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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 35 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
Farias AJ, Wu WH, Du XL
Racial differences in long-term adjuvant endocrine therapy adherence and mortality among Medicaid-insured breast cancer patients in Texas: findings from TCR-Medicaid linked data.
There are racial/ethnic disparities in breast cancer mortality that may be attributed to differences in receipt of adjuvant cancer treatment. The purpose of this article was to determine whether the mortality disparities could be explained by racial/ethnic differences in long-term adherence to adjuvant endocrine therapy (AET). The investigators concluded that long-term adherence in the Medicaid population was suboptimal and racial/ethnic differences in AET adherence may partially explain disparities in mortality.
AHRQ-funded; HS018956.
Citation: Farias AJ, Wu WH, Du XL .
Racial differences in long-term adjuvant endocrine therapy adherence and mortality among Medicaid-insured breast cancer patients in Texas: findings from TCR-Medicaid linked data.
BMC Cancer 2018 Dec 4;18(1):1214. doi: 10.1186/s12885-018-5121-z..
Keywords: Cancer: Breast Cancer, Disparities, Medicaid, Patient Adherence/Compliance, Racial and Ethnic Minorities
Chudy-Onwugaje K, Abutaleb A, Buchwald A
Age modifies the association between depressive symptoms and adherence to self-testing with telemedicine in patients with inflammatory bowel disease.
This study researched the association between age and increased depressive symptoms and adherence to self-testing with telemedicine in patients with inflammatory bowel disease (IBD). It was found that patients 40 and older had worse adherence than patients younger than 40 with depressive symptoms.
AHRQ-funded; HS018975.
Citation: Chudy-Onwugaje K, Abutaleb A, Buchwald A .
Age modifies the association between depressive symptoms and adherence to self-testing with telemedicine in patients with inflammatory bowel disease.
Inflamm Bowel Dis 2018 Nov 29;24(12):2648-54. doi: 10.1093/ibd/izy194..
Keywords: Chronic Conditions, Depression, Digestive Disease and Health, Patient Adherence/Compliance, Patient Self-Management, Telehealth
Parikh K, Paul J, Foushee N
Barriers and facilitators to asthma care after hospitalization as reported by caregivers, health providers, and school nurses.
This study focused on developing a comprehensive understanding of asthma care after hospitalization of children as reported by caregivers, health providers, and school nurses. The children had a median age of 7 years, mean hospital length of stay of 1.9 days, and 56% had a previous hospitalization in the last 12 months. Family caregivers and health professionals were given individual interviews while focus groups were conducted with school nurses. There were different health beliefs about asthma knowledge between caregivers and health professionals. School nurses highlighted specific barriers that focused on medication use in schools.
AHRQ-funded; HS024554.
Citation: Parikh K, Paul J, Foushee N .
Barriers and facilitators to asthma care after hospitalization as reported by caregivers, health providers, and school nurses.
Hosp Pediatr 2018 Nov;8(11):706-17. doi: 10.1542/hpeds.2017-0182..
Keywords: Asthma, Hospitalization, Children/Adolescents, Caregiving, Patient Adherence/Compliance, Education
Badawy SM, Thompson AA, Liem RI
Beliefs about hydroxyurea in youth with sickle cell disease.
The objectives of this study were to assess beliefs about hydroxyurea using the Beliefs about Medicines Questionnaire (BMQ), and to examine the relationship of patients' beliefs to their hydroxyurea adherence and health-related quality of life (HRQOL). The investigators found that beliefs about hydroxyurea correlated with HRQOL scores and adherence levels. The authors suggest that addressing patients' concerns about hydroxyurea and medications overall as well as routine assessment of adherence and beliefs could help to overcome adherence barriers.
AHRQ-funded; HS023011.
Citation: Badawy SM, Thompson AA, Liem RI .
Beliefs about hydroxyurea in youth with sickle cell disease.
Hematol Oncol Stem Cell Ther 2018 Sep;11(3):142-48. doi: 10.1016/j.hemonc.2018.01.001..
Keywords: Children/Adolescents, Medication, Patient Adherence/Compliance, Quality of Life, Sickle Cell Disease
Kang H, Lobo JM, Kim S
Cost-related medication non-adherence among U.S. adults with diabetes.
The purpose of this study is to examine factors that affect cost-related medication non-adherence (CRN), defined as taking medication less than as prescribed because of cost, among adults with diabetes and to determine their relative contribution in explaining CRN. Among other results, the study found that Insulin users had 1.24 times higher risk of CRN compared to those not on insulin.
AHRQ-funded; HS018542.
Citation: Kang H, Lobo JM, Kim S .
Cost-related medication non-adherence among U.S. adults with diabetes.
Diabetes Res Clin Pract 2018 Sep;143:24-33. doi: 10.1016/j.diabres.2018.06.016..
Keywords: Diabetes, Healthcare Costs, Medication, Patient Adherence/Compliance
Flory JH, Keating SJ, Siscovick D
Identifying prevalence and risk factors for metformin non-persistence: a retrospective cohort study using an electronic health record.
Non-persistence may be a significant barrier to the use of metformin. The objective of this study was to assess reasons for metformin non-persistence, and whether initial metformin dosing or use of extended release (ER) formulations affect persistence to metformin therapy. The investigators concluded that their data supported the routine prescribing of low starting doses of metformin as a tool to improve persistence.
AHRQ-funded; HS023898.
Citation: Flory JH, Keating SJ, Siscovick D .
Identifying prevalence and risk factors for metformin non-persistence: a retrospective cohort study using an electronic health record.
BMJ Open 2018 Jul 23;8(7):e021505. doi: 10.1136/bmjopen-2018-021505..
Keywords: Diabetes, Electronic Health Records (EHRs), Health Information Technology (HIT), Medication, Patient Adherence/Compliance, Outcomes, Patient-Centered Outcomes Research, Risk
Turi KN, Gebretsadik T, Lee RL
Seasonal patterns of asthma medication fills among diverse populations of the United States.
Nonadherence to controller and overuse of reliever asthma medications are associated with exacerbations. In this study, the investigators aimed to determine patterns of seasonal asthma medication use and to identify time period(s) during which interventions to improve medication adherence could reduce asthma morbidity. The investigators concluded that a seasonal pattern of asthma medication fill rates likely represented a reactive response to a loss of disease control and increased symptoms.
AHRQ-funded; HS019669; HS022093.
Citation: Turi KN, Gebretsadik T, Lee RL .
Seasonal patterns of asthma medication fills among diverse populations of the United States.
J Asthma 2018 Jul;55(7):764-70. doi: 10.1080/02770903.2017.1362426..
Keywords: Asthma, Chronic Conditions, Medication, Patient Adherence/Compliance
Beebe L, Smith KD, Oppizzi LM
Telephone Intervention-Problem Solving (TIPS) for schizophrenia spectrum disorders: responses of stable outpatients over nine months.
In this study, the investigators conducted a descriptive analysis of data gathered during calls to 87 stable outpatients with schizophrenia spectrum disorders, receiving weekly telephone intervention-problem solving (TIPS) for nine months. The investigators suggest that their findings regarding racial differences in antipsychotic delivery method warrant further investigation.
AHRQ-funded; HS022166.
Citation: Beebe L, Smith KD, Oppizzi LM .
Telephone Intervention-Problem Solving (TIPS) for schizophrenia spectrum disorders: responses of stable outpatients over nine months.
Issues Ment Health Nurs 2018 Jul;39(7):561-67. doi: 10.1080/01612840.2018.1431824..
Keywords: Ambulatory Care and Surgery, Medication, Behavioral Health, Patient Adherence/Compliance
Kanters AE, Morris AM, Albrahamse PH
The effect of peer support on colorectal cancer patients' adherence to guideline-concordant multidisciplinary care.
Dis Colon Rectum 2018 Jul;61(7):817-23. doi: 10.1097/dcr.0000000000001067.
The purpose of this study was to evaluate the effect of peer support on the attitudes of patients with colorectal cancer toward chemotherapy and their adherence to it. The study demonstrated that exposure to peer support is associated with higher adjuvant chemotherapy adherence.
The purpose of this study was to evaluate the effect of peer support on the attitudes of patients with colorectal cancer toward chemotherapy and their adherence to it. The study demonstrated that exposure to peer support is associated with higher adjuvant chemotherapy adherence.
AHRQ-funded; HS000053.
Citation: Kanters AE, Morris AM, Albrahamse PH .
The effect of peer support on colorectal cancer patients' adherence to guideline-concordant multidisciplinary care.
Dis Colon Rectum 2018 Jul;61(7):817-23. doi: 10.1097/dcr.0000000000001067..
Keywords: Cancer: Colorectal Cancer, Treatments, Guidelines, Medication, Patient Adherence/Compliance
Farias AJ, Wu WH, Du XL
Racial and geographic disparities in adherence and discontinuation to adjuvant endocrine therapy in Texas Medicaid-insured patients with breast cancer.
The purpose of the study is to examine disparities in adjuvant endocrine therapy (AET) adherence and discontinuation among Texas Medicaid-insured early-stage breast cancer patients. The studies concluded that patients from the Texas/Mexico border had higher odds of adherence compared to other regions. There are substantial racial and geographic disparities in AET adherence and discontinuation among Texas Medicaid-insured women.
AHRQ-funded; HS018956.
Citation: Farias AJ, Wu WH, Du XL .
Racial and geographic disparities in adherence and discontinuation to adjuvant endocrine therapy in Texas Medicaid-insured patients with breast cancer.
Med Oncol 2018 Jun 20;35(7):113. doi: 10.1007/s12032-018-1168-6..
Keywords: Cancer: Breast Cancer, Disparities, Medicaid, Patient Adherence/Compliance, Racial and Ethnic Minorities
Fredericksen RJ, Gibbons L, Brown S
Medication understanding among patients living with multiple chronic conditions: implications for patient-reported measures of adherence.
The purpose of this study was to assess knowledge of names and purposes of prescribed medications among patients with multiple chronic conditions. The investigators found that many patients demonstrated difficulty identifying the name and purpose of prescribed medications; this did not differ by demographic group or medication storage type. They suggest that patients may benefit from routine review of medications with their provider in order to improve health literacy, outcomes, and patient-reported adherence measurement.
AHRQ-funded; HS022242.
Citation: Fredericksen RJ, Gibbons L, Brown S .
Medication understanding among patients living with multiple chronic conditions: implications for patient-reported measures of adherence.
Res Social Adm Pharm 2018 Jun;14(6):540-44. doi: 10.1016/j.sapharm.2017.06.009..
Keywords: Chronic Conditions, Health Literacy, Medication, Patient Adherence/Compliance
Favier LA, Taylor J, Loiselle Rich K
Barriers to adherence in juvenile idiopathic arthritis: a multicenter collaborative experience and preliminary results.
The purpose of our study was to design and implement a standardized approach to identifying adherence barriers for youth with juvenile idiopathic arthritis (JIA) and to assess the frequency of adherence barriers in patients and their caregivers across treatment modalities. It concluded that implementing a standardized tool assessing adherence barriers in the JIA population across multiple clinical settings is feasible.
AHRQ-funded; HS021114.
Citation: Favier LA, Taylor J, Loiselle Rich K .
Barriers to adherence in juvenile idiopathic arthritis: a multicenter collaborative experience and preliminary results.
J Rheumatol 2018 May;45(5):690-96. doi: 10.3899/jrheum.171087.
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Keywords: Caregiving, Patient Adherence/Compliance, Quality Improvement, Arthritis, Children/Adolescents
Stringer KL, Azuero A, Ott C
Feasibility and acceptability of real-time antiretroviral adherence monitoring among depressed women living with HIV in the deep south of the US.
The purpose of this study was to present feasibility and acceptability data on the use of an electronic adherence monitor (EAM) among African American women in remote areas of the Southeastern United States with HIV and co-occurring depression. EAM and self-reported antiretroviral therapy (ART) adherence was monitored among 25 participants recruited at four HIV clinics in Alabama. Intra-class correlation showed a low degree of concordance between EAM and self-reported adherence. 83% of data collected via EAM was transmitted in real-time; the remainder was delayed though technological failures or was lost entirely. The authors conclude that EAM monitoring is feasible in a rural US setting but that technological difficulties may impede the device's usefulness for just-in-time adherence interventions.
AHRQ-funded; HS013852.
Citation: Stringer KL, Azuero A, Ott C .
Feasibility and acceptability of real-time antiretroviral adherence monitoring among depressed women living with HIV in the deep south of the US.
AIDS Behav 2018 May;23(5):1306-14. doi: 10.1007/s10461-018-2322-z..
Keywords: Depression, Health Information Technology (HIT), Human Immunodeficiency Virus (HIV), Medication, Behavioral Health, Patient Adherence/Compliance, Rural Health, Telehealth, Women
Mishra SR, Miller AD, Haldar S
Supporting collaborative health tracking in the hospital: patients' perspectives.
Through interviews and design probes, the authors of this study investigated hospitalized patients' health data tracking activity and analyzed their results using the stage-based personal informatics model. Their findings uncovered new directions for HCI research and highlighted ways to support patients in tracking their care and improving patient safety.
AHRQ-funded; HS022894.
Citation: Mishra SR, Miller AD, Haldar S .
Supporting collaborative health tracking in the hospital: patients' perspectives.
Proc SIGCHI Conf Hum Factor Comput Syst 2018;2018. doi: 10.1145/3173574.3174224..
Keywords: Health Information Technology (HIT), Hospitals, Health Information Technology (HIT), Patient Adherence/Compliance, Patient and Family Engagement
Ratanawongsa N, Quan J, Handley MA
Language-concordant automated telephone queries to assess medication adherence in a diverse population: a cross-sectional analysis of convergent validity with pharmacy claims.
In a multilingual urban safety net population, the researchers examined the validity of assessing adherence using automated telephone self-management (ATSM) queries, when compared with non-adherence using continuous medication gap (CMG) on pharmacy claims. They concluded that language-concordant ATSM demonstrated modest potential for assessing adherence.
AHRQ-funded; HS022561; HS023558; HS017261; HS020684.
Citation: Ratanawongsa N, Quan J, Handley MA .
Language-concordant automated telephone queries to assess medication adherence in a diverse population: a cross-sectional analysis of convergent validity with pharmacy claims.
BMC Health Serv Res 2018 Apr 6;18(1):254. doi: 10.1186/s12913-018-3071-4.
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Keywords: Health Information Technology (HIT), Medication, Patient Adherence/Compliance, Racial and Ethnic Minorities, Urban Health
Karter AJ, Parker MM, Solomon MD
Effect of out-of-pocket cost on medication initiation, adherence, and persistence among patients with type 2 diabetes: the Diabetes Study of Northern California (DISTANCE).
This study estimated the effect of out-of-pocket (OOP) cost on nonadherence to classes of cardiometabolic medications among patients with diabetes. Primary nonadherence (never dispensed) increased monotonically with OOP cost after adjusting for demographics, neighborhood socioeconomic status, Medicare, medical financial assistance, OOP maximum, deductibles, mail order pharmacy incentive and use, drug type, generic or brand, day's supply, and comorbidity index.
AHRQ-funded; HS022408.
Citation: Karter AJ, Parker MM, Solomon MD .
Effect of out-of-pocket cost on medication initiation, adherence, and persistence among patients with type 2 diabetes: the Diabetes Study of Northern California (DISTANCE).
Health Serv Res 2018 Apr;53(2):1227-47. doi: 10.1111/1475-6773.12700.
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Keywords: Diabetes, Healthcare Costs, Health Insurance, Medication, Patient Adherence/Compliance
Nguyen OK, Higashi RT, Makam AN
The influence of financial strain on health decision-making.
This study sought to explore which unmet social needs are most influential and how these needs affect individuals’ decisions regarding medical treatment and self-management of health needs among community-dwelling low-income adults. It found that financial strain, rather than any single social need, was the most important factor in health decisionmaking among the underserved adults we studied, and may result in non-adherence to medical recommendations.
AHRQ-funded; HS022418.
Citation: Nguyen OK, Higashi RT, Makam AN .
The influence of financial strain on health decision-making.
J Gen Intern Med 2018 Apr;33(4):406-08. doi: 10.1007/s11606-017-4296-3.
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Keywords: Decision Making, Healthcare Costs, Patient Adherence/Compliance, Patient-Centered Healthcare, Vulnerable Populations