National Healthcare Quality and Disparities Report
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Search All Research Studies
Topics
- Ambulatory Care and Surgery (2)
- Behavioral Health (1)
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- Patient-Centered Outcomes Research (3)
- Patient Adherence/Compliance (3)
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- (-) Patient Self-Management (17)
- Quality of Life (1)
- Racial and Ethnic Minorities (3)
- Telehealth (5)
- Vulnerable Populations (1)
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 17 of 17 Research Studies DisplayedWeiner M, Adeoye P, Boeh MJ
Continuous glucose monitoring and other wearable devices to assess hypoglycemia among older adult outpatients with diabetes mellitus.
The purpose of this study was to assess whether vulnerable older adults could use wearable devices, and explore Hypoglycemia frequency over a two week period. The researchers recruited 10 participants with diabetes mellitus to pilot test a continuous glucometer, physical activity monitor, electronic medication bottles, and smartphones which that provided prompts about medications, behaviors, and symptoms. A sample of 70 then wore glucometers and activity monitors and used the smartphone and bottles for a duration of 2 weeks and provided feedback. The study found that patients were interested in assistance with the interpretation of graphs, had challenges with keeping the glucometers attached. Nearly 23% of respondents indicated that they never check their blood sugars. In two weeks of monitoring, 73% had HG and 42% had serious, clinically significant HG.
AHRQ-funded; HS024384.
Citation: Weiner M, Adeoye P, Boeh MJ .
Continuous glucose monitoring and other wearable devices to assess hypoglycemia among older adult outpatients with diabetes mellitus.
Appl Clin Inform 2023 Jan; 14(1):37-44. doi: 10.1055/a-1975-4136..
Keywords: Elderly, Diabetes, Chronic Conditions, Ambulatory Care and Surgery, Patient Self-Management, Medical Devices
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
Fuji KT, Abbott AA, Galt KA
A mixed-methods evaluation of standalone personal health record use by patients with type 2 diabetes.
The purpose of this study was to compare use of a standalone personal health records (PHRs) by patients with Type 2 diabetes to usual care through assessment of self-care behaviors, and short-term impact on social cognitive outcomes and hemoglobin A1c (HbA1c). Five themes emerged from the qualitative analysis describing participants' experiences with the PHR and identifying reasons for lack of engagement. Study findings revealed low PHR uptake and minimal impact on study outcomes, including lack of communication and information-sharing between patients and providers.
AHRQ-funded; HS018625.
Citation: Fuji KT, Abbott AA, Galt KA .
A mixed-methods evaluation of standalone personal health record use by patients with type 2 diabetes.
Perspect Health Inf Manag 2021 Fall;18(4):1e..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Diabetes, Patient Self-Management, Chronic Conditions, Patient and Family Engagement
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
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
Despins LA, Wakefield BJ
Making sense of blood glucose data and self-management in individuals with type 2 diabetes mellitus: a qualitative study.
The purpose of this study was to describe individuals' with type 2 diabetes mellitus sense-making of blood glucose data and other influences impacting self-management behavior. One-on-one interviews with adults diagnosed with type 2 diabetes mellitus were used. Results showed that individuals used self-monitored glucose values and/or HbA1C values to evaluate glucose control. Recommendations included having nurses assess sense-making processes in self-management decisions and providing periodic refresher diabetes education for individuals with type 2 diabetes mellitus.
AHRQ-funded; HS022140.
Citation: Despins LA, Wakefield BJ .
Making sense of blood glucose data and self-management in individuals with type 2 diabetes mellitus: a qualitative study.
J Clin Nurs 2020 Jul;29(13-14):2572-88. doi: 10.1111/jocn.15280..
Keywords: Patient Self-Management, Diabetes, Chronic Conditions, Patient Adherence/Compliance, Decision Making
Andreae SJ, Andreae LJ, Richman JS
Peer-delivered cognitive behavioral training to improve functioning in patients with diabetes: a cluster-randomized trial.
Cognitive behavioral therapy (CBT)-based programs delivered by trained community members could improve functioning and pain in individuals who lack access to such programs. In this study, the investigators tested the effectiveness of a peer-delivered diabetes self-management program integrating CBT principles in improving physical activity, functional status, pain, quality of life (QOL), and health outcomes in individuals with diabetes and chronic pain.
AHRQ-funded; HS019239.
Citation: Andreae SJ, Andreae LJ, Richman JS .
Peer-delivered cognitive behavioral training to improve functioning in patients with diabetes: a cluster-randomized trial.
Ann Fam Med 2020 Jan;18(1):15-23. doi: 10.1370/afm.2469..
Keywords: Diabetes, Chronic Conditions, Pain, Patient Self-Management, Quality of Life
Jolliff AF, Hoonakker P, Ponto K
The desktop, or the top of the desk? The relative usefulness of household features for personal health information management.
This study examined how members of the diabetic population use features of the home environment to support personal health information management (PHIM). Using a simulated home environment (VR CAVE), participants identified the most useful features for performing three examples of PHIM tasks. The computer was perceived as the most useful feature, but perceived usefulness varied based on the PHIM task performed and the rooms in which features appeared. A detailed study of the affordances of features may be needed to ease the burden of managing chronic illness, particularly diabetes mellitus, in the sociotechnical system of the home.
AHRQ-funded; HS022548.
Citation: Jolliff AF, Hoonakker P, Ponto K .
The desktop, or the top of the desk? The relative usefulness of household features for personal health information management.
Appl Ergon 2020 Jan;82:102912. doi: 10.1016/j.apergo.2019.102912..
Keywords: Diabetes, Chronic Conditions, Patient Self-Management
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
Goins RT, Jones J, Schure M
Type 2 diabetes management among older American Indians: beliefs, attitudes, and practices.
This study’s purpose was to examine beliefs, attitudes, and practices of older Native Americans regarding type 2 diabetes mellitus (T2DM) management. This disease is one the leading causes of morbidity and mortality among Native Americans, and they are twice as likely to have T2DM, and over three times the mortality rate from T2DM as Whites. Semi-structured in-depth qualitative interviews were conducted with 28 participants with a mean age of 73 years, with 57% female. Participants’ mean confidence score of their T2DM management was 8.0 on a scale of 1 to 10 and their mean Hb1Ac was 7.3.%. Overall 5 themes were discussed: sociocultural factors, causes and consequences, cognitive and affective assessment, diet and exercise, and medical management.
AHRQ-funded; HS000078.
Citation: Goins RT, Jones J, Schure M .
Type 2 diabetes management among older American Indians: beliefs, attitudes, and practices.
Ethn Health 2020 Nov;25(8):1055-71. doi: 10.1080/13557858.2018.1493092..
Keywords: Diabetes, Chronic Conditions, Elderly, Racial and Ethnic Minorities, Patient Self-Management, Care Management
Schure M, Goins RT, Jones J
Dietary beliefs and management of older American Indians with type 2 diabetes.
This qualitative study examined dietary-related beliefs and self-management among older American Indians with type 2 diabetes mellitus (T2DM). The investigators concluded that American Indian older adults face a variety of challenges to dietary management of T2DM. The investigators suggested that future research efforts can focus on assessing how social support can be leveraged to facilitate healthy diets for American Indians with T2DM.
AHRQ-funded; HS000078.
Citation: Schure M, Goins RT, Jones J .
Dietary beliefs and management of older American Indians with type 2 diabetes.
J Nutr Educ Behav 2019 Jul-Aug;51(7):826-33. doi: 10.1016/j.jneb.2018.11.007..
Keywords: Elderly, Diabetes, Chronic Conditions, Racial and Ethnic Minorities, Nutrition, Patient Self-Management
Cherrington AL, Khodneva Y, Richman JS
Impact of peer support on acute care visits and hospitalizations for individuals with diabetes and depressive symptoms: a cluster-randomized controlled trial.
This study examined the impact of peer support on the number of acute care visits and hospitalizations for individuals with diabetes with and without depressive symptoms. This randomized controlled trial was conducted from 2010-2012. One year of peer support was given to intervention participants, and the usual care to control participants. A Patient Health Questionnaire (PHQ-8) was given to participants to assess depression symptoms at the beginning of the trial, at 6 months and then at 12 months. There was a lower rate of acute care visits and hospitalizations in those patients with depressive symptoms in the intervention group, but it made no difference for individuals without depressive symptoms.
AHRQ-funded; HS013852.
Citation: Cherrington AL, Khodneva Y, Richman JS .
Impact of peer support on acute care visits and hospitalizations for individuals with diabetes and depressive symptoms: a cluster-randomized controlled trial.
Diabetes Care 2018 Dec;41(12):2463-70. doi: 10.2337/dc18-0550..
Keywords: Ambulatory Care and Surgery, Chronic Conditions, Depression, Diabetes, Hospitalization, Behavioral Health, Patient Self-Management
Werner NE, Jolliff AF, Casper G, et al.
Home is where the head is: a distributed cognition account of personal health information management in the home among those with chronic illness.
Researchers combined distributed cognition theory and a patient work-system model to investigate how characteristics of the home interact with the cognitive work of personal health information management (PHIM) for chronic illness. A 3D cave automatic virtual-reality environment (CAVE) enabled participants diagnosed with diabetes to describe how they would perform PHIM within a home context. The researchers found that PHIM is ‘distinctly cognitive work,’ and that features of the physical environment - tasks, people, tools and technologies - continuously shape/are shaped by the PHIM process. They suggest that approaches in which the individual is considered relevant for analysis overlook the role of environment in shaping PHIM.
AHRQ-funded; HS022548.
Citation: Werner NE, Jolliff AF, Casper G, et al..
Home is where the head is: a distributed cognition account of personal health information management in the home among those with chronic illness.
Ergonomics 2018 Aug;61(8):1065-78. doi: 10.1080/00140139.2018.1435910..
Keywords: Chronic Conditions, Diabetes, Patient Self-Management
Quan J, Lee AK, Handley MA
Automated telephone self-management support for diabetes in a low-income health plan: a health care utilization and cost analysis.
The objective was to determine whether automated telephone self-management support for low-income, linguistically diverse health plan members with diabetes affects health care utilization or cost. It found no significant differences in emergency department visits and hospitalizations or in costs.
AHRQ-funded; HS020684; HS017261; HS022561.
Citation: Quan J, Lee AK, Handley MA .
Automated telephone self-management support for diabetes in a low-income health plan: a health care utilization and cost analysis.
Popul Health Manag 2015 Dec;18(6):412-20. doi: 10.1089/pop.2014.0154.
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Keywords: Diabetes, Chronic Conditions, Patient Self-Management, Low-Income, Healthcare Costs
Pillay J, Armstrong MJ, Butalia S
Behavioral programs for type 1 diabetes mellitus: a systematic review and meta-analysis.
The purpose of this review and meta-analysis was to determine the effects of behavioral programs for patients with type 1 diabetes on behavioral, clinical, and health outcomes and to investigate factors that might moderate effect. It concluded that behavioral programs for type 1 diabetes offer some benefit for glycemic control, at least at short-term follow-up, but improvement for other outcomes has not been shown.
AHRQ-funded; 2902012000131.
Citation: Pillay J, Armstrong MJ, Butalia S .
Behavioral programs for type 1 diabetes mellitus: a systematic review and meta-analysis.
Ann Intern Med 2015 Dec 1;163(11):836-47. doi: 10.7326/m15-1399..
Keywords: Diabetes, Education: Patient and Caregiver, Patient Self-Management, Patient-Centered Outcomes Research, Lifestyle Changes, Chronic Conditions
Pillay J, Armstrong MJ, Butalia S
Behavioral programs for type 2 diabetes mellitus: a systematic review and network meta-analysis.
The purpose of this review was to identify factors moderating the effectiveness of behavioral programs for adults with type 2 diabetes. It concluded that diabetes self-management education offering 10 or fewer hours of contact with delivery personnel provided little benefit. Behavioral programs seem to benefit persons with suboptimal or poor glycemic control more than those with good control.
AHRQ-funded; 2902012000131.
Citation: Pillay J, Armstrong MJ, Butalia S .
Behavioral programs for type 2 diabetes mellitus: a systematic review and network meta-analysis.
Ann Intern Med 2015 Dec 1;163(11):848-60. doi: 10.7326/m15-1400..
Keywords: Diabetes, Education: Patient and Caregiver, Patient Self-Management, Patient-Centered Outcomes Research, Lifestyle Changes, Chronic Conditions