient willingness to adopt remote digital monitoring for diabetes management.
Investigators sought to identify the minimum effectiveness patients report they require to adopt 36 different remote digital monitoring (RDM) scenarios. Adults with type 1 or type 2 diabetes living in 30 countries assessed three randomly selected scenarios from a total of 36 that described different combinations of digital monitoring tools. The investigators found that patients required greater health benefits to adopt more intrusive RDM modalities, food monitoring, and real-time feedback by a health care professional. They recommended that patient monitoring devices be designed to be minimally intrusive.
AHRQ-authored.
Citation: Oikonomidi T, Ravaud P, Cosson E .
Evaluation of patient willingness to adopt remote digital monitoring for diabetes management.
JAMA Netw Open 2021 Jan;4(1):e2033115. doi: 10.1001/jamanetworkopen.2020.33115..
Keywords: Telehealth, Health Information Technology (HIT), Diabetes, Chronic Conditions, Care Management, Patient Self-Management, Patient Adherence/Compliance
Howland C, Despins L, Sindt J
Primary care clinic nurse activities with a telehealth monitoring system.
The purpose of this study was to evaluate differences in the types of nursing activities and communication processes reported in a primary care clinic between patients using a home-based monitoring system to electronically communicate self-monitored blood glucose and blood pressure values and those assuming usual care. Significant differences were identified for the direct care nursing activities of providing lifestyle and health education, medication adjustments, and patient follow-up, providing evidence of greater nursing activity reported in a primary care clinic in patients who utilized a home-based monitoring system.
AHRQ-funded; HS017035.
Citation: Howland C, Despins L, Sindt J .
Primary care clinic nurse activities with a telehealth monitoring system.
West J Nurs Res 2021 Jan;43(1):5-12. doi: 10.1177/0193945920923082..
Keywords: Telehealth, Health Information Technology (HIT), Blood Pressure, Primary Care, Clinician-Patient Communication, Communication, Patient Self-Management, Nursing, Patient-Centered Healthcare, Diabetes
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
Luo G, Stone BL, Fassl B
Predicting asthma control deterioration in children.
The researchers developed and tested the first set of models for predicting a child’s asthma control deterioration one week prior to occurrence. Their best model successfully predicted a child’s asthma control level one week ahead. With adequate accuracy, the model could be integrated into electronic asthma self-monitoring systems.
AHRQ-funded; HS018166; HS018678.
Citation: Luo G, Stone BL, Fassl B .
Predicting asthma control deterioration in children.
BMC Med Inform Decis Mak 2015 Oct 14;15:84. doi: 10.1186/s12911-015-0208-9..
Keywords: Asthma, Children/Adolescents, Health Information Technology (HIT), Patient Self-Management
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
Rangachari P, Mehta R, Rethemeyer RK
Short or long end of the lever? Associations between provider communication of the "asthma-action plan" and outpatient revisits for pediatric asthma.
This study addresses the gap in understanding the extent of leverage that healthcare providers may have in preventing hospital revisits for asthma through effective communication of the Asthma-Action Plan (AAP) in the outpatient setting. The Children's Hospital of Georgia survey results suggest limited potential of effective provider communication of AAP in reducing outpatient revisits for pediatric asthma and indicate a need for broader community-based interventions to address patient life variables impacting self-management and hospital revisits for pediatric asthma.
AHRQ-funded; HS019785.
Citation: Rangachari P, Mehta R, Rethemeyer RK .
Short or long end of the lever? Associations between provider communication of the "asthma-action plan" and outpatient revisits for pediatric asthma.
J Hosp Adm 2015 Oct;4(5):26-39. doi: 10.5430/jha.v4n5p26.
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Keywords: Asthma, Children/Adolescents, Ambulatory Care and Surgery, Clinician-Patient Communication, Patient Self-Management
Ancker JS, Witteman HO, Hafeez B
"You get reminded you're a sick person": personal data tracking and patients with multiple chronic conditions.
The researchers’ aim was to explore the perspectives of individuals with multiple chronic conditions (MCC) using a semistructured interview study. Their research questions were (1) How do individuals with MC track their own health and medical data? and (2) How do patients and providers perceive and use patient-tracked data? Their findings potentially explain relatively low adoption of consumer health information technology.
AHRQ-funded; HS021531.
Citation: Ancker JS, Witteman HO, Hafeez B .
"You get reminded you're a sick person": personal data tracking and patients with multiple chronic conditions.
J Med Internet Res 2015 Aug 19;17(8):e202. doi: 10.2196/jmir.4209..
Keywords: Chronic Conditions, Education: Patient and Caregiver, Health Information Technology (HIT), Patient Self-Management
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
Ancker JS, Witteman HO, Hafeez B
The invisible work of personal health information management among people with multiple chronic conditions: qualitative interview study among patients and providers.
The researchers conducted a semistructured interview study with 22 patients with multiple chronic conditions (MCC) with the objective of exploring their role in managing their personal health information. They concluded that personal health information management should be recognized as an additional burden that MCC places upon patients. Their findings suggest that both provider-centered and patient-centered information technologies will continue to be needed.
AHRQ-funded; HS021531.
Citation: Ancker JS, Witteman HO, Hafeez B .
The invisible work of personal health information management among people with multiple chronic conditions: qualitative interview study among patients and providers.
J Med Internet Res 2015 Jun 4;17(6):e137. doi: 10.2196/jmir.4381..
Keywords: Chronic Conditions, Education: Patient and Caregiver, Patient-Centered Healthcare, Health Information Technology (HIT), Patient Self-Management
Lepard MG, Joseph AL, Agne AA
Diabetes self-management interventions for adults with type 2 diabetes living in rural areas: a systematic literature review.
The authors systematically reviewed the evidence for the impact of diabetes self-management education interventions designed for patients living in rural areas on glycemic control and other diabetes outcomes. They were able to identify examples of both telehealth interventions and face-to-face interventions that resulted in improved behavioral, biologic, and diabetes knowledge-related outcomes in adults with T2DM living in rural areas.
AHRQ-funded; HS019465.
Citation: Lepard MG, Joseph AL, Agne AA .
Diabetes self-management interventions for adults with type 2 diabetes living in rural areas: a systematic literature review.
Curr Diab Rep 2015 Jun;15(6):608. doi: 10.1007/s11892-015-0608-3..
Keywords: Diabetes, Patient Self-Management, Rural Health, Telehealth, Health Information Technology (HIT)
Kuhn L, Reeves K, Taylor Y
Planning for action: the impact of an asthma action plan decision support tool integrated into an electronic health record (EHR) at a large health care system.
This project aimed to embed an electronic asthma action plan decision support tool (eAAP) into the medical record to streamline evidence-based guidelines for providers at the point of care, create individualized patient handouts, and evaluate effects on disease outcomes. Its findings supports existing evidence that patient self-management plays an important role in reducing asthma exacerbations.
AHRQ-funded; HS019946.
Citation: Kuhn L, Reeves K, Taylor Y .
Planning for action: the impact of an asthma action plan decision support tool integrated into an electronic health record (EHR) at a large health care system.
J Am Board Fam Med 2015 May-Jun;28(3):382-93. doi: 10.3122/jabfm.2015.03.140248..
Keywords: Electronic Health Records (EHRs), Clinical Decision Support (CDS), Asthma, Patient Self-Management, Evidence-Based Practice
O'Leary K, Eschler J, Kendall L
Understanding design tradeoffs for health technologies: a mixed-methods approach.
The researchers introduced a mixed-methods approach for determining how people weigh tradeoffs in values related to health and technologies for health self-management. Their approach provided these key advantages: a structured health sciences theoretical framework to guide data collection and analysis; the coding of unstructured data with statistical patterns of polarizing and consensus views; and participants to actively weigh competing values that are most personally significant to them.
AHRQ-funded; HS021590.
Citation: O'Leary K, Eschler J, Kendall L .
Understanding design tradeoffs for health technologies: a mixed-methods approach.
Proc SIGCHI Conf Hum Factor Comput Syst 2015 Apr 18;2015:4151-60. doi: 10.1145/2702123.2702576.
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Keywords: Health Information Technology (HIT), Health Information Technology (HIT), Patient Self-Management
Fuji KT, Abbott AA, Galt KA
A qualitative study of how patients with type 2 diabetes use an electronic stand-alone personal health record.
The authors explored how patients with type 2 diabetes used a personal health record (PHR) to manage their diabetes-related health information for self-care. They found that, despite some potential positive benefits resulting from PHR use, several barriers inhibited sustained and effective use over time. They concluded that provider and patient education about the benefits of PHR use and about the potential for filling in information gaps in the provider-based record is key to engage patients and stimulate PHR adoption and use.
AHRQ-funded; HS018625.
Citation: Fuji KT, Abbott AA, Galt KA .
A qualitative study of how patients with type 2 diabetes use an electronic stand-alone personal health record.
Telemed J E Health 2015 Apr;21(4):296-300. doi: 10.1089/tmj.2014.0084.
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Keywords: Diabetes, Electronic Health Records (EHRs), Patient Self-Management, Telehealth
Merlin JS, Walcott M, Kerns R
Pain self-management in HIV-infected individuals with chronic pain: a qualitative study.
The objective of this investigation is to develop an understanding of self-management strategies already used by persons living with these conditions. It found that the primary pain self-management strategies articulated by participants were: physical activity; cognitive and spiritual strategies; spending time with family and friends and social support; avoidance of physical/social activity; medication-centric pain management; and substance use.
AHRQ-funded; HS021694.
Citation: Merlin JS, Walcott M, Kerns R .
Pain self-management in HIV-infected individuals with chronic pain: a qualitative study.
Pain Med 2015 Apr;16(4):706-14. doi: 10.1111/pme.12701..
Keywords: Chronic Conditions, Human Immunodeficiency Virus (HIV), Pain, Patient Self-Management
Wellman BR, Frail CK, Zillich AJ
Pharmacists' experiences with a telephonic medication therapy management program for home health care patients.
This qualitative study involved interviewing four pharmacists on their experiences with a telephone medication therapy management (MTM) program. Several themes emerged from the analysis, including: communication and relationships, coordinating care and patient self-management, logistics, professional fulfillment, service delivery and content, and training opportunities. The researchers concluded that their study provides possible strategies to overcome barriers and facilitate service provision for future telephonic MTM services.
AHRQ-funded; HS022119.
Citation: Wellman BR, Frail CK, Zillich AJ .
Pharmacists' experiences with a telephonic medication therapy management program for home health care patients.
Consult Pharm 2015 Mar;30(3):163-74. doi: 10.4140/TCP.n.2015.163..
Keywords: Home Healthcare, Medication, Provider: Pharmacist, Patient Self-Management
Ejebe IH, Jacobs EA, Wisk LE
Persistent differences in asthma self-efficacy by race, ethnicity, and income in adults with asthma.
The objective of this population-based study was to determine if and to what extent there are differences in asthma self-efficacy by race/ethnicity and income, and whether health status, levels of acculturation, and health care factors may explain these differences. It found that racial/ethnic minorities and individuals living in poverty have the lowest levels of asthma self-efficacy.
AHRQ-funded; HS000063.
Citation: Ejebe IH, Jacobs EA, Wisk LE .
Persistent differences in asthma self-efficacy by race, ethnicity, and income in adults with asthma.
J Asthma 2015 Feb;52(1):105-13. doi: 10.3109/02770903.2014.947429..
Keywords: Asthma, Patient Self-Management, Social Determinants of Health, Low-Income, Racial and Ethnic Minorities