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- Adverse Events (1)
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- Clinician-Patient Communication (1)
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- Community-Based Practice (1)
- Comparative Effectiveness (1)
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- Education: Patient and Caregiver (3)
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- Health Information Technology (HIT) (15)
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- Human Immunodeficiency Virus (HIV) (3)
- Injuries and Wounds (1)
- Kidney Disease and Health (1)
- Lifestyle Changes (1)
- Low-Income (2)
- Medication (1)
- Nursing (1)
- Outcomes (1)
- Pain (1)
- Patient-Centered Healthcare (3)
- Patient-Centered Outcomes Research (2)
- Patient Adherence/Compliance (5)
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- (-) Patient Self-Management (23)
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- Racial and Ethnic Minorities (1)
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- Rural Health (1)
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- Surgery (1)
- (-) Telehealth (23)
- Vulnerable Populations (3)
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 23 of 23 Research Studies DisplayedSchnall R, Sanabria G, Jia R, Sanabria G, Jia H
Efficacy of an mHealth self-management intervention for persons living with HIV: the WiseApp randomized clinical trial.
This study’s objective was to determine the efficacy of WiseApp, a user-centered design mHealth intervention to improve antiretroviral therapy (ART) adherence and viral suppression in persons living with HIV (PLWH). This randomized case-control trial had two study arms: a randomized controlled efficacy trial arm (n = 99) and an attention control intervention arm (n = 101) among PLWH living in New York City. The authors found a significant improvement in ART adherence in the intervention arm compared to the attention control arm from day 1 (69.7% vs 48.3%) to day 59 (51.2% vs 37.2%) of the study period. From day 60 to 120, the intervention had higher but not statistically significant adherence rates. Secondary analyses showed no difference in change from baseline to 3 or 6 months between the 2 study arms.
AHRQ-funded; HS025071.
Citation: Schnall R, Sanabria G, Jia R, Sanabria G, Jia H .
Efficacy of an mHealth self-management intervention for persons living with HIV: the WiseApp randomized clinical trial.
J Am Med Inform Assoc 2023 Feb 16; 30(3):418-26. doi: 10.1093/jamia/ocac233..
Keywords: Telehealth, Patient Self-Management, Human Immunodeficiency Virus (HIV), Chronic Conditions, 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
Oikonomidi T, Ravaud P, James A
AHRQ Author: Montori V
An international, mixed-methods study of the perceived intrusiveness of remote digital diabetes monitoring.
This paper describes an international online vignette-based survey to assess the relationship between remote digital monitoring (RDM) modalities for diabetes and intrusiveness in patients’ lives. The survey was conducted from February-June 2019 in 30 countries with 1010 participants. A total of 2680 vignette-assessments were completed with 52% on type 1 diabetes. Increased intrusiveness was associated with food monitoring compared with glucose- and PA-monitoring alone and permanent monitoring with real-time physician-generated feedback compared with monitoring for a week with feedback. Public-sector data handling was associated with decreased intrusiveness as compared with the private sector.
AHRQ-authored.
Citation: Oikonomidi T, Ravaud P, James A .
An international, mixed-methods study of the perceived intrusiveness of remote digital diabetes monitoring.
Mayo Clin Proc 2021 May;96(5):1236-47. doi: 10.1016/j.mayocp.2020.07.040..
Keywords: Telehealth, Health Information Technology (HIT), Diabetes, Chronic Conditions, Lifestyle Changes, Patient Self-Management
Oikonomidi T, Ravaud P, Cosson E
AHRQ Author: Montori V
Evaluation of patient willingness to adopt remote digital monitoring for diabetes management.
Investigators sought to identify the minimum effectiveness patients report they require to adopt 36 different remote digital monitoring (RDM) scenarios. Adults with type 1 or type 2 diabetes living in 30 countries assessed three randomly selected scenarios from a total of 36 that described different combinations of digital monitoring tools. The investigators found that patients required greater health benefits to adopt more intrusive RDM modalities, food monitoring, and real-time feedback by a health care professional. They recommended that patient monitoring devices be designed to be minimally intrusive.
AHRQ-authored.
Citation: Oikonomidi T, Ravaud P, Cosson E .
Evaluation of patient willingness to adopt remote digital monitoring for diabetes management.
JAMA Netw Open 2021 Jan;4(1):e2033115. doi: 10.1001/jamanetworkopen.2020.33115..
Keywords: Telehealth, Health Information Technology (HIT), Diabetes, Chronic Conditions, Care Management, Patient Self-Management, Patient Adherence/Compliance
Howland C, Despins L, Sindt J
Primary care clinic nurse activities with a telehealth monitoring system.
The purpose of this study was to evaluate differences in the types of nursing activities and communication processes reported in a primary care clinic between patients using a home-based monitoring system to electronically communicate self-monitored blood glucose and blood pressure values and those assuming usual care. Significant differences were identified for the direct care nursing activities of providing lifestyle and health education, medication adjustments, and patient follow-up, providing evidence of greater nursing activity reported in a primary care clinic in patients who utilized a home-based monitoring system.
AHRQ-funded; HS017035.
Citation: Howland C, Despins L, Sindt J .
Primary care clinic nurse activities with a telehealth monitoring system.
West J Nurs Res 2021 Jan;43(1):5-12. doi: 10.1177/0193945920923082..
Keywords: Telehealth, Health Information Technology (HIT), Blood Pressure, Primary Care, Clinician-Patient Communication, Communication, Patient Self-Management, Nursing, Patient-Centered Healthcare, Diabetes
Flynn G, Jia H, Reynolds NR
Protocol of the randomized control trial: the WiseApp trial for improving health outcomes in PLWH (WiseApp).
This paper outlines the protocol for the WiseApp randomized control trial. The WiseApp contains real-time medication monitoring linking an electronic pill bottle and fitness tracker to the app, helping persons living with HIV (PLWH) self-manage their medication adherence and improve their overall quality of life. The primary objective of the trial is to test the effect of the WiseApp's medication adherence features on antiretroviral adherence in underserved PLWH in New York City. The real-time monitoring of the WiseApp has the potential to help providers initiate interventions to help patients resume treatment before drug resistance begins.
AHRQ-funded; HS025071.
Citation: Flynn G, Jia H, Reynolds NR .
Protocol of the randomized control trial: the WiseApp trial for improving health outcomes in PLWH (WiseApp).
BMC Public Health 2020 Nov 25;20(1):1775. doi: 10.1186/s12889-020-09688-0..
Keywords: Human Immunodeficiency Virus (HIV), Medication, Telehealth, Health Information Technology (HIT), Patient Adherence/Compliance, Patient Self-Management, Chronic Conditions, Care Management, Healthcare Delivery
Presley C, Agne A, Shelton T
Mobile-enhanced peer support for African Americans with Type 2 diabetes: a randomized controlled trial.
This study compared the effectiveness of a community-based diabetes self-management education (DSME) plus mobile health (mHealth)-enhanced peer support intervention to community-based DSME alone for African American adults with poorly controlled type 2 diabetes. This randomized controlled trial took place in Jefferson County, Alabama within a safety-net healthcare system with a group diagnosed with type 2 diabetes and hemoglobin A1C ≥ 7.5%. The intervention group reviewed community-based DSME plus 6 months of mHealth-enhanced peer support, including 12 weekly phone calls, then 3 monthly calls from community health workers. The control group received community based DSME only. Primary outcomes were lower A1C and secondary outcomes were lower diabetes distress, depressive symptoms, self-efficacy or confidence in their ability to manage diabetes, and social support. Of 120 participants selected, 97 completed the study. Both groups experienced clinical meaning reduction in A1C. Participants in the intervention group experienced a significantly larger reduction in diabetes distress compared to the control group.
AHRQ-funded; HS019465.
Citation: Presley C, Agne A, Shelton T .
Mobile-enhanced peer support for African Americans with Type 2 diabetes: a randomized controlled trial.
J Gen Intern Med 2020 Oct;35(10):2889-96. doi: 10.1007/s11606-020-06011-w..
Keywords: Telehealth, Health Information Technology (HIT), Patient Self-Management, Diabetes, Chronic Conditions, Racial and Ethnic Minorities, Community-Based Practice, Comparative Effectiveness, Patient-Centered Outcomes Research, Evidence-Based Practice, Outcomes, Education: Patient and Caregiver
Bilgrami Z, Abutaleb A, Chudy-Onwugaje K
Effect of TELEmedicine for inflammatory bowel disease on patient activation and self-efficacy.
This study examined the use of a web-based monitoring system called TELEmedicine to remotely monitor changes in patient activation and self-efficacy for inflammatory bowel disease (IBD) patients. This multicenter, randomized controlled trial enrolled 222 adults with IBD who had experienced an IBD flare within 2 years prior to the trial. Changes in self-efficacy were not significantly different between the two groups although patient activation scores were.
AHRQ-funded; HS018975.
Citation: Bilgrami Z, Abutaleb A, Chudy-Onwugaje K .
Effect of TELEmedicine for inflammatory bowel disease on patient activation and self-efficacy.
Dig Dis Sci 2020 Jan;65(1):96-103. doi: 10.1007/s10620-018-5433-5..
Keywords: Telehealth, Digestive Disease and Health, Patient Self-Management, Care Management, Health Information Technology (HIT), Patient and Family Engagement
Mayberry LS, Lyles CR, Oldenburg B
mHealth interventions for disadvantaged and vulnerable people with type 2 diabetes.
The authors evaluate the impact of diabetes self-management interventions delivered via mobile device and/or Internet on glycemic control of disadvantaged/vulnerable adults with type 2 diabetes. They found evidence suggesting that digital interventions can improve diabetes control, healthcare utilization, and healthcare costs. More research to substantiate these early findings is recommended; the authors suggest that many issues remain in order to optimize the impact of digital interventions on the health outcomes of disadvantaged/vulnerable persons with diabetes.
AHRQ-funded; HS022408; HS025429.
Citation: Mayberry LS, Lyles CR, Oldenburg B .
mHealth interventions for disadvantaged and vulnerable people with type 2 diabetes.
Curr Diab Rep 2019 Nov 25;19(12):148. doi: 10.1007/s11892-019-1280-9.
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Keywords: Diabetes, Vulnerable Populations, Patient Self-Management, Telehealth, Health Information Technology (HIT), Patient-Centered Healthcare, Low-Income, Chronic Conditions
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
Rocque GB, Halilova KI, Varley AL
Feasibility of a telehealth educational program on self-management of pain and fatigue in adult cancer patients.
The primary objective was to assess the feasibility of a telehealth pain and fatigue self-management program among adult cancer patients. The program did not meet feasibility requirements because of only 34% of eligible patients choosing to participate. However, 50 percent of patients starting the program graduated. Differences in baseline characteristics and retention rates were noted by recruitment strategy.
AHRQ-funded; HS013852.
Citation: Rocque GB, Halilova KI, Varley AL .
Feasibility of a telehealth educational program on self-management of pain and fatigue in adult cancer patients.
J Pain Symptom Manage 2017 Jun;53(6):1071-78. doi: 10.1016/j.jpainsymman.2016.12.345.
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Keywords: Cancer, Pain, Education: Patient and Caregiver, Patient Self-Management, Telehealth
Schnall R, Cho H, Webel A
Predictors of willingness to use a smartphone for research in underserved persons living with HIV.
The purpose of this study was to assess factors associated with persons living with HIV (PLVH) for participation in research using smartphones. It concluded that future mHealth interventions targeting PLWH should take into account the inverse relationship between smartphone use and age, HIV stigma, and social isolation, and other predictor variables.
AHRQ-funded; HS023963.
Citation: Schnall R, Cho H, Webel A .
Predictors of willingness to use a smartphone for research in underserved persons living with HIV.
Int J Med Inform 2017 Mar;99:53-59. doi: 10.1016/j.ijmedinf.2017.01.002.
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Keywords: Human Immunodeficiency Virus (HIV), Patient Self-Management, Social Stigma, Telehealth, Vulnerable Populations
Mayberry LS, Berg CA, Harper KJ
The design, usability, and feasibility of a family-focused diabetes self-care support mHealth intervention for diverse, low-income adults with type 2 diabetes.
Through user-centered design and iterative usability/feasibility testing, the researchers developed a mobile Health intervention for disadvantaged adults with type 2 diabetes (T2D) called FAMS. FAMS delivers phone coaching to set self-care goals and improve patient participant's (PP) ability to identify and address family actions that support/impede self-care. PPs reported FAMS increased self-care and both PPs and support persons reported FAMS improved support for and communication about diabetes.
AHRQ-funded; HS022990.
Citation: Mayberry LS, Berg CA, Harper KJ .
The design, usability, and feasibility of a family-focused diabetes self-care support mHealth intervention for diverse, low-income adults with type 2 diabetes.
J Diabetes Res 2016;2016:7586385. doi: 10.1155/2016/7586385.
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Keywords: Diabetes, Low-Income, Patient and Family Engagement, Patient Self-Management, Telehealth
Sarkar U, Gourley GI, Lyles CR
Usability of commercially available mobile applications for diverse patients.
The objective of this study was to investigate the usability of existing mobile health applications ("apps") for diabetes, depression, and caregiving, in order to facilitate development and tailoring of patient-facing apps for diverse populations. Participants completed 43 percent of tasks across 11 apps without assistance. Three themes emerged from participant comments: lack of confidence with technology, frustration with design features and navigation, and interest in having technology to support their self-management.
AHRQ-funded; HS022408.
Citation: Sarkar U, Gourley GI, Lyles CR .
Usability of commercially available mobile applications for diverse patients.
J Gen Intern Med 2016 Dec;31(12):1417-26. doi: 10.1007/s11606-016-3771-6.
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Keywords: Chronic Conditions, Health Information Technology (HIT), Patient Self-Management, Telehealth, Vulnerable Populations
Masterson Creber RM, Hickey KT, Maurer MS
Gerontechnologies for older patients with heart failure: what is the role of smartphones, tablets, and remote monitoring devices in improving symptom monitoring and self-care management?
The authors discussed the role of gerontechnologies, specifically the use of mobile applications available on smartphones and tablets as well as remote monitoring systems, for outpatient disease management among older adults with heart failure.
AHRQ-funded; HS021816.
Citation: Masterson Creber RM, Hickey KT, Maurer MS .
Gerontechnologies for older patients with heart failure: what is the role of smartphones, tablets, and remote monitoring devices in improving symptom monitoring and self-care management?
Curr Cardiovasc Risk Rep 2016 Oct;10(10). doi: 10.1007/s12170-016-0511-8.
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Keywords: Elderly, Telehealth, Health Information Technology (HIT), Heart Disease and Health, Cardiovascular Conditions, Patient Self-Management
Darlow S, Wen KY
Development testing of mobile health interventions for cancer patient self-management: a review.
The purpose of the current study was to conduct a review of published articles that describe the development process of mobile health interventions for patients’ cancer care self-management. The following trends emerged: importance of stakeholder engagement during the development process, addressing the unique needs and experiences of cancer patients and care providers, ensuring user satisfaction with the system, and identifying perceived benefits and limitations of the system.
AHRQ-funded; HS019001.
Citation: Darlow S, Wen KY .
Development testing of mobile health interventions for cancer patient self-management: a review.
Health Informatics J 2016 Sep;22(3):633-50. doi: 10.1177/1460458215577994..
Keywords: Patient Self-Management, Cancer, Chronic Conditions, Telehealth, Health Information Technology (HIT)
Ritchie CS, Houston TK, Richman JS
The E-Coach technology-assisted care transition system: a pragmatic randomized trial.
The researchers sought to evaluate the impact of a technology-supported care transition support program (E-Coach) on hospitalizations, days out of the community, and mortality. for patients with congestive heart failure (CHF) and chronic obstructive pulmonary disease (COPD). They found that rehospitalization rates did not differ between E-Coach and usual care groups; however, E-Coach was associated with fewer days in the hospital with the COPD subgroup, suggesting that E-Coach may be more beneficial among those with COPD but not those with CHF.
AHRQ-funded; HS017786.
Citation: Ritchie CS, Houston TK, Richman JS .
The E-Coach technology-assisted care transition system: a pragmatic randomized trial.
Transl Behav Med 2016 Sep;6(3):428-37. doi: 10.1007/s13142-016-0422-8.
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Keywords: Respiratory Conditions, Heart Disease and Health, Hospitalization, Patient Self-Management, Telehealth
Cherrington AL, Agne AA, Lampkin Y
Diabetes Connect: developing a mobile health intervention to link diabetes community health workers with primary care.
The authors tested a model for the integration of a community health worker-delivered mobile health technology intervention to improve diabetes self-management. They found that the integration of mobile health technology into community health worker programs was successfully achieved and readily accepted.
AHRQ-funded; HS019465.
Citation: Cherrington AL, Agne AA, Lampkin Y .
Diabetes Connect: developing a mobile health intervention to link diabetes community health workers with primary care.
J Ambul Care Manage 2015 Oct-Dec;38(4):333-45. doi: 10.1097/jac.0000000000000110.
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Keywords: Education: Patient and Caregiver, Diabetes, Primary Care, Patient Self-Management, Telehealth
Lepard MG, Joseph AL, Agne AA
Diabetes self-management interventions for adults with type 2 diabetes living in rural areas: a systematic literature review.
The authors systematically reviewed the evidence for the impact of diabetes self-management education interventions designed for patients living in rural areas on glycemic control and other diabetes outcomes. They were able to identify examples of both telehealth interventions and face-to-face interventions that resulted in improved behavioral, biologic, and diabetes knowledge-related outcomes in adults with T2DM living in rural areas.
AHRQ-funded; HS019465.
Citation: Lepard MG, Joseph AL, Agne AA .
Diabetes self-management interventions for adults with type 2 diabetes living in rural areas: a systematic literature review.
Curr Diab Rep 2015 Jun;15(6):608. doi: 10.1007/s11892-015-0608-3..
Keywords: Diabetes, Patient Self-Management, Rural Health, Telehealth, Health Information Technology (HIT)
Fuji KT, Abbott AA, Galt KA
A qualitative study of how patients with type 2 diabetes use an electronic stand-alone personal health record.
The authors explored how patients with type 2 diabetes used a personal health record (PHR) to manage their diabetes-related health information for self-care. They found that, despite some potential positive benefits resulting from PHR use, several barriers inhibited sustained and effective use over time. They concluded that provider and patient education about the benefits of PHR use and about the potential for filling in information gaps in the provider-based record is key to engage patients and stimulate PHR adoption and use.
AHRQ-funded; HS018625.
Citation: Fuji KT, Abbott AA, Galt KA .
A qualitative study of how patients with type 2 diabetes use an electronic stand-alone personal health record.
Telemed J E Health 2015 Apr;21(4):296-300. doi: 10.1089/tmj.2014.0084.
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Keywords: Diabetes, Electronic Health Records (EHRs), Patient Self-Management, Telehealth
Sanger P, Hartzler A, Lober WB
Design considerations for post-acute care mHealth: patient perspectives.
The authors are developing an mHealth platform to engage patients in wound tracking to identify and manage surgical site infections (SSI) after hospital discharge. Their key design qualities include: meeting basic accessibility, usability and security needs; encouraging patient-centeredness; facilitating better, more predictable communication; and supporting personalized management by providers. In this article, they illustrated their application of these guiding design considerations and proposed a new framework for mHealth design based on illness duration and intensity.
AHRQ-funded; HS019482.
Citation: Sanger P, Hartzler A, Lober WB .
Design considerations for post-acute care mHealth: patient perspectives.
AMIA Annu Symp Proc 2014 Nov 14;2014:1920-9.
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Keywords: Telehealth, Patient Self-Management, Surgery, Injuries and Wounds, Healthcare-Associated Infections (HAIs), Hospital Discharge, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Adverse Events
Nundy S, Mishra A, Hogan P
How do mobile phone diabetes programs drive behavior change? Evidence from a mixed methods observational cohort study.
The purpose of this study was to investigate the behavioral effects of a theory-driven, mobile phone–based intervention that combines automated text messaging and remote nursing, using an automated, interactive text messaging system. It found that the intervention was associated with improvements in 5 of 6 domains of self-care (medication taking, glucose monitoring, foot care, exercise, and healthy eating).
AHRQ-funded; HS015054.
Citation: Nundy S, Mishra A, Hogan P .
How do mobile phone diabetes programs drive behavior change? Evidence from a mixed methods observational cohort study.
Diabetes Educ 2014 Nov-Dec;40(6):806-19. doi: 10.1177/0145721714551992..
Keywords: Diabetes, Health Information Technology (HIT), Patient Self-Management, Telehealth
Nundy S, Dick JJ, Chou CH
Mobile phone diabetes project led to improved glycemic control and net savings for Chicago plan participants.
Mobile phones are a promising tool to use in engaging patients in behavior change and facilitating self-care between visits. The researchers examined the impact of a six-month mobile health (mHealth) demonstration project among adults with diabetes. In addition to pre-post improvements in glycemic control and patients’ satisfaction with overall care, they observed a net cost savings of 8.8 percent.
AHRQ-funded; HS000084.
Citation: Nundy S, Dick JJ, Chou CH .
Mobile phone diabetes project led to improved glycemic control and net savings for Chicago plan participants.
Health Aff 2014 Feb;33(2):265-72. doi: 10.1377/hlthaff.2013.0589..
Keywords: Diabetes, Health Information Technology (HIT), Patient Adherence/Compliance, Patient Self-Management, Telehealth