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Research Studies is a monthly compilation of research articles funded by AHRQ or authored by AHRQ researchers and recently published in journals or newsletters.
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1 to 25 of 26 Research Studies Displayed
Davidson KW, Krist AH, Tseng CW
Incorporation of social risk in US Preventive Services Task Force Recommendations and identification of key challenges for primary care.
The authors assessed how social risks have been considered in USPSTF recommendation statements and identified current gaps in evidence needed to expand the systematic inclusion of social risks in future recommendations. They concluded that their report serves as a benchmark and foundation for ongoing work to advance the goal of ensuring that health equity and social risks are incorporated into USPSTF methods and recommendations.
AHRQ-authored.
Citation:
Davidson KW, Krist AH, Tseng CW .
Incorporation of social risk in US Preventive Services Task Force Recommendations and identification of key challenges for primary care.
JAMA 2021 Oct 12;326(14):1410-15. doi: 10.1001/jama.2021.12833..
Keywords:
U.S. Preventive Services Task Force (USPSTF), Primary Care, Social Determinants of Health, Risk, Evidence-Based Practice, Research Methodologies, Guidelines
Bierman AS, Wang J, O'Malley PG
Transforming care for people with multiple chronic conditions: Agency for Healthcare Research and Quality's research agenda.
This article describes issues addressing the needs of those with multiple chronic conditions and discusses the AHRQ research agenda.
AHRQ-authored.
Citation:
Bierman AS, Wang J, O'Malley PG .
Transforming care for people with multiple chronic conditions: Agency for Healthcare Research and Quality's research agenda.
Health Serv Res 2021 Oct;56(Suppl 1):973-79. doi: 10.1111/1475-6773.13863..
Keywords:
Chronic Conditions, Health Services Research (HSR), Healthcare Delivery, Quality of Care, Primary Care, Guidelines, Evidence-Based Practice
Tanabe P, Blewer AL, Bonnabeau E
Dissemination of evidence-based recommendations for sickle cell disease to primary care and emergency department providers in North Carolina: a cost benefit analysis.
Sickle cell disease (SCD) is a genetic condition affecting primarily individuals of African descent, who happen to be disproportionately impacted by poverty and who lack access to health care. Many providers do not feel prepared to care for individuals with SCD, despite the existence of evidence-based guidelines. The authors report the development of a SCD toolbox and the dissemination process to primary care and emergency department (ED) providers in North Carolina (NC). They report the effect of this dissemination on health-care utilization, cost of care, and overall cost-benefit.
AHRQ-funded; HS024501.
Citation:
Tanabe P, Blewer AL, Bonnabeau E .
Dissemination of evidence-based recommendations for sickle cell disease to primary care and emergency department providers in North Carolina: a cost benefit analysis.
J Health Econ Outcomes Res 2021 Apr 1;8(1):18-28. doi: 10.36469/jheor.2021.21535..
Keywords:
Sickle Cell Disease, Evidence-Based Practice, Guidelines, Primary Care, Emergency Department, Tools & Toolkits
Gold HT, Siman N, Cuthel AM
A practice facilitation-guided intervention in primary care settings to reduce cardiovascular disease risk: a cost analysis.
In this randomized controlled trial, researchers estimated the associated cost of practice facilitation (PF) for guideline adoption in small, private primary care practices. They found that the PF strategy cost approximately $10,000 per practice per quarter for program and practice costs, once implemented and running at highest efficiency. They indicated that whether or not this program is worthwhile to the decision-maker depends on the relative costs and effectiveness of their other options for improving cardiovascular risk reduction.
AHRQ-funded; HS023922.
Citation:
Gold HT, Siman N, Cuthel AM .
A practice facilitation-guided intervention in primary care settings to reduce cardiovascular disease risk: a cost analysis.
Implement Sci Commun 2021 Feb 6;2(1):15. doi: 10.1186/s43058-021-00116-x..
Keywords:
Primary Care, Cardiovascular Conditions, Guidelines, Prevention, Evidence-Based Practice, Primary Care: Models of Care, Healthcare Costs
Nguyen AM, Cuthel AM, Rogers ES
Attributes of high-performing small practices in a guideline implementation: a multiple-case study.
This study called HealthyHearts NYC was a stepped wedge randomized control trial that tested the effectiveness of practice facilitation in small primary care practices in adopting cardiovascular disease guidelines. The practice-level benchmark desired was having 70% or greater of hypertensive patients having controlled blood pressure. A mixed methods multiple-case study design was used and implemented at 6 small practices. The investigator’s first key finding was that the high-performing and improved practices in their study looked and acted similarly during the intervention implementation. Three key attributes of these practices were found to be: 1) advanced use of electronic health records; 2) dedicated resources and commitment to quality improvement; and 3) an actively engaged lead clinician and office manager.
AHRQ-funded; HS023922.
Citation:
Nguyen AM, Cuthel AM, Rogers ES .
Attributes of high-performing small practices in a guideline implementation: a multiple-case study.
J Prim Care Community Health 2020 Jan-Dec;11. doi: 10.1177/2150132720984411..
Keywords:
Heart Disease and Health, Cardiovascular Conditions, Primary Care, Evidence-Based Practice, Guidelines, Implementation
Harder VS, Shaw JS, McCulloch CE
Statewide asthma learning collaborative participation and asthma-related emergency department use.
This study looked at outcomes from participation of pediatric practices in a quality improvement (QI) collaborative to decrease asthma-related emergency department (ED) visits. A statewide network of practices participated in the collaborative from 2015 to 2016. Asthma-related ED visit rates per 100 child-years for children ages 3 to 21 was evaluated using the state’s all-payer claims databases. The authors found that in the postintervention year (2017) participating practices’ ED visit rate decreased by 5.8 per 100 child-years, compared to an increase of 1.8 per 100 child-years in non-participating practices. There were no statistically significant differences in asthma-related ED visit rates during 2016, which indicated that it took some time for QI elements to be successfully implemented in pediatric practices.
AHRQ-funded; HS025297.
Citation:
Harder VS, Shaw JS, McCulloch CE .
Statewide asthma learning collaborative participation and asthma-related emergency department use.
Pediatrics 2020 Dec;146(6):e20200213. doi: 10.1542/peds.2020-0213..
Keywords:
Children/Adolescents, Asthma, Emergency Department, Quality Improvement, Quality of Care, Primary Care, Guidelines
Mills J, Wonoprabowo L
Primary care-based interventions to prevent illicit drug use in children, adolescents, and young adults.
This case study concerns a 14-year-old patient who presents for a well-child visit. The patient eats a healthy diet, is part of a local soccer league, is an overall good student, and just started high school in the fall. The patient denies trying any illicit substances but reports trying to “get high” from cough syrup. Three questions are presented, and answers provided.
AHRQ-authored.
Citation:
Mills J, Wonoprabowo L .
Primary care-based interventions to prevent illicit drug use in children, adolescents, and young adults.
Am Fam Physician 2020 Oct 15;102(8):493-94..
Keywords:
Children/Adolescents, Young Adults, Substance Abuse, Primary Care, Prevention, U.S. Preventive Services Task Force (USPSTF), Case Study, Guidelines, Evidence-Based Practice
Davidson KW, Kemper AR, Doubeni CA
Developing primary care-based recommendations for social determinants of health: methods of the U.S. Preventive Services Task Force.
This article highlights social determinants already included in USPSTF recommendations and proposes a process by which others may be considered for primary care preventive recommendations. By reviewing the evidence on the effects of screening and interventions on social determinants relevant to primary care, the USPSTF will continue to be able to provide recommendations on clinical preventive services to improve the health of all Americans.
AHRQ-authored.
Citation:
Davidson KW, Kemper AR, Doubeni CA .
Developing primary care-based recommendations for social determinants of health: methods of the U.S. Preventive Services Task Force.
Ann Intern Med 2020 Sep 15;173(6):461-67. doi: 10.7326/m20-0730..
Keywords:
U.S. Preventive Services Task Force (USPSTF), Primary Care, Social Determinants of Health, Evidence-Based Practice, Guidelines, Screening, Prevention
Patnode CD, Perdue LA, Rushkin M
Screening for unhealthy drug use: updated evidence report and systematic review for the US Preventive Services Task Force.
Illicit drug use is among the most common causes of preventable morbidity and mortality in the US. The objective of this study was to conduct a systematic review of the literature on screening and interventions for drug use to inform the US Preventive Services Task Force. The investigators concluded that several screening instruments with acceptable sensitivity and specificity are available to screen for drug use, although there is no direct evidence on the benefits or harms of screening.
AHRQ-funded; 290201500007I.
Citation:
Patnode CD, Perdue LA, Rushkin M .
Screening for unhealthy drug use: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2020 Jun 9;323(22):2310-28. doi: 10.1001/jama.2019.21381..
Keywords:
U.S. Preventive Services Task Force (USPSTF), Substance Abuse, Screening, Evidence-Based Practice, Guidelines, Primary Care, Prevention
O'Connor E, Thomas R, Senger CA
Interventions to prevent illicit and nonmedical drug use in children, adolescents, and young adults: updated evidence report and systematic review for the US Preventive Services Task Force.
The authors reviewed the benefits and harms of interventions to prevent illicit and nonmedical drug use in children, adolescents, and young adults to inform the US Preventive Services Task Force. They found that the evidence for behavioral counseling interventions to prevent initiation of illicit and nonmedical drug use among adolescents and young adults was inconsistent and imprecise, with some interventions associated with reduction in use and others associated with no benefit or increased use. Health, social, and legal outcomes were sparsely reported, and few showed improvements.
AHRQ-funded; 2902015000017I.
Citation:
O'Connor E, Thomas R, Senger CA .
Interventions to prevent illicit and nonmedical drug use in children, adolescents, and young adults: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2020 May 26;323(20):2067-79. doi: 10.1001/jama.2020.1432..
Keywords:
U.S. Preventive Services Task Force (USPSTF), Children/Adolescents, Young Adults, Substance Abuse, Primary Care, Prevention, Guidelines, Evidence-Based Practice
Selph S, Patnode C, Bailey SR
Primary care-relevant interventions for tobacco and nicotine use prevention and cessation in children and adolescents: updated evidence report and systematic review for the US Preventive Services Task Force.
Interventions to discourage the use of tobacco products (including electronic nicotine delivery systems or e-cigarettes) among children and adolescents may help decrease tobacco-related illness and injury. The objective of this study was to update the 2013 review on primary care-relevant interventions for tobacco use prevention and cessation in children and adolescents to inform the US Preventive Services Task Force.
AHRQ-funded; 290201500009I.
Citation:
Selph S, Patnode C, Bailey SR .
Primary care-relevant interventions for tobacco and nicotine use prevention and cessation in children and adolescents: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2020 Apr 28;323(16):1599-608. doi: 10.1001/jama.2020.3332..
Keywords:
U.S. Preventive Services Task Force (USPSTF), Children/Adolescents, Tobacco Use, Tobacco Use: Smoking Cessation, Prevention, Primary Care, Evidence-Based Practice, Guidelines
Nelson HD, Fu R, Zakher B
Medication use for the risk reduction of primary breast cancer in women: updated evidence report and systematic review for the US Preventive Services Task Force.
The purpose of this paper was to update the 2013 US Preventive Services Task Force systematic review on medications to reduce risk of primary (first diagnosis) invasive breast cancer in women. Investigators abstracted data on methods, participant characteristics, eligibility criteria, outcome ascertainment, and follow-up; individual trial results were combined using a profile likelihood random-effects model. Results showed that tamoxifen, raloxifene, and aromatase inhibitors were associated with lower risk of primary invasive breast cancer in women but also were associated with adverse effects that differed between medications. Risk stratification methods to identify patients with increased breast cancer risk demonstrated low accuracy.
AHRQ-funded; 290201500009I.
Citation:
Nelson HD, Fu R, Zakher B .
Medication use for the risk reduction of primary breast cancer in women: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2019 Sep 3;322(9):868-86. doi: 10.1001/jama.2019.5780..
Keywords:
Cancer: Breast Cancer, Cancer, Medication, U.S. Preventive Services Task Force (USPSTF), Evidence-Based Practice, Guidelines, Prevention, Primary Care
Krist AH, Davidson KW, Ngo-Metzger Q
What evidence do we need before recommending routine screening for social determinants of health?
This editorial, co-written by two members of the U.S. Preventive Services Task Force (USPSTF), and a member of the Agency for Healthcare Research and Quality (AHRQ) discusses the need to determine if social determinants of health (SDOH) should be discussed during a primary care visit. At the present time only 2 USPSTF recommendations are social determinants (intimate partner violence, elder abuse, and abuse of vulnerable adults; and child maltreatment). However, there are recommendations for nine health behaviors and three mental health behaviors that are included in SDOH. There is an absence of evidence of benefit for routine screening for many of the social determinants, and the USPSTF is currently conducting an evaluation to understand the state of screening for SDOH.
AHRQ-authored.
Citation:
Krist AH, Davidson KW, Ngo-Metzger Q .
What evidence do we need before recommending routine screening for social determinants of health?
Am Fam Physician 2019 May 15;99(10):602-05..
Keywords:
Evidence-Based Practice, Guidelines, Primary Care, Screening, Social Determinants of Health, U.S. Preventive Services Task Force (USPSTF)
Egan BM, Li J, Davis RA
Differences in primary cardiovascular disease prevention between the 2013 and 2016 cholesterol guidelines and impact of the 2017 hypertension guideline in the United States.
The US Preventive Services Task Force cholesterol guideline recommended statins for fewer adults than the 2013 American College of Cardiology/American Heart Association (ACC/AHA) guideline by setting a higher 10-year atherosclerotic cardiovascular disease threshold and requiring concomitant diabetes mellitus, hypertension, dyslipidemia, or cigarette smoking. The 2017 ACC/AHA hypertension guideline lowered the hypertension threshold, increasing 2016 guideline statin-eligible adults. This article discusses differences in primary cardiovascular disease prevention between the 2013 and 2016 cholesterol guidelines and impact of the 2017 hypertension guideline in the United States.
AHRQ-funded; P30 HS021667.
Citation:
Egan BM, Li J, Davis RA .
Differences in primary cardiovascular disease prevention between the 2013 and 2016 cholesterol guidelines and impact of the 2017 hypertension guideline in the United States.
J Clin Hypertens 2018 Jun;20(6):991-1000. doi: 10.1111/jch.13314..
Keywords:
Cardiovascular Conditions, Heart Disease and Health, Evidence-Based Practice, Guidelines, Hypertension, Medication, Prevention, Primary Care, U.S. Preventive Services Task Force (USPSTF)
McCreedy EM, Kane RL, Gollust SE
Patient-centered guidelines for geriatric diabetes care: potential missed opportunities to avoid harm.
Clinicians strive to deliver individualized, patient-centered care. However, these intentions are understudied. This research explored how patient characteristics associated with a high risk-to-benefit ratio with hypoglycemia medications affected decision making by primary care clinicians. The investigators found that primary care clinicians often chose to intensify glycemic control despite individual patient factors that warranted higher glycemic targets based on existing guidelines.
AHRQ-funded; HS000011.
Citation:
McCreedy EM, Kane RL, Gollust SE .
Patient-centered guidelines for geriatric diabetes care: potential missed opportunities to avoid harm.
J Am Board Fam Med 2018 Mar-Apr;31(2):192-200. doi: 10.3122/jabfm.2018.02.170141..
Keywords:
Diabetes, Elderly, Patient-Centered Healthcare, Guidelines, Evidence-Based Practice, Decision Making, Medication, Primary Care, Practice Patterns, Provider: Physician, Provider: Clinician, Provider
Krist AH, Bibbins-Domingo K, Wolff TA
Advancing the methods of the U.S. Preventive Services Task Force.
The mission of the U.S. Preventive Services Task Force (USPSTF) is to provide evidence-based recommendations on preventive services to primary care clinicians who deliver preventive care.This editorial introduces a journal supplement issue the purpose of which is to present and discuss some of the key methodologic concepts and questions that the USPSTF is currently addressing.
AHRQ-authored.
Citation:
Krist AH, Bibbins-Domingo K, Wolff TA .
Advancing the methods of the U.S. Preventive Services Task Force.
Am J Prev Med 2018 Jan;54(1s1):S1-s3. doi: 10.1016/j.amepre.2017.10.012.
.
.
Keywords:
Evidence-Based Practice, Guidelines, Prevention, Primary Care, U.S. Preventive Services Task Force (USPSTF)
Doherty JA, Crelia SJ, Smith MW
Large health systems' prevention guideline implementation: a qualitative study.
In 2015, researchers conducted and analyzed interviews with quality leaders from eight hospital-based systems and one physician organization who explained organizational processes to adapt, adopt, disseminate, and incentivize adherence to preventive services guidelines. Nearly all have a formal process for reviewing and refining guidelines, developing clinician support, and disseminating the approved guidelines.
AHRQ-authored.
Citation:
Doherty JA, Crelia SJ, Smith MW .
Large health systems' prevention guideline implementation: a qualitative study.
Am J Prev Med 2018 Jan;54(1s1):S88-s94. doi: 10.1016/j.amepre.2017.07.025.
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.
Keywords:
Primary Care, Guidelines, Evidence-Based Practice, Prevention, Implementation, Healthcare Delivery
Kurth AE, Krist AH, Borsky AE
U.S. Preventive Services Task Force methods to communicate and disseminate clinical preventive services recommendations.
The U.S. Preventive Services Task Force (USPSTF) issues evidence-based screening and prevention recommendations, and key to this task is dissemination and implementation of these recommendations. This paper outlines the approaches used by the USPSTF to both solicit input (e.g., public comment periods), as well as to facilitate dissemination of its recommendations to help improve the health of all Americans (e.g., web-based and mobile application tools, journal publications, and annual reports to Congress).
AHRQ-authored.
Citation:
Kurth AE, Krist AH, Borsky AE .
U.S. Preventive Services Task Force methods to communicate and disseminate clinical preventive services recommendations.
Am J Prev Med 2018 Jan;54(1s1):S81-s87. doi: 10.1016/j.amepre.2017.07.004.
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.
Keywords:
Communication, Evidence-Based Practice, Guidelines, Prevention, Primary Care, U.S. Preventive Services Task Force (USPSTF)
Krist AH, Wolff TA, Jonas DE
Update on the methods of the U.S. Preventive Services Task Force: methods for understanding certainty and net benefit when making recommendations.
Since the 1980s, the U.S. Preventive Services Task Force (USPSTF) has developed and used rigorous methods to make evidence-based recommendations about preventive services to promote health and well-being for all Americans. This manuscript details examples of how the USPSTF uses different methods to make recommendations that truly reflect the evidence.
AHRQ-authored.
Citation:
Krist AH, Wolff TA, Jonas DE .
Update on the methods of the U.S. Preventive Services Task Force: methods for understanding certainty and net benefit when making recommendations.
Am J Prev Med 2018 Jan;54(1s1):S11-s18. doi: 10.1016/j.amepre.2017.09.011.
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.
Keywords:
Evidence-Based Practice, Guidelines, Prevention, Primary Care, U.S. Preventive Services Task Force (USPSTF)
Fontil V, Bibbins-Domingo K, Nguyen OK
Management of hypertension in primary care safety-net clinics in the United States: a comparison of community health centers and private physicians' offices.
The researchers examined adherence to guideline-concordant hypertension treatment practices at community health centers (CHCs) compared with private physicians' offices.: Medicaid patients at CHCs were as likely as privately insured individuals to receive a new medication for uncontrolled hypertension, whereas Medicaid patients at private physicians' offices were less likely to receive a new medication.
AHRQ-funded; HS018090.
Citation:
Fontil V, Bibbins-Domingo K, Nguyen OK .
Management of hypertension in primary care safety-net clinics in the United States: a comparison of community health centers and private physicians' offices.
Health Serv Res 2017 Apr;52(2):807-25. doi: 10.1111/1475-6773.12516.
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.
Keywords:
Hypertension, Primary Care, Safety Net, Guidelines
Bierman AS, Tinetti ME
Precision medicine to precision care: managing multimorbidity.
Multimorbidity is the most common condition managed in practice. The authors argue that health-care delivery must be transformed to provide precision care to people with multimorbidity. Accomplishing this transition will require a change in practice, research, and policy from disease-specific to patient-centered models of care delivery.
AHRQ-authored.
Citation:
Bierman AS, Tinetti ME .
Precision medicine to precision care: managing multimorbidity.
Lancet 2016 Dec 3;388(10061):2721-23. doi: 10.1016/s0140-6736(16)32232-2.
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Keywords:
Healthcare Delivery, Chronic Conditions, Guidelines, Patient-Centered Healthcare, Primary Care, Primary Care: Models of Care
Patnode CD, Henninger ML, Senger CA
Primary care interventions to support breastfeeding: updated evidence report and systematic review for the US Preventive Services Task Force.
This updated report found no significant association between interventions and breastfeeding initiation . There was limited mixed evidence of an association between system-level interventions and rates of breastfeeding from well-controlled studies as well as for harms related to breastfeeding interventions, including maternal anxiety scores, decreased confidence, and concerns about confidentiality.
AHRQ-funded.
Citation:
Patnode CD, Henninger ML, Senger CA .
Primary care interventions to support breastfeeding: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2016 Oct 25;316(16):1694-705. doi: 10.1001/jama.2016.8882.
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Keywords:
U.S. Preventive Services Task Force (USPSTF), Breast Feeding, Primary Care, Evidence-Based Practice, Guidelines
Shelley DR, Ogedegbe G, Anane S
Testing the use of practice facilitation in a cluster randomized stepped-wedge design trial to improve adherence to cardiovascular disease prevention guidelines: HealthyHearts NYC.
The long-term goal of the HealthyHearts NYC trial is to create a robust infrastructure for implementing and disseminating evidence-based practice guidelines in primary care practices. The authors hypothesized that practice facilitation will result in superior clinical outcomes compared to usual care and that the effects of practice facilitation will be mediated by greater adoption of system changes in accord with patient-centered medical homes and the chronic care model.
AHRQ-funded; HS023922.
Citation:
Shelley DR, Ogedegbe G, Anane S .
Testing the use of practice facilitation in a cluster randomized stepped-wedge design trial to improve adherence to cardiovascular disease prevention guidelines: HealthyHearts NYC.
Implement Sci 2016 Jul 4;11(1):88. doi: 10.1186/s13012-016-0450-2.
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Keywords:
Cardiovascular Conditions, Evidence-Based Practice, Guidelines, Patient-Centered Outcomes Research, Primary Care
El-Shami K, Oeffinger KC, Erb NL
American Cancer Society colorectal cancer survivorship care guidelines.
Communication and coordination of care between the treating oncologist and the primary care clinician is critical to effectively and efficiently manage the long-term care of colorectal cancer (CRC) survivors. The guidelines in this article are intended to assist primary care clinicians in delivering risk-based health care for CRC survivors who have completed active therapy.
AHRQ-funded; HS020937.
Citation:
El-Shami K, Oeffinger KC, Erb NL .
American Cancer Society colorectal cancer survivorship care guidelines.
CA Cancer J Clin 2015 Nov-Dec;65(6):428-55. doi: 10.3322/caac.21286.
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Keywords:
Cancer, Cancer: Colorectal Cancer, Care Coordination, Guidelines, Primary Care
Alcantara C, Klesges LM, Resnicow K
Enhancing the evidence for behavioral counseling: a perspective from the society of behavioral medicine.
The members of the Society of Behavioral Medicine (SBM)-a multidisciplinary scientific organization committed to improving population health through behavior change- review the USPSTF mandate and current recommendations for behavioral counseling interventions and provide a perspective for the future that calls for concerted and coordinated efforts among SBM, USPSTF, and other organizations invested in the rapid and wider uptake of beneficial, feasible, and referable primary care-focused behavioral counseling interventions.
AHRQ-funded; 290201000004I.
Citation:
Alcantara C, Klesges LM, Resnicow K .
Enhancing the evidence for behavioral counseling: a perspective from the society of behavioral medicine.
Am J Prev Med 2015 Sep;49(3 Suppl 2):S184-93. doi: 10.1016/j.amepre.2015.05.015.
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Keywords:
Behavioral Health, Evidence-Based Practice, Guidelines, Health Promotion, Primary Care, U.S. Preventive Services Task Force (USPSTF)
