National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Events (1)
- Blood Pressure (2)
- (-) Cardiovascular Conditions (9)
- Chronic Conditions (1)
- Comparative Effectiveness (1)
- Data (1)
- (-) Diabetes (9)
- Elderly (1)
- Healthcare Utilization (1)
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- Home Healthcare (1)
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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 9 of 9 Research Studies DisplayedZullo AR, Hersey M, Lee Y
Outcomes of "diabetes-friendly" vs "diabetes-unfriendly" beta-blockers in older nursing home residents with diabetes after acute myocardial infarction.
This study analyzed outcomes of using beta-blockers that are considered “diabetes-friendly” vs “diabetes-unfriendly” in older nursing home residents with diabetes after acute myocardial infarction (AMI). Primary outcomes included hospitalizations for hypoglycemia and hyperglycemia in the 90 days after AMI and secondary outcomes functional decline, death, all-cause re-hospitalization and fracture hospitalization. Out of 2855 nursing home residents with type-2 diabetes (T2D), 29% were prescribed a diabetes-friendly beta-blocker vs. 24% without. T2D medicine showed a reduction in hospitalization for hyperglycemia but was unassociated with hypoglycemia. For secondary outcomes T2D-friendly beta-blocks were associated with a greater rate of re-hospitalization but not death, functional decline, or fracture.
AHRQ-funded; HS022998.
Citation: Zullo AR, Hersey M, Lee Y .
Outcomes of "diabetes-friendly" vs "diabetes-unfriendly" beta-blockers in older nursing home residents with diabetes after acute myocardial infarction.
Diabetes Obes Metab 2018 Dec;20(12):2724-32. doi: 10.1111/dom.13451..
Keywords: Cardiovascular Conditions, Diabetes, Elderly, Heart Disease and Health, Hospitalization, Medication, Nursing Homes, Outcomes, Patient-Centered Outcomes Research
Myerson RM, Colantonio LD, Safford MM
Does identification of previously undiagnosed conditions change care-seeking behavior?
The purpose of the study was to determine whether identification of previously undiagnosed high cholesterol, hypertension, and/or diabetes during an in-home assessment impacts care seeking among Medicare beneficiaries. The study concluded that in-home assessment of cholesterol, blood pressure, and blood glucose can increase doctor visits for individuals with previously undiagnosed conditions. However, biomarker assessment may have more limited impact among individuals with low access to care.
AHRQ-funded; HS000084.
Citation: Myerson RM, Colantonio LD, Safford MM .
Does identification of previously undiagnosed conditions change care-seeking behavior?
Health Serv Res 2018 Jun;53(3):1517-38. doi: 10.1111/1475-6773.12644..
Keywords: Blood Pressure, Diabetes, Home Healthcare, Cardiovascular Conditions
Sharma A, Al-Khatib SM, Ezekowitz JA
Implantable cardioverter-defibrillators in heart failure patients with reduced ejection fraction and diabetes.
This study evaluates the effectiveness of a strategy that uses an implantable cardioverter-defibrillator (ICD) plus medical therapy versus medical therapy alone among patients with heart failure (HF) and diabetes. Researchers conducted a patient-level combined-analysis using a combined dataset that included four primary prevention ICD trials of patients with HF or severely reduced ejection fractions. The results indicate that primary prevention ICD in combination with medical therapy versus medical therapy alone was not significantly associated with a reduced risk of all-cause death. The authors conclude that further studies are needed to evaluate the effectiveness of ICDs among patients with diabetes.
AHRQ-funded; HS018505.
Citation: Sharma A, Al-Khatib SM, Ezekowitz JA .
Implantable cardioverter-defibrillators in heart failure patients with reduced ejection fraction and diabetes.
Eur J Heart Fail 2018 Jun;20(6):1031-38. doi: 10.1002/ejhf.1192..
Keywords: Cardiovascular Conditions, Comparative Effectiveness, Diabetes, Heart Disease and Health, Medical Devices, Prevention
Chaddha A, Smith MA, Palta M
Hypertension control after an initial cardiac event among Medicare patients with diabetes mellitus: a multidisciplinary group practice observational study.
The objective of the study was to determine rates and predictors of achieving hypertension control among Medicare patients with diabetes and uncontrolled hypertension after hospital discharge for an initial cardiac event. A retrospective analysis of linked electronic health record and Medicare data was performed. The study findings demonstrated the importance of implementing guideline-directed multidisciplinary care in this population.
AHRQ-funded; HS018368; HS017646.
Citation: Chaddha A, Smith MA, Palta M .
Hypertension control after an initial cardiac event among Medicare patients with diabetes mellitus: a multidisciplinary group practice observational study.
J Clin Hypertens 2018 May;20(5):891-901. doi: 10.1111/jch.13282..
Keywords: Cardiovascular Conditions, Diabetes, Blood Pressure
Pantalone KM, Misra-Hebert AD, Hobbs TM
Antidiabetic treatment patterns and specialty care utilization among patients with type 2 diabetes and cardiovascular disease.
The researchers evaluated real-world patient characteristics, medication use, and health care utilization patterns in patients with type 2 diabetes with established cardiovascular disease (CVD). Their data indicated underutilization of specialists and antidiabetic medications reported to confer CV benefit in patients with type 2 diabetes and CVD. The impact of recently updated guidelines and cardiovascular outcome trial results on management patterns in such patients remains to be seen.
AHRQ-funded; HS024128.
Citation: Pantalone KM, Misra-Hebert AD, Hobbs TM .
Antidiabetic treatment patterns and specialty care utilization among patients with type 2 diabetes and cardiovascular disease.
Cardiovasc Diabetol 2018 Apr 10;17(1):54. doi: 10.1186/s12933-018-0699-7.
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Keywords: Cardiovascular Conditions, Diabetes, Healthcare Utilization, Patient-Centered Healthcare
Stocco FG, Evaristo E, Shah NR
Marked exercise-induced T-wave heterogeneity in symptomatic diabetic patients with nonflow-limiting coronary artery stenosis.
The authors investigated whether T-wave heterogeneity (TWH) is elevated during exercise tolerance testing (ETT) in symptomatic diabetic patients with nonflow-limiting coronary artery stenosis compared to control subjects without diabetes. They found that TWH is capable of detecting latent repolarization abnormalities, which are present during ETT in diabetic patients with nonflow-limiting stenosis but not in control subjects. They concluded that the technique developed in this study permits TWH analysis from archived ECGs and thereby enables mining of extensive databases for retrospective studies and hypothesis testing.
AHRQ-funded; HS022998.
Citation: Stocco FG, Evaristo E, Shah NR .
Marked exercise-induced T-wave heterogeneity in symptomatic diabetic patients with nonflow-limiting coronary artery stenosis.
Ann Noninvasive Electrocardiol 2018 Mar;23(2):e12503. doi: 10.1111/anec.12503.
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Keywords: Cardiovascular Conditions, Data, Diabetes, Research Methodologies
Magnan EM, Bolt DM, Greenlee RT
Stratifying patients with diabetes into clinically relevant groups by combination of chronic conditions to identify gaps in quality of care.
The purpose of this paper was to find clinically relevant combinations of chronic conditions among patients with diabetes and to examine their relationships with six diabetes quality metrics. The researchers analyzed 12 conditions that were concordant with diabetes care to define five mutually exclusive combinations of conditions based on condition co-occurrence. They found the following condition classes: severe cardiac, cardiac, noncardiac vascular, risk factors, and no concordant comorbidities. They concluded that patients had distinct quality metric achievement by condition class, and those in less severe classes were less likely to achieve diabetes metrics.
AHRQ-funded; HS021899; HS018368.
Citation: Magnan EM, Bolt DM, Greenlee RT .
Stratifying patients with diabetes into clinically relevant groups by combination of chronic conditions to identify gaps in quality of care.
Health Serv Res 2018 Feb;53(1):450-68. doi: 10.1111/1475-6773.12607.
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Keywords: Cardiovascular Conditions, Chronic Conditions, Diabetes, Quality of Care, Quality Measures
Evaristo E, Stocco FG, Shah NR
Ranolazine reduces repolarization heterogeneity in symptomatic patients with diabetes and non-flow-limiting coronary artery stenosis.
In symptomatic diabetic patients with non-flow-limiting coronary artery stenosis with diffuse atherosclerosis and/or microvascular dysfunction, the authors explored whether ranolazine reduces T-wave heterogeneity (TWH). They found that, in the studied population, ranolazine reduced TWH at rest but not during exercise; reduction in repolarization abnormalities appears to be independent of alterations in myocardial blood flow.
AHRQ-funded; HS022998.
Citation: Evaristo E, Stocco FG, Shah NR .
Ranolazine reduces repolarization heterogeneity in symptomatic patients with diabetes and non-flow-limiting coronary artery stenosis.
Ann Noninvasive Electrocardiol 2018 Jan;23(1). doi: 10.1111/anec.12480.
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Keywords: Cardiovascular Conditions, Diabetes, Medication, Patient-Centered Outcomes Research
Lee AK, Warren B, Lee CJ
The association of severe hypoglycemia with incident cardiovascular events and mortality in adults with type 2 diabetes.
There is suggestive evidence linking hypoglycemia with cardiovascular disease, but few data have been collected in a community-based setting. This study found that hypoglycemia was not associated with stroke, heart failure, atrial fibrillation, or noncardiovascular and noncancer death. Results were robust within subgroups defined by age, sex, race, diabetes duration, and baseline cardiovascular risk.
AHRQ-funded; HS018542.
Citation: Lee AK, Warren B, Lee CJ .
The association of severe hypoglycemia with incident cardiovascular events and mortality in adults with type 2 diabetes.
Diabetes Care 2018 Jan;41(1):104-11. doi: 10.2337/dc17-1669.
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Keywords: Adverse Events, Cardiovascular Conditions, Diabetes, Mortality