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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
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1 to 8 of 8 Research Studies DisplayedIsbell LM, Chimowitz H, Huff NR
A qualitative study of emergency physicians' and nurses' experiences caring for patients with psychiatric conditions and/or substance use disorders.
This study’s aim was to develop a comprehensive data-driven model of the complex challenges and unique dynamics associated with caring for patients with psychiatric conditions and/or substance use disorders (SUDs) in the emergency department (ED), as well as the effect on patient care quality. The authors conducted a preplanned topical analysis of grounded theory data obtained from semistructured interviews with 86 ED physicians and nurses from 8 hospitals in the Northeastern USA. Participants described in detail their experiences and challenges in caring for patients with psychiatric conditions and/or SUDs. The authors identified themes inductively using constant comparative analysis and developed a grounded model of physicians' and nurses' perceptions of challenges, biases, and effects on patient care. Challenges identified were emotional, diagnostic, and logistical. These challenges magnified existing health care system issues and social structures, which fuel and reinforce negative attitudes, expectations, and biases. This creates a cyclical process whereby challenges and biases associated with patients with psychiatric conditions and/or SUDs can reciprocally threaten patient care quality.
AHRQ-funded; HS025752.
Citation: Isbell LM, Chimowitz H, Huff NR .
A qualitative study of emergency physicians' and nurses' experiences caring for patients with psychiatric conditions and/or substance use disorders.
Ann Emerg Med 2023 Jun; 81(6):715-27. doi: 10.1016/j.annemergmed.2022.10.014..
Keywords: Behavioral Health, Substance Abuse, Emergency Department, Provider: Nurse, Provider: Physician
Cross WF, West JC, Crean HF
Measurement of primary care providers' suicide prevention skills following didactic education.
This study’s objective was to determine if didactic training by medical residents and nurse practitioner (NP) trainees increased their skills to assess and manage patients’ suicidal ideation, intent, and behaviors. Online didactic training was provided to 127 medical resident and NP trainees followed by a standardized patient interaction conducted to assess demonstrated suicide prevention skills (i.e., assessment of risk factors, protective factors, suicidal ideation and behavior, safety planning). Participants demonstrated only about half of the possible total skills in most domains and were least competent in assessing potential risk for suicide. Residents were rated significantly higher than NPs on observed skills.
AHRQ-funded; HS024224.
Citation: Cross WF, West JC, Crean HF .
Measurement of primary care providers' suicide prevention skills following didactic education.
Suicide Life Threat Behav 2022 Jun;52(3):373-82. doi: 10.1111/sltb.12827..
Keywords: Behavioral Health, Primary Care, Prevention, Education: Continuing Medical Education, Provider: Physician, Training
Benson NM, Myong C, Newhouse JP
Psychiatrist participation in private health insurance markets: paucity in the land of plenty.
Using 2013 Massachusetts licensing data and the All-Payer Claims Database, researchers performed a cross-sectional analysis of licensed psychiatrists in Massachusetts to examine the extent of participation in private insurance. They found that, among Massachusetts psychiatrists, participation in the private insurance market appeared to be limited. Older psychiatrists were more likely to participate, and patients' access to psychiatrists who accept insurance could worsen as these psychiatrists retire.
AHRQ-funded; HS024725.
Citation: Benson NM, Myong C, Newhouse JP .
Psychiatrist participation in private health insurance markets: paucity in the land of plenty.
Psychiatr Serv 2020 Dec;71(12):1232-38. doi: 10.1176/appi.ps.202000022..
Keywords: Health Insurance, Behavioral Health, Access to Care, Provider: Physician, Provider
Shechter A, Diaz F, Moise N
Psychological distress, coping behaviors, and preferences for support among New York healthcare workers during the COVID-19 pandemic.
The mental health toll of COVID-19 on healthcare workers (HCW) is not yet fully described. In this study the authors, using a cross-sectional web survey, characterized distress, coping, and preferences for support among NYC HCWs during the COVID-19 pandemic. They concluded that NYC HCWs, especially nurses and advanced practice providers, were experiencing COVID-19-related psychological distress.
AHRQ-funded; HS024262.
Citation: Shechter A, Diaz F, Moise N .
Psychological distress, coping behaviors, and preferences for support among New York healthcare workers during the COVID-19 pandemic.
Gen Hosp Psychiatry 2020 Sep-Oct;66:1-8. doi: 10.1016/j.genhosppsych.2020.06.007..
Keywords: COVID-19, Stress, Provider: Clinician, Provider: Physician, Provider: Nurse, Provider: Health Personnel, Behavioral Health
Rhee TG, Olfson M, Nierenberg AA
20-year trends in the pharmacologic treatment of bipolar disorder by psychiatrists in outpatient care settings.
Pharmacological options for treating bipolar disorder have increased over the past 20 years, with several second-generation antipsychotics receiving regulatory approval in the 1990s. In this study the authors describe trends in use of pharmacological agents in the outpatient management of bipolar disorder. The authors concluded that substantial changes occurred in the treatment of bipolar disorder over the past 20 years, with second-generation antipsychotics in large measure supplanting traditional mood stabilizers.
AHRQ-funded; HS023000.
Citation: Rhee TG, Olfson M, Nierenberg AA .
20-year trends in the pharmacologic treatment of bipolar disorder by psychiatrists in outpatient care settings.
Am J Psychiatry 2020 Aug;177(8):706-15. doi: 10.1176/appi.ajp.2020.19091000..
Keywords: Behavioral Health, Medication, Practice Patterns, Ambulatory Care and Surgery, Provider: Physician, Provider
Rhee TG, Wilkinson ST
Exploring the psychiatrist-industry financial relationship: insight from the open payment data of Centers for Medicare and Medicaid Services.
The Physician Payments Sunshine Act (PPSA) requires reporting of financial payments by pharmaceutical and medical device companies to teaching hospitals and individual physicians in the United States. In this study, industry payments made to psychiatrists were quantified. The investigators found that over half of active psychiatrists (55.7%) received some form of payments from pharmaceutical manufacturers.
AHRQ-funded; HS023000.
Citation: Rhee TG, Wilkinson ST .
Exploring the psychiatrist-industry financial relationship: insight from the open payment data of Centers for Medicare and Medicaid Services.
Adm Policy Ment Health 2020 Jul;47(4):526-30. doi: 10.1007/s10488-020-01009-2.
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Keywords: Provider: Physician, Provider, Behavioral Health, Payment, Policy
Brunsberg KA, Landrigan CP, Garcia BM
Association of pediatric resident physician depression and burnout with harmful medical errors on inpatient services.
The objective of this paper was to determine whether higher rates of medical errors were associated with positive screenings for depression or burnout among resident physicians. Results of this prospective cohort study showed that resident physicians with a positive depression screen were three times more likely than those who screened negative to make harmful errors, indicating the importance of determining what interventions might mitigate the patient safety risk.
AHRQ-funded; HS019456.
Citation: Brunsberg KA, Landrigan CP, Garcia BM .
Association of pediatric resident physician depression and burnout with harmful medical errors on inpatient services.
Acad Med 2019 Aug;94(8):1150-56. doi: 10.1097/acm.0000000000002778..
Keywords: Children/Adolescents, Provider: Physician, Provider, Medical Errors, Adverse Events, Burnout, Patient Safety, Depression, Behavioral Health
Simpkin AL, Khan A, West DC
Stress from uncertainty and resilience among depressed and burned out residents: a cross-sectional study.
This study examined how stress from uncertainty is related to resilience among medical residents and whether those attributes are related to depression and burnout. The investigators surveyed 86 residents in pediatric residency programs from 4 urban freestanding children’s hospitals in North America in 2015. They used the Physicians’ Reaction to Uncertainty Scale to measure stress from uncertainty, the 14-item Resilience Scale to measure uncertainty, the Harvard National Depression Scale for depression, and the Maslach Burnout Inventory for burnout. There was a response rate of 58.1%. Five residents met depression criteria, and 15 residents met the burnout criteria. Depressed and burned out residents both had higher mean levels of stress compared to residents who neither depressed nor burned out.
AHRQ-funded; HS022986.
Citation: Simpkin AL, Khan A, West DC .
Stress from uncertainty and resilience among depressed and burned out residents: a cross-sectional study.
Acad Pediatr 2018 Aug;18(6):698-704. doi: 10.1016/j.acap.2018.03.002..
Keywords: Burnout, Stress, Depression, Provider: Physician, Behavioral Health, Provider, Education: Continuing Medical Education, Hospitals
