National Healthcare Quality and Disparities Report
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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 74 Research Studies DisplayedMcQuillan J, Andersen JA, Berdahl TA
AHRQ Author: Berdahl TA
Associations of rheumatoid arthritis and depressive symptoms over time: are there differences by education, race/ethnicity, and gender?
The objective of this study was to examine associations between changes in Rheumatoid Arthritis symptoms and depressive symptoms and to test if these associations differed by education, or gender, or race/ethnicity. Data was taken from the National Rheumatoid Arthritis Study, 1988-98. The results indicated that people with Rheumatoid Arthritis experienced increases in depressive symptoms as well as pain, functional disability, and household work disability over the study period. There was no difference noted in the rate of change in depressive symptoms by education, gender, nor race/ethnicity, but the association of functional disability with depressive symptoms was stronger for men than women. The researchers concluded that it is important to monitor and treat both mental and physical health symptoms, and that future research should focus on the collection of data that reflects the educational, gender, and racial/ethnic diversity of people with Rheumatoid Arthritis.
AHRQ-authored.
Citation: McQuillan J, Andersen JA, Berdahl TA .
Associations of rheumatoid arthritis and depressive symptoms over time: are there differences by education, race/ethnicity, and gender?
Arthritis Care Res 2022 Dec;74(12):2050-58. doi: 10.1002/acr.24730..
Keywords: Arthritis, Depression, Behavioral Health, Racial and Ethnic Minorities, Sex Factors, Chronic Conditions
Berkman ND, Chang E, Seibert J
Characteristics of high-need, high-cost patients : a "best-fit" framework synthesis.
This paper’s objective was to identify characteristics and criteria to distinguish high-need, high-cost (HNHC) patients. Searches of multiple databases and gray literature from 2000 to January 2022 were conducted. The final review included 64 studies comprising multivariate exposure studies (n = 47), cluster analyses (n = 11), and qualitative studies (n = 6). National Academy of Medicine (NAM) taxonomy was used for organizing the synthesis of findings. Patient characteristics associated with being defined as HNHC included number and severity of comorbid conditions and having chronic clinical conditions, particularly heart disease, chronic kidney disease, chronic lung disease, diabetes, cancer, and hypertension. HNHC risk was often amplified by behavioral health conditions and social risk factors. The authors revised the NAM taxonomy to create a final framework, adding chronic pain and prior patterns of high health care use as characteristics associated with an increased risk for being HNHC.
AHRQ-funded; 290201500011I
Citation: Berkman ND, Chang E, Seibert J .
Characteristics of high-need, high-cost patients : a "best-fit" framework synthesis.
Ann Intern Med 2022 Dec;175(12):1728-41. doi: 10.7326/m21-4562..
Keywords: Chronic Conditions, Healthcare Costs, Healthcare Delivery
Lock LJ, Channa R, Brennan MB
Effect of health system on the association of rurality and level of disadvantage with receipt of diabetic eye screening.
The goal of this retrospective cohort study was to determine the role of level of disadvantage in diabetic eye screening to explain the effect of health systems on rural and urban disparities. Researchers used an all-payer, statewide claims database to include adult Wisconsin residents with diabetes who had claims billed throughout the baseline and measurement years. Results indicated that patients from urban underserved clinics were more likely to receive screening than those from rural underserved clinics; similar findings emerged for both Medicare and non-Medicare subgroups. The researchers concluded that health systems, especially those that serve urban underserved populations, have an opportunity to increase screening rates by leveraging health system-level interventions and supporting patients in overcoming barriers.
AHRQ-funded; HS026279.
Citation: Lock LJ, Channa R, Brennan MB .
Effect of health system on the association of rurality and level of disadvantage with receipt of diabetic eye screening.
BMJ Open Diabetes Res Care 2022 Dec;10(6):e003174. doi: 10.1136/bmjdrc-2022-003174..
Keywords: Rural Health, Access to Care, Screening, Diabetes, Eye Disease and Health, Disparities, Chronic Conditions, Health Systems
Hinesley JLG, Brooks EM, O'Loughlin K
Feasibility of patient navigation for care planning in primary care.
The purpose of this study was to help better control chronic conditions by connecting patients with a navigator for support creating a personal care goal. Twenty-four clinicians in 12 practices in the Virginia Ambulatory Care Outcomes Research Network (ACORN) participated in a care planning intervention under a structured process that guided 87 patients with uncontrolled chronic conditions, trained navigators, and adapted the navigation process to meet the needs of each practice. Findings indicated that patient navigation to address care plans should be feasible, with a minimal time commitment and non-intensive training. However, given the burden and competing demands in primary care, this help cannot be offered without additional resources.
AHRQ-funded; HS026223.
Citation: Hinesley JLG, Brooks EM, O'Loughlin K .
Feasibility of patient navigation for care planning in primary care.
J Prim Care Community Health 2022 Jan-Dec;13:21501319221134754. doi: 10.1177/21501319221134754..
Keywords: Primary Care, Chronic Conditions, Patient and Family Engagement
Auty SG, Griffith KN, Shafer PR
Improving access to high-value, high-cost medicines: the use of subscription models to treat hepatitis C using direct acting antivirals in the United States.
This paper discusses the use of state-sponsored subscription models to support increased access to high-value medications such as direct acting antivirals (DAAs) which can cure chronic Hepatitis C virus (HCV). The authors discuss the use of subscription models, a type of advanced purchase commitment (APC), to support increased access to high-value DAAs to treat HCV. They provide background information on HCV, its treatment, and state financing of prescription medications. They review the implementation of HCV subscription models in two states, Louisiana and Washington, and early evidence of their impact, as DAAs can cost upwards of $90,000 for treatment course.
AHRQ-funded; HS026395.
Citation: Auty SG, Griffith KN, Shafer PR .
Improving access to high-value, high-cost medicines: the use of subscription models to treat hepatitis C using direct acting antivirals in the United States.
J Health Polit Policy Law 2022 Dec 1;47(6):691-708. doi: 10.1215/03616878-10041121..
Keywords: Hepatitis, Medication, Chronic Conditions, Access to Care
Carlile N, Fuller TE, Benneyan JC
Lessons learned in implementing a chronic opioid therapy management system.
This article describes a research collaborative of health service researchers, systems engineers, and clinicians that sought to improve processes for safer chronic opioid therapy management in an academic primary care center. The authors present implementation results and lessons learned along with an intervention toolkit that others may consider using within their organization. They designed, tested, and implemented two key safe opioid use process metrics-percent for patients with recent opioid treatment agreements and urine drug tests. Focus groups were conducted after the conclusion of the implementation. They found a general lack of knowledge regarding resources available to patients and prescribers in the primary care clinic. In addition, 69% of clinicians reported largely “inheriting” (rather than initiating) their chronic opioid therapy patients. They also tracked 68 patients over a 4-year period and found although process measures improved, full adherence was not achieved for the entire population. Barriers identified included team structure, the evolving opioid environment, and surveillance challenges, along with disruptions resulting from the 2019 novel coronavirus.
AHRQ-funded; HS024453.
Citation: Carlile N, Fuller TE, Benneyan JC .
Lessons learned in implementing a chronic opioid therapy management system.
J Patient Saf 2022 Dec 1;18(8):e1142-e49. doi: 10.1097/pts.0000000000001039..
Keywords: Opioids, Medication, Pain, Chronic Conditions, Substance Abuse, Behavioral Health, Practice Patterns
Schuttner L, Hockett Sherlock S, Simons CE
My goals are not their goals: barriers and facilitators to delivery of patient-centered care for patients with multimorbidity.
This study’s goal was to clarify facilitators and barriers perceived by primary care physicians in the Veterans Health Administration to delivering patient-centered care for high-risk or complex patients with multimorbidity. The authors conducted semi-structured telephone interviews from April to July 2020 with 23 physicians across 20 clinical sites, with most being female (61%). Facilitators included: effective physician-patient communication to individualize care, prioritize among multiple needs, and elicit goals to improve patient engagement; access to care, enabled by interdisciplinary teams, and dictating personalized care planning; effortful but worthwhile care coordination and continuity; meeting complex needs through effective teamwork; and integrating medical and non-medical care aspects in recognition of patients' psychosocial contexts. Barriers included: intra- and interpersonal (e.g., perceived patient reluctance to engage in care); organizational (e.g., limited encounter time); and community or policy impediments (e.g., state decisional capacity laws) to patient-centered care.
AHRQ-funded; HS026369.
Citation: Schuttner L, Hockett Sherlock S, Simons CE .
My goals are not their goals: barriers and facilitators to delivery of patient-centered care for patients with multimorbidity.
J Gen Intern Med 2022 Dec;37(16):4189-96. doi: 10.1007/s11606-022-07533-1..
Keywords: Patient-Centered Healthcare, Healthcare Delivery, Chronic Conditions, Clinician-Patient Communication, Communication, Patient and Family Engagement
Schuttner L, Lee JR, Hockett Sherlock S
Primary care physician perspectives on the influence of patient values, health priorities, and preferences on clinical decision-making for complex patients with multimorbidity: a qualitative study.
The purpose of this study was to explore primary care physician (PCP) perspectives on the influence of patients' values, health priorities and goals, and preferences on clinical decisions for patients with multimorbidity and higher psychosocial complexity. Between May and July 2020 the researchers utilized semi-structured telephone interviews with 23 PCPs in patient-centered medical home teams in a nationally integrated health system in the United States. The study found three major themes: (1) The personal values of patients were rarely directly discussed in routine clinical encounters but informed more typically discussed constructs of patient preferences, goals, and priorities; (2) Patient preferences, goals, and priorities were sources of conflicting perspectives about care plans between healthcare teams, patients, and families; (3) Physicians used direct strategies to communicate and negotiate about patient preferences, goals, and priorities when developing care plans. The researchers concluded that during clinical decision-making for complex patients with multimorbidity, primary care physicians perceive patient values, preferences, health priorities and goals as influential.
AHRQ-funded; HS026369.
Citation: Schuttner L, Lee JR, Hockett Sherlock S .
Primary care physician perspectives on the influence of patient values, health priorities, and preferences on clinical decision-making for complex patients with multimorbidity: a qualitative study.
Risk Manag Healthc Policy 2022 Nov 16; 15:2135-46. doi: 10.2147/rmhp.S380021..
Keywords: Primary Care, Provider: Physician, Decision Making, Chronic Conditions
Gartlehner G, Patel SV, Reddy S
Hormone therapy for the primary prevention of chronic conditions in postmenopausal persons: updated evidence report and systematic review for the US Preventive Services Task Force.
This US Preventive Services Task Force (USPSTF) recommendation is an updated evidence report and systematic review on the use of hormone therapy in postmenopausal persons for the primary prevention of chronic conditions. The reviewers included 20 trials (N = 39,145) and 3 cohort studies (N = 1,155,410) from a dual review of abstracts, full-text articles, and study quality. Harms and benefits were compared for participants using estrogen only compared with estrogen plus progestin. Participants using estrogen only compared with placebo had significantly lower risks for diabetes and fractures, but increased for gallbladder disease over 7.1 years, stroke over 7.2 years, venous thromboembolism over 7.2 years and urinary incontinence over 1 year. For participants using estrogen plus progestin some benefits were found, but there was also an increased risk of harms significantly for invasive breast cancer, gallbladder disease, venous thromboembolism, probable dementia, and urinary incontinence.
AHRQ-funded; 75Q80120D00007.
Citation: Gartlehner G, Patel SV, Reddy S .
Hormone therapy for the primary prevention of chronic conditions in postmenopausal persons: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2022 Nov 1;328(17):1747-65. doi: 10.1001/jama.2022.18324..
Keywords: U.S. Preventive Services Task Force (USPSTF), Prevention, Evidence-Based Practice, Guidelines, Chronic Conditions, Women
Sneed NM, Azuero A, Morrison SA
Prediabetes awareness is not associated with lower consumption of self-reported added sugar in U.S. adults.
This study examined whether prediabetes awareness is associated with lower consumption of self-reported added sugar in US adults 20 years and older. Cross-sectional data for 3314 adults with prediabetes were analyzed from 2013-2018 National Health and Nutrition Examination Survey data. Among 3314 adults, 528 reported being aware and 2786 were unaware of their condition. Prediabetes awareness was not significantly associated with added sugar consumption with no differences for age, sex, or race/Hispanic origin.
AHRQ-funded; HS026122.
Citation: Sneed NM, Azuero A, Morrison SA .
Prediabetes awareness is not associated with lower consumption of self-reported added sugar in U.S. adults.
Ann Epidemiol 2022 Nov;75:21-24. doi: 10.1016/j.annepidem.2022.08.039..
Keywords: Diabetes, Chronic Conditions, Education: Patient and Caregiver, Nutrition, Health Promotion
Pritchard KT, Baillargeon J, Lee WC
Trends in the use of opioids vs nonpharmacologic treatments in adults with pain, 2011-2019.
This serial cross-sectional analysis on trends in the use of prescription opioids and nonpharmacologic alternatives in treating pain used MEPS to estimate the use of outpatient services by cancer-free adults with chronic or surgical pain from 2011 to 2019. A total of unweighted 46,420 respondents, 9643 (20.4% weighted) received surgery and 36,777 (79.6% weighted) did not. The prevalence of nonpharmacologic treatments increased in 2019 for both chronic and surgical pain cohorts, especially with exclusive use compared with 2011. Chiropractors and physical therapists were the most common licensed healthcare professionals used among the cohort who used nonpharmacologic treatment.
AHRQ-funded; T32HS026133.
Citation: Pritchard KT, Baillargeon J, Lee WC .
Trends in the use of opioids vs nonpharmacologic treatments in adults with pain, 2011-2019.
JAMA Netw Open 2022 Nov;5(11):e2240612. doi: 10.1001/jamanetworkopen.2022.40612..
Keywords: Medical Expenditure Panel Survey (MEPS), Opioids, Medication, Pain, Chronic Conditions, Treatments
Rogal SS, Chinman MJ, DeMonte W
Using intervention mapping to develop a novel pain self-management intervention for people with cirrhosis.
The purpose of this study was to design a pain self-management (PSM) intervention for patients with cirrhosis. The LEAP (Liver Education About Pain) intervention is a 12-week, modular intervention delivered by phone via individual and group sessions with a health coach. Participants described barriers to PSM behaviors, including the absence of simple, evidence-based interventions for pain for patients with cirrhosis, inadequate provider knowledge, time, and training, with lack of champions, funding, and communication. Patients described high motivation to treat pain using behavioral methods including meditation, prayer, and exercise. The intervention was designed to address barriers to PSM behaviors for patients with cirrhosis, using behavior change methods that address knowledge, self-efficacy, and outcome expectations.
AHRQ-funded; HS019461.
Citation: Rogal SS, Chinman MJ, DeMonte W .
Using intervention mapping to develop a novel pain self-management intervention for people with cirrhosis.
Dig Dis Sci 2022 Nov;67(11):5063-78. doi: 10.1007/s10620-022-07380-4..
Keywords: Pain, Chronic Conditions, Patient Self-Management
Umeukeje EM, Koonce TY, Kusnoor SV
Systematic review of international studies evaluating MDRD and CKD-EPI estimated glomerular filtration rate (eGFR) equations in Black adults.
The authors conducted a systematic review to assess how well estimating glomerular filtration rate (eGFR), with and without race adjustment, estimates measured GFR (mGFR) in Black adults globally. They identified 12 studies which included patients with and without kidney disease from Africa, the United States, Europe, and Brazil. They found that the majority of these studies determined that removal of race adjustment improved bias, accuracy, and precision of eGFR equations for Black adults. They concluded that their systematic review supports the need for future studies to be conducted in diverse populations to assess the possibility of alternative approaches for estimating GFR.
AHRQ-funded; HS026122.
Citation: Umeukeje EM, Koonce TY, Kusnoor SV .
Systematic review of international studies evaluating MDRD and CKD-EPI estimated glomerular filtration rate (eGFR) equations in Black adults.
PLoS One 2022 Oct 18;17(10):e0276252. doi: 10.1371/journal.pone.0276252..
Keywords: Kidney Disease and Health, Chronic Conditions, Racial and Ethnic Minorities, Diagnostic Safety and Quality
Snyder BM, Patterson MF, Gebretsadik T
Association between asthma status and prenatal antibiotic prescription fills among women in a Medicaid population.
The objective of this study was to assess the relationship between maternal asthma and outpatient prenatal antibiotic prescription fills to inform antibiotic stewardship. With data from the Tennessee Medicaid Program, findings showed that women with asthma had an increased risk of filling at least one prenatal antibiotic prescription and had an increased number of fills during pregnancy compared to women without asthma. These findings highlight that pregnant women with asthma disproportionately fill more antibiotic prescriptions during pregnancy.
AHRQ-funded; HS018454.
Citation: Snyder BM, Patterson MF, Gebretsadik T .
Association between asthma status and prenatal antibiotic prescription fills among women in a Medicaid population.
J Asthma 2022 Oct;59(10):2100-07. doi: 10.1080/02770903.2021.1993247..
Keywords: Asthma, Respiratory Conditions, Pregnancy, Antibiotics, Antimicrobial Stewardship, Medication, Maternal Care, Women, Chronic Conditions
Becker NV, Scott JW, Moniz MH
Association of chronic disease with patient financial outcomes among commercially insured adults.
This study examined the association between chronic disease and adverse financial outcomes. The authors used claims data for patients enrolled in a preferred provider organization in Michigan. Patients diagnosed with thirteen common chronic conditions (cancer, congestive heart failure, chronic kidney disease, dementia, depression and anxiety, diabetes, hypertension, ischemic heart disease, liver disease, chronic obstructive pulmonary disease and asthma, serious mental illness, stroke, and substance use disorders) were included in the cohort of 2,854,481 adults aged 21 and over. The cohort included 61.4% with no chronic conditions, 17.7% with 1 chronic condition, 14.8% with 2 to 3 chronic conditions, 5.4% with 4 to 6 chronic conditions, and 0.7% with 7 to 13 chronic conditions. Among the cohort, 9.6% had medical debt in collections, 8.3% had nonmedical debt in collections, 16.3% had delinquent debt, 19.3% had a low credit score, and 0.6% had recent bankruptcy. For individuals with 0 vs 7 to 13 chronic conditions, the predicted probabilities of having any medical debt in collections (7.6% vs 32%), any nonmedical debt in collections (7.2% vs 24%), any delinquent debt (14% vs 43%), a low credit score (17% vs 47%) or recent bankruptcy (0.4% vs 1.7%) were all considerably higher for individuals with more chronic conditions and increased with each added chronic condition. Among individuals with medical debt in collections, the estimated amount increased with the number of chronic conditions ($784 for individuals with 0 conditions vs $1252 for individuals with 7-13 conditions).
AHRQ-funded; HS028672.
Citation: Becker NV, Scott JW, Moniz MH .
Association of chronic disease with patient financial outcomes among commercially insured adults.
JAMA Intern Med 2022 Oct;182(10):1044-51. doi: 10.1001/jamainternmed.2022.3687..
Keywords: Chronic Conditions, Healthcare Costs, Cancer, Kidney Disease and Health
Glynn A, Hernandez I, Roberts ET
Consequences of forgoing prescription drug subsidies among low-income Medicare beneficiaries with diabetes.
This study’s objective was to estimate the take-up of the Medicare Part D Low-Income Subsidy (LIS) among Medicare beneficiaries with diabetes and examine differences in out-of-pocket costs and prescription drug use between LIS enrollees and LIS-eligible non-enrollees. Data from the Health and Retirement Study linked to Medicare administrative data from 2008 to 2016 was used. The authors first estimated LIS take-up stratified by income (≤100% of the Federal Poverty Level [FPL] and >100% to ≤150% of FPL). Second, to assess the consequences of forgoing the LIS among near-poor beneficiaries (incomes >100% to ≤150% of FPL), they conducted propensity score-weighted regression analyses to compare out-of-pocket costs, prescription drug use, and cost-related medication non-adherence among LIS enrollees and LIS-eligible non-enrollees. Among Medicare beneficiaries with diabetes, 68.1% of those considered near-poor (incomes >100% to ≤150% of FPL) received the LIS, compared to 90.3% of those with incomes ≤100% of FPL. Among near-poor beneficiaries, LIS-eligible non-enrollees incurred higher annual out-of-pocket drug spending ($518], filled 7.3 fewer prescriptions for diabetes, hypertension, and hyperlipidemia drugs, and were 8.9 percentage points more likely to report skipping drugs due to cost. all compared to LIS enrollees.
AHRQ-funded; HS026727.
Citation: Glynn A, Hernandez I, Roberts ET .
Consequences of forgoing prescription drug subsidies among low-income Medicare beneficiaries with diabetes.
Health Serv Res 2022 Oct;57(5):1136-44. doi: 10.1111/1475-6773.13990..
Keywords: Medication, Diabetes, Chronic Conditions, Low-Income, Medicare, Healthcare Costs
Tisdale RL, Cusick MM, Aluri KZ
Cost-effectiveness of dapagliflozin for non-diabetic chronic kidney disease.
The purpose of this study was to determine the cost-effectiveness of adding dapagliflozin to standard management of patients with non-diabetic chronic kidney disease (CKD). Findings showed that adding dapagliflozin to standard care improved life expectancy by 2 years, increased discounted quality-adjusted life years, and reduced the total incidence of both kidney failure on kidney replacement therapy (KRT) and average years on KRT over the lifetime of the cohort. Further, dapagliflozin plus standard care was more effective than standard care alone while increasing lifetime costs.
AHRQ-funded; HS026128.
Citation: Tisdale RL, Cusick MM, Aluri KZ .
Cost-effectiveness of dapagliflozin for non-diabetic chronic kidney disease.
J Gen Intern Med 2022 Oct;37(13):3380-87. doi: 10.1007/s11606-021-07311-5..
Keywords: Kidney Disease and Health, Medication, Chronic Conditions, Healthcare Costs
Grauer A, Duran AT, Liyanage-Don NA
Association between telemedicine use and diabetes risk factor assessment and control in a primary care network.
The purpose of this retrospective cohort study was to explore whether there is a relationship between telemedicine use in primary care and risk factor assessment and control for patients with diabetes mellitus. The study included patients with diabetes mellitus ages 18-75 with a telemedicine visit in a primary care network between February 2020 and December 2020. Researchers evaluated whether low-density lipoprotein cholesterol (LDL-C), blood pressure (BP), and hemoglobin A1c (HbA1c) and were assessed for each patient. The study identified 1,824 patients with diabetes during the study period and found that telemedicine use was associated with a lower proportion of patients with all three risk factors assessed. The researchers concluded that telemedicine use was related with gaps in risk factor assessment for patients with diabetes during the COVID-19 pandemic.
AHRQ-funded; HS026121; HS024262.
Citation: Grauer A, Duran AT, Liyanage-Don NA .
Association between telemedicine use and diabetes risk factor assessment and control in a primary care network.
J Endocrinol Invest 2022 Sep;45(9):1749-56. doi: 10.1007/s40618-022-01814-6..
Keywords: Diabetes, Chronic Conditions, Telehealth, Health Information Technology (HIT), Primary Care, Risk
Jackson P, Goodin BR, Long DL
The area deprivation index corresponds effectively with other measures of objective socioeconomic status in adults with chronic low back pain.
The purpose of this study was to compare the Area Deprivation Index (ADI) and other measures of socioeconomic status (SES), including income, education, and subjective social status (SSS), in their ability to predict pain severity/ interference in patients with chronic low back pain. The study found that pain severity/ interference correlated negatively with income and education and correlated positively with ADI. Criterion scores of the pain severity model indicate income performs best followed by ADI, with similar results with the pain interference model. The study concluded that when attempting to understand the impact of SES on chronic low back pain, neighborhood-level and individual-level factors should be considered.
AHRQ-funded; HS013852.
Citation: Jackson P, Goodin BR, Long DL .
The area deprivation index corresponds effectively with other measures of objective socioeconomic status in adults with chronic low back pain.
J Nurs Meas 2022 Sep 1;30(3):433-48. doi: 10.1891/jnm-d-20-00126..
Keywords: Back Health and Pain, Pain, Chronic Conditions, Social Determinants of Health
McGinnis KA, Justice AC, Moore RD
Discrimination and calibration of the veterans aging cohort study index 2.0 for predicting mortality among people with human immunodeficiency virus in North America.
Using data from the North American AIDS Cohort Collaboration (NA-ACCORD), the authors translated Veterans Aging Cohort Study (VACS) Index 2.0 scores into validated probability estimates of mortality among people with HIV (PWH). They found that predicted and observed mortality largely overlapped in VACS and the NA-ACCORD subset, overall and within subgroups. Based on this validation, they concluded that VACS Index 2.0 can reliably estimate probability of all-cause mortality, at various follow-up times, among PWH in North America.
AHRQ-funded; 90047713.
Citation: McGinnis KA, Justice AC, Moore RD .
Discrimination and calibration of the veterans aging cohort study index 2.0 for predicting mortality among people with human immunodeficiency virus in North America.
Clin Infect Dis 2022 Aug 25;75(2):297-304. doi: 10.1093/cid/ciab883..
Keywords: Human Immunodeficiency Virus (HIV), Chronic Conditions
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
McDonagh MS, Morasco BJ, Wagner J
Cannabis-based products for chronic pain : a systematic review.
Researchers sought to evaluate the benefits and harms of cannabinoids for chronic pain. They found that oral, synthetic cannabis products with high THC-to-CBD ratios and sublingual, extracted cannabis products with comparable THC-to-CBD ratios may be associated with short-term improvements in chronic pain and increased risk for dizziness and sedation.
AHRQ-funded; 75Q80120D00006.
Citation: McDonagh MS, Morasco BJ, Wagner J .
Cannabis-based products for chronic pain : a systematic review.
Ann Intern Med 2022 Aug;175(8):1143-53. doi: 10.7326/m21-4520.
AHRQ-funded; 75Q80120D00006..
AHRQ-funded; 75Q80120D00006..
Keywords: Pain, Chronic Conditions, Complementary and Alternative Medicine, Treatments, Evidence-Based Practice
Nair D, Hall RK
Clin-Star corner: what is new at the interface of geriatrics and nephrology?
In this article, the authors highlight key findings of three recent original investigations in nephrology and describe each study, the relevance to the care of older adults, and current areas of uncertainty that warrant further investigation. The three articles relate to removal of the race adjustment in the estimation of kidney function, the use of novel therapeutics to halt chronic kidney disease progression and improve cardiovascular outcomes, and medication management for short-term pain control in chronic kidney disease.
AHRQ-funded; HS026395.
Citation: Nair D, Hall RK .
Clin-Star corner: what is new at the interface of geriatrics and nephrology?
J Am Geriatr Soc 2022 Aug;70(8):2219-24. doi: 10.1111/jgs.17942..
Keywords: Elderly, Kidney Disease and Health, Chronic Conditions
Mercer AN, Mauskar S, Baird J
Family safety reporting in hospitalized children with medical complexity.
This prospective cohort study was conducted to evaluate safety concerns from families of hospitalized children with medical complexity (CMC) who are at high risk of medical errors. This survey was done predischarge with English- and Spanish-speaking parents/staff of hospitalized CMC on 5 units caring for complex care patients at a tertiary care children's hospital. A total of 155 parents and 214 staff completed surveys, with 43% (n = 66) having ≥1 hospital safety concerns, totaling 115 concerns (1-6 concerns each). A physician review found that 69% of concerns were medical errors, and 22% nonsafety-related quality issues. Most parents (68%) reported concerns to staff, particularly bedside nurses, but only 32% of parents recalled being told how to report safety concerns. Higher education and longer length of stay were associated with family safety concerns.
AHRQ-funded; HS025781.
Citation: Mercer AN, Mauskar S, Baird J .
Family safety reporting in hospitalized children with medical complexity.
Pediatrics 2022 Aug 1; 150(2):e2021055098. doi: 10.1542/peds.2021-055098..
Keywords: Children/Adolescents, Family Health and History, Chronic Conditions, Patient Safety, Medical Errors, Adverse Events, Inpatient Care
Kim B, Mulready-Ward C, Thorpe LE
Housing environments and asthma outcomes within population-based samples of adults and children in NYC.
This study assessed the relationship between housing type (i.e., home ownership, public housing, rental assistance, rent-controlled housing, and other rental housing) and asthma outcomes among New York City (NYC) adults and children (ages 1-13). The authors used the 2019 NYC Community Health Survey (CHS) and 2019 NYC KIDS survey to analyze associations between housing type and ever having been diagnosed with asthma (“ever asthma”) and experiencing an asthma attack within the past year. They also examined whether associations were modified by smoking status (among adults), smoking within the house (among children), and overweight/obesity. Among adults, living in public housing, compared to home ownership, was associated with higher odds of ever asthma and past-year asthma attack. Rental assistance housing living was also significantly associated with ever asthma. Public or rental assistance housing associations and ever asthma were marginally significant among children but were more pronounced among ever smokers than among never smokers.
AHRQ-funded; HS026120.
Citation: Kim B, Mulready-Ward C, Thorpe LE .
Housing environments and asthma outcomes within population-based samples of adults and children in NYC.
Prev Med 2022 Aug;161:107147. doi: 10.1016/j.ypmed.2022.107147..
Keywords: Children/Adolescents, Asthma, Respiratory Conditions, Social Determinants of Health, Vulnerable Populations, Urban Health, Chronic Conditions