National Healthcare Quality and Disparities Report
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Topics
- Access to Care (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 DisplayedLuther M, Poppert Cordts KM, Williams CN
Sleep disturbances after pediatric traumatic brain injury: a systematic review of prevalence, risk factors, and association with recovery.
This is a systematic review to quantify sleep wake disturbances (SWD) after pediatric traumatic brain injury (TBI). These SWD can place children at risk for worse outcomes since sleep is needed for brain development and healing after injury. They also evaluated interventions for SWD and the association between SWD and other post-traumatic outcomes. Literature was searched from 1999-2019 evaluating sleep or fatigue in children hospitalized for TBI. Two independent reviewers assessed quality of the studies using the Newcastle-Ottowa Score for observational studies. Out of 966 identified articles, 126 full text articles were reviewed and 24 studies were included. Studies showed at least 20% of children with TBI had some degree of SWD including trouble falling or staying asleep, fatigue, daytime fatigue, and nightmares. SWD was negatively correlated with cognitive, behavioral, and quality of life outcomes. There was moderate-high risk of bias for all studies due to small sample size and lack of validated or objective SWD measures.
AHRQ-funded; HS022981.
Citation: Luther M, Poppert Cordts KM, Williams CN .
Sleep disturbances after pediatric traumatic brain injury: a systematic review of prevalence, risk factors, and association with recovery.
Sleep 2020 Oct;43(10):zsaa083. doi: 10.1093/sleep/zsaa083..
Keywords: Children/Adolescents, Sleep Problems, Brain Injury, Neurological Disorders, Trauma, Risk, Patient-Centered Outcomes Research, Outcomes, Quality of Life, Evidence-Based Practice
Lindly O, Crossman M, Eaves M
Health literacy and health outcomes among children with developmental disabilities: a systematic review.
This systematic literature review focused on the impact of health literacy on health outcomes of children with developmental disabilities (DDs). A review of the literature of most of the major scientific databases was conducted. Out of 2,768 unique records identified, 53 full text articles were reviewed and four articles were included. The associations of family health literacy with health outcomes among children with DDs were mixed. Future research was recommended.
AHRQ-funded; HS000063.
Citation: Lindly O, Crossman M, Eaves M .
Health literacy and health outcomes among children with developmental disabilities: a systematic review.
Am J Intellect Dev Disabil 2020 Sep 1;125(5):389-407. doi: 10.1352/1944-7558-125.5.389..
Keywords: Children/Adolescents, Health Literacy, Disabilities, Evidence-Based Practice, Patient-Centered Outcomes Research, Outcomes
Mogul DB, Perito ER, Wood N
Impact of acuity circles on outcomes for pediatric liver transplant candidates.
In December 2018, UNOS approved an allocation scheme based on recipients' geographic distance from a deceased donor ("acuity circles"). Previous analyses suggested acuity circles (AC) would reduce waitlist mortality overall, but their impact on pediatric subgroups was not considered. In this study, the investigators applied Scientific Registry of Transplant Recipients data from 2011-2016 towards the Liver Simulated Allocation Model (LSAM) to compare outcomes by age and illness severity for the UNOS-approved AC and the existing Donor Service Area (DSA)/Region-based allocation schemes.
AHRQ-funded; HS023876.
Citation: Mogul DB, Perito ER, Wood N .
Impact of acuity circles on outcomes for pediatric liver transplant candidates.
Transplantation 2020 Aug;104(8):1627-32. doi: 10.1097/tp.0000000000003079..
Keywords: Children/Adolescents, Transplantation, Outcomes, Patient-Centered Outcomes Research, Evidence-Based Practice, Registries, Surgery, Access to Care
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, 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
Heneghan MB, Hussain T, Barrera L
Applying the COM-B model to patient-reported barriers to medication adherence in pediatric acute lymphoblastic leukemia.
This study examined parent- and patient-reported barriers to oral chemotherapy adherence with children with pediatric acute lymphoblastic leukemia (ALL). The medicine most often used was 6-mercaptopurine (6-MP). Forty-nine parents and 15 patients were surveyed and most reported at least one adherence barrier. Most of the barriers were about meeting other patients with ALL or meeting other parents. Patients also reported difficulty in finding out what their medications are, and what 6-MP does. These barriers can lead to relapse if they are not addressed.
AHRQ-funded; HS023011.
Citation: Heneghan MB, Hussain T, Barrera L .
Applying the COM-B model to patient-reported barriers to medication adherence in pediatric acute lymphoblastic leukemia.
Pediatr Blood Cancer 2020 May;67(5):e28216. doi: 10.1002/pbc.28216..
Keywords: Children/Adolescents, Treatments, Cancer, Medication, Patient Adherence/Compliance, Patient-Centered Outcomes Research
Whiteside SPH, Sim LA, Morrow AS
A meta-analysis to guide the enhancement of CBT for childhood anxiety: exposure over anxiety management.
Cognitive behavior therapy (CBT) is the most empirically supported therapy for childhood anxiety disorders (CADs) but has not reliably outperformed other credible interventions. The current study used meta-analysis to examine the frequency with which the most common treatment components are included in outcome studies and the relation of these components to symptom improvement.
AHRQ-funded; 290201500013I.
Citation: Whiteside SPH, Sim LA, Morrow AS .
A meta-analysis to guide the enhancement of CBT for childhood anxiety: exposure over anxiety management.
Clin Child Fam Psychol Rev 2020 Mar;23(1):102-21. doi: 10.1007/s10567-019-00303-2..
Keywords: Children/Adolescents, Anxiety, Behavioral Health, Treatments, Patient-Centered Outcomes Research, Evidence-Based Practice
Bowring MG, Massie AB, Chu NM
Projected 20- and 30-year outcomes for pediatric liver transplant recipients in the United States.
Researchers aimed to use national registry data and parametric models to project 20- and 30-year post-transplant outcomes for recently transplanted pediatric liver transplant (LT) recipients. Using Scientific Registry of Transplant Recipients data, they found that projected long-term outcomes for recently transplanted pediatric LT recipients are excellent, reflective of substantial improvements in medical care, and informative for physician-patient education and decision making in the current era.
AHRQ-funded; HS023876.
Citation: Bowring MG, Massie AB, Chu NM .
Projected 20- and 30-year outcomes for pediatric liver transplant recipients in the United States.
J Pediatr Gastroenterol Nutr 2020 Mar;70(3):356-63. doi: 10.1097/mpg.0000000000002592..
Keywords: Children/Adolescents, Transplantation, Patient-Centered Outcomes Research, Outcomes, Surgery, Registries, Evidence-Based Practice
Barry-Menkhaus SA, Wagner DV, Riley AR
Small interventions for big change: brief strategies for distress and self-management amongst youth with type 1 diabetes.
In this article, the authors review existing evidence for brief interventions, describe several untested clinical strategies, and make recommendations for accelerating the translational study of brief interventions among youth with type 1 diabetes.
AHRQ-funded; HS022981.
Citation: Barry-Menkhaus SA, Wagner DV, Riley AR .
Small interventions for big change: brief strategies for distress and self-management amongst youth with type 1 diabetes.
Curr Diab Rep 2020 Jan 30;20(1):3. doi: 10.1007/s11892-020-1290-7..
Keywords: Diabetes, Patient-Centered Healthcare, Patient Self-Management, Patient Adherence/Compliance, Care Management, Patient-Centered Outcomes Research, Healthcare Delivery, Children/Adolescents