National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (1)
- Alcohol Use (1)
- Ambulatory Care and Surgery (2)
- Antibiotics (1)
- Antimicrobial Stewardship (1)
- Back Health and Pain (1)
- Behavioral Health (1)
- Care Management (3)
- Children/Adolescents (3)
- Decision Making (1)
- Diabetes (1)
- Elderly (2)
- Electronic Health Records (EHRs) (2)
- Health Information Technology (HIT) (2)
- Health Services Research (HSR) (1)
- Imaging (1)
- Medicare (1)
- Medication (5)
- Medication: Safety (1)
- Opioids (2)
- Patient-Centered Healthcare (1)
- (-) Practice Patterns (11)
- (-) Primary Care (11)
- Provider (1)
- Provider: Nurse (1)
- Provider: Physician (2)
- Provider: Physician Assistant (1)
- Quality of Care (1)
- Respiratory Conditions (2)
- Screening (1)
- Skin Conditions (1)
- Substance Abuse (1)
- Teams (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 11 of 11 Research Studies DisplayedLozada MJ, Raji MA, Goodwin JS
Opioid prescribing by primary care providers: a cross-sectional analysis of nurse practitioner, physician assistant, and physician prescribing patterns.
The purpose of this study was to identify prescription opioid over-prescribers by comparing prescribing patterns of primary care physicians (MDs), nurse practitioners (NPs), and physician assistants (PAs). Participants were a national sample of 2015 Medicare Part D enrollees. Findings showed that most NPs/PAs prescribed opioids in a pattern similar to MDs, but NPs/PAs had more outliers who prescribed high-frequency, high-dose opioids than did MDs. Recommendations included efforts to reduce opioid overprescribing including targeted provider education, risk stratification, and state legislation.
AHRQ-funded; HS020642.
Citation: Lozada MJ, Raji MA, Goodwin JS .
Opioid prescribing by primary care providers: a cross-sectional analysis of nurse practitioner, physician assistant, and physician prescribing patterns.
J Gen Intern Med 2020 Sep;35(9):2584-92. doi: 10.1007/s11606-020-05823-0..
Keywords: Opioids, Medication, Primary Care, Practice Patterns, Medication: Safety, Provider: Nurse, Provider: Physician, Provider: Physician Assistant, Provider
Fishbein AB, Hamideh N, Lor J
Management of atopic dermatitis in children younger than two years of age by community pediatricians: a survey and chart review.
The authors characterized primary care providers' (PCPs) practice patterns for atopic dermatitis (AD) in children under 2 years of age and determined the need for AD guidelines for PCPs focused on this age group. They found that PCP management of AD in children under 2 years of age is different from that of older children, with possible underuse of medium/high-potency topical corticosteroids. They recommended clear guidelines for this age group.
AHRQ-funded; HS023011.
Citation: Fishbein AB, Hamideh N, Lor J .
Management of atopic dermatitis in children younger than two years of age by community pediatricians: a survey and chart review.
J Pediatr 2020 Jun;221:138-44.e3. doi: 10.1016/j.jpeds.2020.02.015..
Keywords: Children/Adolescents, Skin Conditions, Provider: Physician, Practice Patterns, Primary Care, Medication, Care Management
Kuhns LM, Carlino B, Greeley K
A chart review of substance use screening and related documentation among adolescents in outpatient pediatric clinics: implications for practice.
This study looked at rates of substance use screening and related documentation among adolescents aged 12-17 in outpatient pediatric clinics in a large academic medical center. The authors abstracted a random sample of 127 records and coded clinical notes to describe screening cases and related characteristics. They then analyzed descriptive patterns within the data to calculate screening rates, characteristics of screening, and identify related factors. Rates of screening by providers was 72% for each common substance and a total of 6% of patients reported substance use during screening.
AHRQ-funded; HS026385.
Citation: Kuhns LM, Carlino B, Greeley K .
A chart review of substance use screening and related documentation among adolescents in outpatient pediatric clinics: implications for practice.
Subst Abuse Treat Prev Policy 2020 May 25;15(1):36. doi: 10.1186/s13011-020-00276-4..
Keywords: Children/Adolescents, Substance Abuse, Screening, Ambulatory Care and Surgery, Alcohol Use, Practice Patterns, Primary Care
Peterson EL, Ndumele CD, Busch SH
National referral and treatment patterns among mental health pediatric primary care visits.
The current study explored factors that predict referral from pediatric primary care to mental health specialty care among a nationally representative sample of visits. Results indicated that patient visits that included rarer/serious diagnoses (e.g., bipolar disorder) were more likely to receive a referral in comparison to those with ADHD.
AHRQ-funded; HS017589.
Citation: Peterson EL, Ndumele CD, Busch SH .
National referral and treatment patterns among mental health pediatric primary care visits.
Adm Policy Ment Health 2020 Jan;47(1):86-93. doi: 10.1007/s10488-019-00972-9..
Keywords: Children/Adolescents, Behavioral Health, Primary Care, Practice Patterns
Raji MY, Chen NW, Raji M
Factors associated with seeking physician care by Medicare beneficiaries who receive all their primary care from nurse practitioners.
The authors sought to examine rate and correlates of switching from exclusive nurse practitioner (NP) primary care to receiving some or all primary care from physicians. The study group consisted of Medicare beneficiaries with diabetes, congrestive heart failure, or chronic obstructive pulmonary disease. The researchers found that about half of Medicare patients under exclusive NP primary care switched to physicians for some or all primary care over a 3-year period.
AHRQ-funded; HS022134; HS020642.
Citation: Raji MY, Chen NW, Raji M .
Factors associated with seeking physician care by Medicare beneficiaries who receive all their primary care from nurse practitioners.
J Prim Care Community Health 2016 Oct;7(4):249-57. doi: 10.1177/2150131916659674.
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Keywords: Elderly, Medicare, Primary Care, Practice Patterns
Penti B, Liebschutz JM, Kopcza B
Novel peer review method for improving controlled substance prescribing in primary care.
The authors sought to determine if peer feedback through a chart review tool (CRT) can impact opioid prescribing for patients with chronic noncancer pain in an outpatient family medicine clinic at an urban, safety-net teaching hospital. They reviewed 99 patient charts from 14 physicians over 1 year. They found that the mean dose of opioids decreased 2.6 mg morphine equivalent dose (MED)/day from time of chart review until the end of the project, compared to a 6.9 mg MED/day increase that occurred from 12 months prior to chart review to the time of chart review, and 14 patients were taken off of opioids after the chart review.
AHRQ-funded; HS022242.
Citation: Penti B, Liebschutz JM, Kopcza B .
Novel peer review method for improving controlled substance prescribing in primary care.
J Opioid Manag 2016 Jul-Aug;12(4):269-79. doi: 10.5055/jom.2016.0342.
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Keywords: Adverse Drug Events (ADE), Medication, Opioids, Primary Care, Practice Patterns
Renati S, Linder JA
Necessity of office visits for acute respiratory infections in primary care.
The researchers measured the proportion of primary care acute respiratory infection (ARI) visits that may not require an office visit. They concluded that about two-thirds of primary care ARI visits may not be necessary for appropriate antibiotic management.
AHRQ-funded; HS018419.
Citation: Renati S, Linder JA .
Necessity of office visits for acute respiratory infections in primary care.
Fam Pract 2016 Jun;33(3):312-7. doi: 10.1093/fampra/cmw019.
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Keywords: Decision Making, Medication, Primary Care, Practice Patterns, Respiratory Conditions
Chung S, Zhao B, Lauderdale D
Initiation of treatment for incident diabetes: evidence from the electronic health records in an ambulatory care setting.
The researchers examined patterns and predictors of initiation of treatment for incident diabetes in an ambulatory care setting in the US. They found that only half of patients were treated during the first year following diabetes incidence, and only 20% of patients received both medication prescription and lifestyle modification interventions.
AHRQ-funded; HS019815.
Citation: Chung S, Zhao B, Lauderdale D .
Initiation of treatment for incident diabetes: evidence from the electronic health records in an ambulatory care setting.
Prim Care Diabetes 2015 Feb;9(1):23-30. doi: 10.1016/j.pcd.2014.04.005..
Keywords: Ambulatory Care and Surgery, Care Management, Diabetes, Electronic Health Records (EHRs), Health Information Technology (HIT), Primary Care, Practice Patterns
Gidengil CA, Linder JA, Beach S
Using clinical vignettes to assess quality of care for acute respiratory infections.
Overprescribing of antibiotics for acute respiratory infections (ARIs) is common. The objective of this study was to develop and validate a vignette-based method to estimate clinician ARI antibiotic prescribing. The researchers concluded that responses to 3 clinical vignettes can identify clinicians with relatively poor quality ARI antibiotic prescribing. Vignettes may be a mechanism to target clinicians for quality improvement efforts.
AHRQ-funded; HS018419.
Citation: Gidengil CA, Linder JA, Beach S .
Using clinical vignettes to assess quality of care for acute respiratory infections.
Inquiry 2016 Apr 20;53:pii: 0046958016636531. doi: 10.1177/0046958016636531..
Keywords: Antibiotics, Antimicrobial Stewardship, Electronic Health Records (EHRs), Health Information Technology (HIT), Health Services Research (HSR), Medication, Practice Patterns, Primary Care, Quality of Care, Respiratory Conditions
Howard HA, Malouin R, Callow-Rucker M
Care managers and knowledge shift in primary care patient-centered medical home transformation.
Based on a health insurance company-sponsored primary care transformation project, this study explores the perceptions of care management from the perspective of providers and practice staff to examine shifts in knowledge and their broader implications for primary care. It demonstrates how the diffusion of clinical power and knowledge production redefine primary care relationships to patients, as traditional hierarchies shift to team-based care.
AHRQ-funded; HS020046; HS01795.
Citation: Howard HA, Malouin R, Callow-Rucker M .
Care managers and knowledge shift in primary care patient-centered medical home transformation.
Hum Organ 2016 Spring;75(1):10-20..
Keywords: Care Management, Patient-Centered Healthcare, Primary Care, Practice Patterns, Teams
Tan A, Zhou J, Kuo YF
Variation among primary care physicians in the use of imaging for older patients with acute low back pain.
The authors sought to estimate the variation among primary care providers (PCPs) in the use of diagnostic imaging for older patients with non-specific acute low back pain. They used Texas Medicare claims data and tracked whether each patient received lumbar imaging within 4 weeks of the initial visit. They found that the specific physician seen by a patient accounted for 25 % of the variability in whether imaging was performed and that the use of imaging by individual physicians was stable over time.
AHRQ-funded; HS022134.
Citation: Tan A, Zhou J, Kuo YF .
Variation among primary care physicians in the use of imaging for older patients with acute low back pain.
J Gen Intern Med 2016 Feb;31(2):156-63. doi: 10.1007/s11606-015-3475-3.
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Keywords: Back Health and Pain, Elderly, Imaging, Primary Care, Practice Patterns