National Healthcare Quality and Disparities Report
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- Antibiotics (1)
- (-) Asthma (20)
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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 20 of 20 Research Studies DisplayedHarder VS, Shaw JS, McCulloch CE
Statewide asthma learning collaborative participation and asthma-related emergency department use.
This study looked at outcomes from participation of pediatric practices in a quality improvement (QI) collaborative to decrease asthma-related emergency department (ED) visits. A statewide network of practices participated in the collaborative from 2015 to 2016. Asthma-related ED visit rates per 100 child-years for children ages 3 to 21 was evaluated using the state’s all-payer claims databases. The authors found that in the postintervention year (2017) participating practices’ ED visit rate decreased by 5.8 per 100 child-years, compared to an increase of 1.8 per 100 child-years in non-participating practices. There were no statistically significant differences in asthma-related ED visit rates during 2016, which indicated that it took some time for QI elements to be successfully implemented in pediatric practices.
AHRQ-funded; HS025297.
Citation: Harder VS, Shaw JS, McCulloch CE .
Statewide asthma learning collaborative participation and asthma-related emergency department use.
Pediatrics 2020 Dec;146(6):e20200213. doi: 10.1542/peds.2020-0213..
Keywords: Children/Adolescents, Asthma, Emergency Department, Quality Improvement, Quality of Care, Primary Care, Guidelines
Cotter JM, Tyler A, Reese J
Steroid variability in pediatric inpatient asthmatics: survey on provider preferences of dexamethasone versus prednisone.
This study looked at pediatric emergency department (ED) inpatient use of dexamethasone versus prednisone by providers for asthma treatment. A survey was distributed to providers who care for inpatient asthmatics. Ninety-two providers completed the survey. When patients received dexamethasone in the ED, 44% continued dexamethasone, 14% switched to prednisone, 2% stopped steroid use, and 40% said it depended on the circumstances. Hospitalists were significantly more likely to continue dexamethasone than pulmonologists (61% versus 15%). Switching to prednisone included factors such as severity of exacerbation (73%) and asthma history (47%). Just over half of providers (5f1%) felt uncomfortable using dexamethasone because of “minimal data to support [its] use inpatient.”
AHRQ-funded; HS026512.
Citation: Cotter JM, Tyler A, Reese J .
Steroid variability in pediatric inpatient asthmatics: survey on provider preferences of dexamethasone versus prednisone.
J Asthma 2020 Sep;57(9):942-48. doi: 10.1080/02770903.2019.1622713..
Keywords: Children/Adolescents, Asthma, Respiratory Conditions, Medication, Inpatient Care, Care Management, Hospitalization, Emergency Department, Practice Patterns, Provider: Physician, Provider
Greenhawt M, Shaker M
Keeping risk in context while rethinking the setting of asthma biologics in patient-centered care.
This perspective article discusses the benefits and risks of patients with severe asthma self-administering asthma biologics at home instead of at a physician’s office. While most biologics are now FDA-approved to be administered at home, many of them are also recommended by the FDA to be administered by a health care professional with post-injection monitoring due to the possibility of post-injection anaphylaxis. The authors argue that there can be more risk associated with getting into an automobile accident on the way to or from the clinic or office. Given the current circumstances with limited patient visit hours due to COVID-19 it is even more important that patients can administer the biologic themselves.
AHRQ-funded; K08 HS024599.
Citation: Greenhawt M, Shaker M .
Keeping risk in context while rethinking the setting of asthma biologics in patient-centered care.
Ann Allergy Asthma Immunol 2020 Aug;125(2):124-25. doi: 10.1016/j.anai.2020.05.029..
Keywords: Asthma, Respiratory Conditions, Home Healthcare, Medication, Patient-Centered Healthcare
Kaiser SV, Johnson MD, Walls TA
Pathways to improve pediatric asthma care: a multisite, national study of emergency department asthma pathway implementation.
This quality improvement study’s aim was to determine the effects of pediatric asthma pathway implementation in a diverse, national sample of emergency departments (EDs). Desired outcomes included systemic corticosteroid administration within 60 minutes (primary), assessment of severity at ED triage, chest radiograph use, hospital admission or transfer for higher level of care, and ED length of stay. Charts were reviewed each month by EDs for children ages 2-17 years with a primary diagnosis of asthma. A total of 83 EDs were enrolled, with 37 of them children’s hospitals, and 46 community hospitals. Seventy-three percent completed the study (n = 22,963). There was a significant increase in systematic corticosteroid administration within 60 minutes of arrival as well as increased odds of severity assessment at triage and decreased rate of change in odds of hospital admission/transfer. Chest radiograph or ED length of stay was not associated with pathway implementation.
AHRQ-funded; HS024592.
Citation: Kaiser SV, Johnson MD, Walls TA .
Pathways to improve pediatric asthma care: a multisite, national study of emergency department asthma pathway implementation.
J Pediatr 2020 Aug;223:100-07.e2. doi: 10.1016/j.jpeds.2020.02.080..
Keywords: Children/Adolescents, Emergency Department, Asthma, Quality Improvement, Quality of Care, Care Management, Healthcare Delivery, Patient-Centered Outcomes Research, Evidence-Based Practice, Outcomes
Kaiser SV, Lam Cabana, MD
Best practices in implementing inpatient pediatric asthma pathways: a qualitative study.
The objective of this study was to identify potential best practices in pathway implementation. Building upon a previous observational study in which the researchers identified higher and lower performing children's hospitals based on hospital-level changes in asthma patient length of stay after implementation of a pathway, they conducted semi-structured interviews with a sample of healthcare providers involved in pathway implementation at these hospitals. They identified several potential best practices to support pathway implementation. They recommended that hospitals implementing pathways consider applying these strategies to ensure success in improving quality of asthma care for children.
AHRQ-funded; HS024592.
Citation: Kaiser SV, Lam Cabana, MD .
Best practices in implementing inpatient pediatric asthma pathways: a qualitative study.
J Asthma 2020 Jul;57(7):744-54. doi: 10.1080/02770903.2019.1606237..
Keywords: Children/Adolescents, Asthma, Respiratory Conditions, Hospitals, Inpatient Care, Guidelines, Evidence-Based Practice, Implementation, Quality Improvement, Quality of Care
Kaiser SV, Jennings B, Rodean J
Pathways for improving inpatient pediatric asthma care (PIPA): a multicenter, national study.
This study examined whether implementation of a pathway strategy for inpatient pediatric asthma patients improve outcomes for these patients. Outcomes measured included length of stay (LOS), early administration of metered-dose inhalers, screening for secondhand tobacco exposure and referral to cessation resources, and 7-day hospital readmissions or emergency revisits. Eighty-five hospitals were enrolled and 68 completed the study with (n=12,013) admissions. Pathways were associated with increases in early administration of metered-dose inhalers, and referral to smoking cessation resources, but no statistically significant changes in the other outcomes were observed. Most hospitals did improve in at least one outcome.
AHRQ-funded; HS024592; HS024554.
Citation: Kaiser SV, Jennings B, Rodean J .
Pathways for improving inpatient pediatric asthma care (PIPA): a multicenter, national study.
Pediatrics 2020 Jun;145(6):e20193026. doi: 10.1542/peds.2019-3026..
Keywords: Children/Adolescents, Asthma, Respiratory Conditions, Inpatient Care, Patient-Centered Outcomes Research, Outcomes, Hospitalization, Care Management
Johnson MD, Zorc JJ, Nelson DS
Intravenous magnesium in asthma pharmacotherapy: variability in use in the PECARN Registry.
Researchers examined the use, efficacy, and safety of intravenous magnesium sulfate (IVMg) in children with asthma whose emergency department (ED) management is recorded in the Pediatric Emergency Care Applied Research Network (PECARN) Registry. They found that, in PECARN Registry EDs, administration of IVMg occurred late in ED treatment, for a minority of the children likely to benefit, with variation between sites, which suggested the current clinical role for IVMg in preventing hospitalization was limited. Discharge after IVMg administration would likely be safe. They recommended further research to assess the efficacy and safety of early IVMg administration.
AHRQ-funded; HS020270.
Citation: Johnson MD, Zorc JJ, Nelson DS .
Intravenous magnesium in asthma pharmacotherapy: variability in use in the PECARN Registry.
J Pediatr 2020 May;220:165-74.e2. doi: 10.1016/j.jpeds.2020.01.062..
Keywords: Children/Adolescents, Asthma, Medication, Emergency Department, Registries, Treatments, Patient Safety, Medication: Safety
Donovan BM, Abreo A, Ding T
Dose, timing, and type of infant antibiotic use and the risk of childhood asthma.
This study examined the association between dose, timing and type of infant antibiotic use and the risk of childhood asthma. The study examined a cohort of 152,622 children enrolled in the Tennessee Medicaid Program. At least 79% had at least one antibiotic prescription fill during infancy. There was a 20% increase in odds of childhood asthma for each additional antibiotic filled. There was no significant association between timing, formulation, anaerobic coverage and class of antibiotics and childhood asthma. However, broad spectrum antibiotic fills increased the odds of development of childhood asthma compared to narrow spectrum only fills.
AHRQ-funded; HS018454.
Citation: Donovan BM, Abreo A, Ding T .
Dose, timing, and type of infant antibiotic use and the risk of childhood asthma.
Clin Infect Dis 2020 Apr 10;70(8):1658-65. doi: 10.1093/cid/ciz448..
Keywords: Newborns/Infants, Children/Adolescents, Antibiotics, Medication, Asthma, Respiratory Conditions, Risk, Chronic Conditions
Cushing AM, Bucholz E, Michelson KA
Trends in regionalization of emergency care for common pediatric conditions.
This study examined trends in regionalization of emergency care for common pediatric conditions. The authors sought to determine how the likelihood of definitive care has changed for 3 common conditions: asthma, croup, and gastroenteritis. They used the National Emergency Department Sample Database to study children from 2008 to 2016 who presented to emergency departments with those primary diagnoses, excluding critically ill patients. Researchers conducted analyses by stratification of annual emergency department pediatric volume categorized by quartiles. Referral rates increased for all conditions in all volume quartiles, with referral rates greatest in the lowest pediatric volume quartile.
AHRQ-funded; HS026503.
Citation: Cushing AM, Bucholz E, Michelson KA .
Trends in regionalization of emergency care for common pediatric conditions.
Pediatrics 2020 Apr;145(4). doi: 10.1542/peds.2019-2989..
Keywords: Healthcare Cost and Utilization Project (HCUP), Children/Adolescents, Emergency Department, Asthma, Respiratory Conditions, Digestive Disease and Health, Healthcare Delivery
Oka S, Goto T, Hirayama A
Association of obstructive sleep apnea with severity of patients hospitalized for acute asthma. Ann Allergy Asthma Immunol 2020 Feb;124(2):165-70.e4. doi: 10.1016/j.anai.2019.11.002.
Researchers investigated the association of obstructive sleep apnea (OSA) with acute asthma severity in a retrospective cohort study that used State Inpatient Databases from eight geographically diverse states. Outcomes examined were markers of acute severity such as mechanical ventilation use, hospital length of stay, and in-hospital mortality. The researchers found that, among patients hospitalized for acute asthma, OSA was associated with a higher risk of noninvasive positive pressure ventilation use and longer length of stay compared with those without OSA.
AHRQ-funded; HS023305.
Citation: Oka S, Goto T, Hirayama A .
Association of obstructive sleep apnea with severity of patients hospitalized for acute asthma. Ann Allergy Asthma Immunol 2020 Feb;124(2):165-70.e4. doi: 10.1016/j.anai.2019.11.002.
Ann Allergy Asthma Immunol 2020 Feb;124(2):165-70.e4. doi: 10.1016/j.anai.2019.11.002..
Keywords: Healthcare Cost and Utilization Project (HCUP), Sleep Problems, Asthma, Respiratory Conditions, Hospitalization
Shaker M, Briggs A, Dbouk A
Estimation of health and economic benefits of clinic versus home administration of omalizumab and mepolizumab.
Biologic therapy is a paradigm-shifting management strategy for many patients with asthma and chronic urticaria, but concerns for therapy-associated anaphylaxis may limit access to these therapies for patients unable to travel to medical clinics. The objective of this study was to characterize the cost-effectiveness of in-clinic versus at-home biologic therapy with omalizumab and mepolizumab.
AHRQ-funded; HS024599.
Citation: Shaker M, Briggs A, Dbouk A .
Estimation of health and economic benefits of clinic versus home administration of omalizumab and mepolizumab.
J Allergy Clin Immunol Pract 2020 Feb;8(2):565-72. doi: 10.1016/j.jaip.2019.09.037..
Keywords: Medication, Healthcare Costs, Asthma, Respiratory Conditions, Chronic Conditions
Strom MA, Silverberg JI
Asthma, hay fever, and food allergy are associated with caregiver-reported speech disorders in US children.
This study sought to determine whether asthma, hay fever, and food allergy are associated with speech disorder in children and whether disease severity, sleep disturbance, or ADD/ADHD modified such associations. It concluded that childhood asthma, hay fever, and food allergy are associated with increased risk of speech disorder.
AHRQ-funded; HS023011.
Citation: Strom MA, Silverberg JI .
Asthma, hay fever, and food allergy are associated with caregiver-reported speech disorders in US children.
Pediatr Allergy Immunol 2016 Sep;27(6):604-11. doi: 10.1111/pai.12580.
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Keywords: Asthma, Children/Adolescents, Respiratory Conditions
Wu AC, Li L, Fung V
Mismatching among guidelines, providers, and parents on controller medication use in children with asthma.
The authors sought to assess provider prescribing patterns for asthma controller medications and to assess how frequently parental reports of children's asthma controller medicine use were mismatched with provider recommendations. They found that mismatches between parental reports and provider intentions regarding how the child was supposed to use inhaled steroids occurred for half of the children. They recommended that efforts focus on ways to reduce these mismatches.
AHRQ-funded; HS019669.
Citation: Wu AC, Li L, Fung V .
Mismatching among guidelines, providers, and parents on controller medication use in children with asthma.
J Allergy Clin Immunol Pract 2016 Sep-Oct;4(5):910-6. doi: 10.1016/j.jaip.2016.04.004.
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Keywords: Asthma, Children/Adolescents, Guidelines, Medication, Practice Patterns
Wu AC, Butler MG, Li L
Primary adherence to controller medications for asthma is poor.
The objective of this study was to compare real-world adherence, including both primary and secondary adherence, to the major controller regimens (inhaled corticosteroids (ICSs), leukotriene antagonists (LTRAs), or ICS/long-acting b-agonists (ICS/LABAs) in diverse, insured populations. It found that adherence to controller medications is poor and many patients do not ever fill prescriptions for controller medications. However, primary adherence to ICSs was better than to LTRAs and ICS/LABAs.
AHRQ-funded; HS019669.
Citation: Wu AC, Butler MG, Li L .
Primary adherence to controller medications for asthma is poor.
Ann Am Thorac Soc 2015 Feb;12(2):161-6. doi: 10.1513/AnnalsATS.201410-459OC..
Keywords: Asthma, Patient Adherence/Compliance, Medication, Comparative Effectiveness
Fiks AG, DuRivage N, Mayne SL
Adoption of a portal for the primary care management of pediatric asthma: a mixed-methods implementation study.
The researchers evaluated the feasibility of using a patient portal for pediatric asthma in primary care. Fewer than three percent of those families invited to enroll used the portal. The authors found that although use of the portal was associated with higher treatment engagement, their results suggested that achieving widespread portal adoption is unlikely in the short term.
AHRQ-funded; HS021645; HS022689.
Citation: Fiks AG, DuRivage N, Mayne SL .
Adoption of a portal for the primary care management of pediatric asthma: a mixed-methods implementation study.
J Med Internet Res 2016 Jun 29;18(6):e172. doi: 10.2196/jmir.5610.
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Keywords: Web-Based, Primary Care, Children/Adolescents, Patient-Centered Healthcare, Asthma
Press VG, Arora VM, Trela KC
Effectiveness of interventions to teach metered-dose and diskus inhaler techniques. A randomized trial.
This study evaluated the relative effects of two different educational strategies (teach-to-goal instruction vs. brief verbal instruction) in adults hospitalized with asthma or chronic obstructive pulmonary disease. It concluded that, Acute care events were less common among teach-to-goal participants than brief intervention participants at 30 days (17 percent vs. 36 percent,), but not at 90 days.
AHRQ-funded; HS016967.
Citation: Press VG, Arora VM, Trela KC .
Effectiveness of interventions to teach metered-dose and diskus inhaler techniques. A randomized trial.
Ann Am Thorac Soc 2016 Jun;13(6):816-24. doi: 10.1513/AnnalsATS.201509-603OC.
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Keywords: Asthma, Respiratory Conditions, Comparative Effectiveness, Health Literacy, Medication
Johnson KB, Patterson BL, Ho YX
The feasibility of text reminders to improve medication adherence in adolescents with asthma.
The goal of this study was to assess the impact of MyMediHealth (MMH) - a website and a short messaging service (SMS)-based reminder system - on medication adherence and perceived self-efficacy in adolescents with asthma. The investigators found that MMH was associated with improved medication adherence, perceived quality of life, and self-efficacy.
AHRQ-funded; HS018168.
Citation: Johnson KB, Patterson BL, Ho YX .
The feasibility of text reminders to improve medication adherence in adolescents with asthma.
J Am Med Inform Assoc 2016 May;23(3):449-55. doi: 10.1093/jamia/ocv158..
Keywords: Asthma, Children/Adolescents, Health Information Technology (HIT), Medication, Patient Adherence/Compliance
Palmsten K, Schatz M, Chan PH
Validation of the pregnancy asthma control test.
The researchers sought to validate telephone administration of a modified version of the Asthma Control Test (ACT) during pregnancy. They found that the Pregnancy Asthma Control Test (p-ACT) demonstrated good internal consistency, varied in the expected direction by impairment level, and was responsive to changes in asthma course. Telephone administration of the p-ACT was reliable and valid for assessing asthma control during pregnancy.
AHRQ-funded; HS018474.
Citation: Palmsten K, Schatz M, Chan PH .
Validation of the pregnancy asthma control test.
J Allergy Clin Immunol Pract 2016 Mar-Apr;4(2):310-15.e1. doi: 10.1016/j.jaip.2015.11.019.
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Keywords: Pregnancy, Asthma, Diagnostic Safety and Quality, Patient-Centered Outcomes Research
Speck AL, Hess M, Baptist AP
An electronic asthma self-management intervention for young African American adults.
The objective of this study was to develop and assess the feasibility of an electronic asthma self-management program for young African American adults. The researchers found that all subjects completing the 2-week postprogram survey reported that the program was helpful, and 97% would recommend it to others. Asthma control as measured by the Asthma Control Test improved, and asthma quality of life as measured by the Mini Asthma Quality of Life Questionnaire also improved. They concluded that the Breathe Michigan program is feasible for recruitment and retention, and demonstrated an improvement in asthma control and quality of life for young African American adults.
AHRQ-funded; HS020977.
Citation: Speck AL, Hess M, Baptist AP .
An electronic asthma self-management intervention for young African American adults.
J Allergy Clin Immunol Pract 2016 Jan-Feb;4(1):89-95.e2. doi: 10.1016/j.jaip.2015.08.007.
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Keywords: Asthma, Health Information Technology (HIT), Racial and Ethnic Minorities, Patient Self-Management, Young Adults
Drury KE, Schaeffer M, Silverberg JL
Association between atopic disease and anemia in US children.
Atopic disease is associated with chronic inflammation, food allergen avoidance, and use of systemic immunosuppressant medications. All these factors have been shown to be associated with anemia. This study investigated whether atopic disease is associated with increased risk of childhood anemia. It concluded that the association between atopic disease and anemia was reproducible in multiple cohorts.
AHRQ-funded; HS023011.
Citation: Drury KE, Schaeffer M, Silverberg JL .
Association between atopic disease and anemia in US children.
JAMA Pediatr 2016 Jan;170(1):29-34. doi: 10.1001/jamapediatrics.2015.3065..
Keywords: Asthma, Children/Adolescents, Chronic Conditions, Risk