National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (1)
- Adverse Events (1)
- Arthritis (1)
- Asthma (1)
- Behavioral Health (2)
- Cancer (1)
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- Care Management (1)
- Centers for Education and Research on Therapeutics (CERTs) (1)
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- (-) Chronic Conditions (26)
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- Heart Disease and Health (1)
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- Human Immunodeficiency Virus (HIV) (3)
- Medicaid (1)
- Medicare (2)
- (-) Medication (26)
- Outcomes (1)
- Patient-Centered Healthcare (4)
- (-) Patient Adherence/Compliance (26)
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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 26 Research Studies DisplayedMcClintock HF, Edmonds SE, Bogner HR
Adherence patterns to oral hypoglycemic agents among primary care patients with type 2 diabetes.
This study’s objective was to examine patterns of adherence to oral hypoglycemic agents among primary care patients with type 2 diabetes mellitus and to assess whether these patterns were associated with baseline intervention allocation, sociodemographic characteristics, and clinical indicators. Adherence patterns for 72 participants were examined by Medication Event Monitoring System (MEMS) caps at baseline and 12 weeks. Participants were randomly allocated to a Patient Prioritized Planning (PPP) intervention or a control group. A card-sort task was used in the PPP intervention to identify health-related priorities that included social determinants of health to address medication nonadherence. Afterward, a problem-solving process was used to address unmet needs involving referral to resources. Patients were found to be either adherent, increasingly adherent, or non-adherent. Participants assigned to the PPP intervention were significantly more likely to have a pattern of improving adherence and adherence than participants assigned to the control group.
AHRQ-funded; HS023445.
Citation: McClintock HF, Edmonds SE, Bogner HR .
Adherence patterns to oral hypoglycemic agents among primary care patients with type 2 diabetes.
Prim Care Diabetes 2023 Apr;17(2):180-84. doi: 10.1016/j.pcd.2023.01.014.
Keywords: Diabetes, Patient Adherence/Compliance, Primary Care, Medication, Chronic Conditions
Creary SE, Beeman C, Stanek J
Impact of hydroxyurea dose and adherence on hematologic outcomes for children with sickle cell anemia.
The purpose of this study was to quantify the contributions of hydroxyurea dose and medication adherence to the association between hydroxyurea exposure and hematologic parameters in children with sickle cell anemia (SCA.) Using data from children with SCA who were enrolled in two prospective hydroxyurea adherence studies, the researchers assessed the association by video of directly observed therapy or electronic pill bottle and medication administration record. Forty-five participants were included in the analysis. The study reported that higher exposure was related with higher fetal hemoglobin and mean corpuscular volume. The researchers concluded that higher hydroxyurea dose was related with improved hematologic parameters and is affected by level of prescribed dose and adherence.
AHRQ-funded; HS023011.
Citation: Creary SE, Beeman C, Stanek J .
Impact of hydroxyurea dose and adherence on hematologic outcomes for children with sickle cell anemia.
Pediatr Blood Cancer 2022 Jun;69(6):e29607. doi: 10.1002/pbc.29607..
Keywords: Children/Adolescents, Medication, Sickle Cell Disease, Chronic Conditions, Outcomes, Patient Adherence/Compliance
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
Sun K, Szymonifka J, Tian H
Association of traditional Chinese medicine use with adherence to prescribed Western rheumatic medications among Chinese American patients: a cross-sectional survey.
Chinese Americans are a fast-growing immigrant group with worse rheumatic disease outcomes compared to white populations and frequently use traditional Chinese medicine (TCM). Whether TCM use is associated with lower adherence to Western rheumatic medications is unknown. The purpose of this study was to examine adherence to Western medications for systemic rheumatic diseases in the Chinese American immigrant population and its association with TCM use.
Citation: Sun K, Szymonifka J, Tian H .
Association of traditional Chinese medicine use with adherence to prescribed Western rheumatic medications among Chinese American patients: a cross-sectional survey.
Arthritis Care Res 2020 Oct;72(10):1474-80. doi: 10.1002/acr.24031..
Keywords: Medication, Complementary and Alternative Medicine, Patient Adherence/Compliance, Racial and Ethnic Minorities, Arthritis, Chronic Conditions
Sherwin LB, Deroche CB, Krisanabud P
Adherence to short-course pharmacotherapy in adults with irritable bowel syndrome.
Irritable Bowel Syndrome (IBS), characterized by abdominal pain and bowel dysfunction, treatment focuses on alleviating symptoms. Adherence is crucial for pharmacologic management success. This study examined 73 adult's objective adherence to rifaximin using the taxonomy for adherence. Demographic, quality of life (QOL), psychological distress, perceived stress, adverse childhood experiences (ACE), pain, and adherence data were collected.
AHRQ-funded; HS022140.
Citation: Sherwin LB, Deroche CB, Krisanabud P .
Adherence to short-course pharmacotherapy in adults with irritable bowel syndrome.
AHRQ-funded; HS022140..
Keywords: Digestive Disease and Health, Chronic Conditions, Medication, Patient Adherence/Compliance
Flory JH, Mushlin AI
Effect of cost and formulation on persistence and adherence to initial metformin therapy for type 2 diabetes.
This paper studied whether persistence and adherence to initial release (IR) metformin was at the same levels as extended release (ER) metform for adults with type 2 diabetes. A study was conducted using merged de-identified claims data from commercial insurance carriers in the US from 2012 to 2016. The cohort used was identified as patients aged 18 years or older who filled an initial 30-day prescription for metformin monotherapy with a baseline type 2 diabetes diagnosis, at least 1 year of baseline and follow-up data, and no prior antidiabetes drug use. “Persistence” was defined as at least one metformin prescription claim during the 6-12 month window after the initial prescription. “Adherence” was defined as the percentage of days for which the patient had filled sufficient prescriptions to be taking it “as prescribed”. The final study population was 81,406 patients, with 78% having commercial insurance, 19% Medicare Advantage, and 2.5% were dual-eligible for Medicare and Medicare. Persistence was slightly higher for ER metformin than for IR metformin, as was adherence and adequate adherence (80% or more). Despite the slightly higher cost, initial use of ER metformin was associated with better adherence.
AHRQ-funded; HS023898.
Citation: Flory JH, Mushlin AI .
Effect of cost and formulation on persistence and adherence to initial metformin therapy for type 2 diabetes.
Diabetes Care 2020 Jun;43(6):e66-e67. doi: 10.2337/dc19-2426..
Keywords: Diabetes, Chronic Conditions, Healthcare Costs, Medication, Patient Adherence/Compliance
Aronson BD, Sittner KJ, Walls ML
The mediating role of diabetes distress and depressive symptoms in type 2 diabetes medication adherence gender differences.
Medication adherence is negatively related to both diabetes distress (DD) and depressive symptoms (DS). Past research suggests gender differences in adherence, DD, and DS. A gap exists in determining if gender differences in adherence are mediated by DD and DS, or if gender moderates differences in adherence by DD/DS. Aims. This study investigated the relationship between gender, DD, DS, and medication adherence and tested for mediating and moderating effects on medication adherence among American Indian adults with type 2 diabetes.
AHRQ-funded; HS024180.
Citation: Aronson BD, Sittner KJ, Walls ML .
The mediating role of diabetes distress and depressive symptoms in type 2 diabetes medication adherence gender differences.
Health Educ Behav 2020 Jun;47(3):474-82. doi: 10.1177/1090198119885416..
Keywords: Medication, Diabetes, Patient Adherence/Compliance, Chronic Conditions, Sex Factors
Badawy SM, Shah R, Beg U
Habit strength, medication adherence, and habit-based mobile health interventions across chronic medical conditions: systematic review.
This review’s goal was to systematically evaluate the most recent evidence for habit strength, medication adherence, and habit-based mHealth interventions across chronic medical conditions. Findings revealed that habit strength was strongly correlated with medication adherence, and stronger habit was associated with higher medication adherence rates, regardless of the theoretical model and/or guiding framework. Habit-based interventions were recommended to increase medication adherence, leveraging widely-available mobile technology tools and existing routines.
AHRQ-funded; HS023011.
Citation: Badawy SM, Shah R, Beg U .
Habit strength, medication adherence, and habit-based mobile health interventions across chronic medical conditions: systematic review.
J Med Internet Res 2020 Apr 28;22(4):e17883. doi: 10.2196/17883..
Keywords: Medication, Patient Adherence/Compliance, Telehealth, Health Information Technology (HIT), Chronic Conditions
Goyal P, Gorodeski EZ, Marcum ZA
Cardiac rehabilitation to optimize medication regimens in heart failure.
This paper discusses the use of cardiac rehabilitation (CR) to optimize medication regimens for older adults with heart failure. Challenges in CR are discussed length and strategies were offered for leveraged CR.
AHRQ-funded; HS022982.
Citation: Goyal P, Gorodeski EZ, Marcum ZA .
Cardiac rehabilitation to optimize medication regimens in heart failure.
Clin Geriatr Med 2019 Nov;35(4):549-60. doi: 10.1016/j.cger.2019.06.001..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Rehabilitation, Medication, Patient-Centered Healthcare, Patient Adherence/Compliance, Chronic Conditions
Cole AL, Jazowski SA, Dusetzina SB
Initiation of generic imatinib may improve medication adherence for patients with chronic myeloid leukemia.
Investigators compared adherence to tyrosine kinase inhibitors (TKIs) between patients with chronic myeloid leukemia (CML) who initiated branded or generic imatinib using MarketScan commercial claims data. They found that patients initiating generic imatinib achieved clinically significant improvements in adherence to TKI therapy relative to branded drug users, presumably due to lower out-of-pocket costs. Given the importance of optimal adherence in CML, considering barriers to adherence when selecting initial treatment may improve long-term medication adherence.
AHRQ-funded; HS000032.
Citation: Cole AL, Jazowski SA, Dusetzina SB .
Initiation of generic imatinib may improve medication adherence for patients with chronic myeloid leukemia.
Pharmacoepidemiol Drug Saf 2019 Nov;28(11):1529-33. doi: 10.1002/pds.4893..
Keywords: Patient Adherence/Compliance, Medication, Chronic Conditions, Cancer
Bassett SM, Schuette SA, O'Dwyer LC
Positive affect and medication adherence in chronic conditions: a systematic review.
This systematic evidence review was conducted to determine the current state of knowledge on the relationship between positive affect and medication adherence in persons living with chronic conditions. The review was conducted using PsycINFO, PubMed MEDLINE, Cochrane Central Register of Controlled Trials, CINAHL and Embase. Nine studies met the inclusion criteria and examined the correlation in people living with HIV or cardiovascular conditions. The review further proved a link between positive affect and medication adherence for chronic conditions.
AHRQ-funded; HS000078.
Citation: Bassett SM, Schuette SA, O'Dwyer LC .
Positive affect and medication adherence in chronic conditions: a systematic review.
Health Psychol 2019 Nov;38(11):960-74. doi: 10.1037/hea0000778..
Keywords: Patient Adherence/Compliance, Medication, Chronic Conditions
Fung VC, Overhage LN, Sylvia LG
Complex polypharmacy in bipolar disorder: side effect burden, adherence, and response predictors.
Investigators assessed the associations between complex polypharmacy (CP), adherence, and side effect burden, and patient traits associated with clinical improvement in relationship to CP in patients with bipolar disorder. They found that bipolar disorder patients with CP were less likely to adhere to therapy, and those with worse adherence to CP were less likely to clinically respond. They recommended that clinicians assess medication adherence prior to adding another agent to medication regimens.
AHRQ-funded; HS019371.
Citation: Fung VC, Overhage LN, Sylvia LG .
Complex polypharmacy in bipolar disorder: side effect burden, adherence, and response predictors.
J Affect Disord 2019 Oct 1;257:17-22. doi: 10.1016/j.jad.2019.06.050..
Keywords: Adverse Drug Events (ADE), Adverse Events, Medication, Behavioral Health, Chronic Conditions, Patient Adherence/Compliance
Fredericksen RJ, Yang FM, Gibbons LE
Development and content validation of measures assessing adherence barriers and behaviors for use in clinical care.
The authors developed brief, computer-administered patient-reported measures in English and Spanish assessing prescribed medication adherence behaviors and barriers for use with patients living with chronic diseases focusing on clinical relevance, brevity, and content validity for use in clinical care.
AHRQ-funded; HS022242.
Citation: Fredericksen RJ, Yang FM, Gibbons LE .
Development and content validation of measures assessing adherence barriers and behaviors for use in clinical care.
Res Social Adm Pharm 2019 Sep;15(9):1168-76. doi: 10.1016/j.sapharm.2018.10.001..
Keywords: Patient Adherence/Compliance, Medication, Chronic Conditions, Human Immunodeficiency Virus (HIV)
Turi KN, Gebretsadik T, Lee RL
Seasonal patterns of asthma medication fills among diverse populations of the United States.
Nonadherence to controller and overuse of reliever asthma medications are associated with exacerbations. In this study, the investigators aimed to determine patterns of seasonal asthma medication use and to identify time period(s) during which interventions to improve medication adherence could reduce asthma morbidity. The investigators concluded that a seasonal pattern of asthma medication fill rates likely represented a reactive response to a loss of disease control and increased symptoms.
AHRQ-funded; HS019669; HS022093.
Citation: Turi KN, Gebretsadik T, Lee RL .
Seasonal patterns of asthma medication fills among diverse populations of the United States.
J Asthma 2018 Jul;55(7):764-70. doi: 10.1080/02770903.2017.1362426..
Keywords: Asthma, Chronic Conditions, Medication, Patient Adherence/Compliance
Fredericksen RJ, Gibbons L, Brown S
Medication understanding among patients living with multiple chronic conditions: implications for patient-reported measures of adherence.
The purpose of this study was to assess knowledge of names and purposes of prescribed medications among patients with multiple chronic conditions. The investigators found that many patients demonstrated difficulty identifying the name and purpose of prescribed medications; this did not differ by demographic group or medication storage type. They suggest that patients may benefit from routine review of medications with their provider in order to improve health literacy, outcomes, and patient-reported adherence measurement.
AHRQ-funded; HS022242.
Citation: Fredericksen RJ, Gibbons L, Brown S .
Medication understanding among patients living with multiple chronic conditions: implications for patient-reported measures of adherence.
Res Social Adm Pharm 2018 Jun;14(6):540-44. doi: 10.1016/j.sapharm.2017.06.009..
Keywords: Chronic Conditions, Health Literacy, Medication, Patient Adherence/Compliance
Hansen RA, Hohmann N, Maciejewski ML
Continuity of medication management among adults with schizophrenia and comorbid cardiometabolic conditions.
This study examined whether medication adherence, inpatient admissions, and emergency department (ED) visits vary by the number and types of prescribers seen by adults with schizophrenia and cardiometabolic conditions. Greater antipsychotic adherence for adults receiving prescriptions from multiple psychiatric specialists was counteracted by lower statin adherence and greater risk of ED and inpatient utilization.
AHRQ-funded; HS023099.
Citation: Hansen RA, Hohmann N, Maciejewski ML .
Continuity of medication management among adults with schizophrenia and comorbid cardiometabolic conditions.
J Pharm Health Serv Res 2018 Mar;9(1):13-20. doi: 10.1111/jphs.12201.
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Keywords: Chronic Conditions, Medication, Behavioral Health, Patient Adherence/Compliance, Patient-Centered Healthcare
Maciejewski ML, Hammill BG, Voils CI
Prescriber continuity and medication availability in older adults with cardiometabolic conditions.
Researchers examined whether the number of prescribers of essential medications was associated with the availability of medications, a surrogate for adherence, to manage diabetes, hypertension or dyslipidemia. They found that the number of prescribers was not significantly associated with availability of oral diabetes agents but having more prescribers is associated with increased medication availability in older Medicare beneficiaries with dyslipidemia or hypertension.
AHRQ-funded; HS023085.
Citation: Maciejewski ML, Hammill BG, Voils CI .
Prescriber continuity and medication availability in older adults with cardiometabolic conditions.
SAGE Open Med 2018 Feb 6;6:2050312118757388. doi: 10.1177/2050312118757388.
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Keywords: Chronic Conditions, Elderly, Medicare, Medication, Patient Adherence/Compliance
Shen C, Zhao B, Liu L
Adherence to tyrosine kinase inhibitors among Medicare Part D beneficiaries with chronic myeloid leukemia.
The authors of this study identified 836 patients with chronic myeloid leukemia (CML) with Medicare Part D insurance coverage who were new tyrosine kinase inhibitors (TKI) users and examined treatment nonadherence. They indicted that the current population-based study found a significantly higher rate of nonadherence among heavily subsidized patients with substantially lower out-of-pocket costs, which suggested that future research is needed to help lower the nonadherence rate among these individuals.
AHRQ-funded; HS020263.
Citation: Shen C, Zhao B, Liu L .
Adherence to tyrosine kinase inhibitors among Medicare Part D beneficiaries with chronic myeloid leukemia.
Cancer 2018 Jan 15;124(2):364-73. doi: 10.1002/cncr.31050.
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Keywords: Chronic Conditions, Medication, Medicare, Patient Adherence/Compliance
Yeung K, Basu A, Marcum ZA
Impact of a value-based formulary in three chronic disease cohorts.
This study assessed the impact of a value based formulary (VBF) on medication adherence and patient and health plan expenditures on 3 chronic disease states: diabetes, hypertension, and hyperlipidemia. The investigators measured medication expenditures from member, health plan, and member-plus-health plan (overall) perspectives and medication adherence as proportion of days covered. They conducted an exploratory analysis of medication utilization classifying medications according to whether co-payments moved up or down in the year following VBF implementation.
AHRQ-funded; HS022982.
Citation: Yeung K, Basu A, Marcum ZA .
Impact of a value-based formulary in three chronic disease cohorts.
Am J Manag Care 2017 Mar; 23(3 Suppl):S46-s53..
Keywords: Chronic Conditions, Health Insurance, Patient Adherence/Compliance, Medication, Healthcare Costs
LaFleur J, Hoop R, Korner E
Predictors of early discontinuation of pegylated interferon for reasons other than lack of efficacy in United States veterans with chronic hepatitis C.
The researchers determined whether selected patient characteristics predicted discontinued therapy for reasons other than lack of efficcacy (non-LOE) using national databases of U.S. veterans. They found that predictors of greatest magnitude included comorbidities of myocardial infarction/congestive heart failure, renal disease, platelets 100/mm or more, Black race, albumin 3.5 mg/dl or more, sleep aid use, and poor persistence with antidepressants and antihypertensive agents.
AHRQ-funded; HS018582.
Citation: LaFleur J, Hoop R, Korner E .
Predictors of early discontinuation of pegylated interferon for reasons other than lack of efficacy in United States veterans with chronic hepatitis C.
Gastroenterol Nurs 2015 Nov-Dec;38(6):417-28. doi: 10.1097/sga.0000000000000214.
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Keywords: Chronic Conditions, Hepatitis, Medication, Patient Adherence/Compliance
Shah ED, Siegel CA, Chong K
Patients with Crohn's disease are more likely to remain on biologics than immunomodulators: a meta-analysis of treatment durability.
The researchers aimed to clarify treatment durability by assessing subject discontinuations from clinical trials in the context of treatment efficacy. They found that for patients with Crohn’s disease, biologic therapies had higher durability than immunomodulators for induction and maintenance therapy.
AHRQ-funded; HS021747.
Citation: Shah ED, Siegel CA, Chong K .
Patients with Crohn's disease are more likely to remain on biologics than immunomodulators: a meta-analysis of treatment durability.
Dig Dis Sci 2015 Aug;60(8):2408-18. doi: 10.1007/s10620-015-3618-8..
Keywords: Patient Adherence/Compliance, Medication, Chronic Conditions, Comparative Effectiveness
Hansen RA, Voils CI, Farley JF
Prescriber continuity and medication adherence for complex patients.
The purpose of this study was to examine the relationship between number of prescribers, number of conditions, and refill adherence to oral medications among 7,933 veterans who were identified with 1 to 4 cardiometabolic conditions: diabetes, hypertension, dyslipidemia, and/or heart failure. It found that for veterans taking antihypertensive or lipid-lowering medications, having more prescribers involved in care modestly decreased the likelihood of being adherent.
AHRQ-funded; HS019445.
Citation: Hansen RA, Voils CI, Farley JF .
Prescriber continuity and medication adherence for complex patients.
Ann Pharmacother 2015 Mar;49(3):293-302. doi: 10.1177/1060028014563266..
Keywords: Patient Adherence/Compliance, Medication, Chronic Conditions
Beadles CA, Farley JF, Ellis AR
Do medical homes increase medication adherence for persons with multiple chronic conditions?
The goal of this study was to assess the association between medical homes and adherence to newly initiated medications among Medicaid enrollees with multiple chronic conditions (MCC). The researchers examined data from North Carolina Medicaid enrollees with MCC and found that adherence to new medications is greater for those enrolled in medical homes.
AHRQ-funded; HS000032; HS019659.
Citation: Beadles CA, Farley JF, Ellis AR .
Do medical homes increase medication adherence for persons with multiple chronic conditions?
Med Care 2015 Feb;53(2):168-76. doi: 10.1097/mlr.0000000000000292..
Keywords: Chronic Conditions, Medication, Medicaid, Patient Adherence/Compliance, Patient-Centered Healthcare
McMullen CK, Safford MM, Bosworth HB
Patient-centered priorities for improving medication management and adherence.
The goal of the workshop was to identify and prioritize opportunities to advance PCMM by convening diverse stakeholders involved in prescribing and/or medication taking. A major conclusion was that engaging multiple stakeholders in setting a patient-centered research agenda and broadening the scope of adherence interventions to include other aspects of medication management resulted in priorities outside the traditional scope of adherence research.
AHRQ-funded; HS021093; HS021094; HS021107.
Citation: McMullen CK, Safford MM, Bosworth HB .
Patient-centered priorities for improving medication management and adherence.
Patient Educ Couns 2015 Jan;98(1):102-10. doi: 10.1016/j.pec.2014.09.015..
Keywords: Centers for Education and Research on Therapeutics (CERTs), Chronic Conditions, Medication, Patient Adherence/Compliance, Patient-Centered Healthcare
Kesselheim AS, Bykov K, Avorn J
Burden of changes in pill appearance for patients receiving generic cardiovascular medications after myocardial infarction: cohort and nested case-control studies.
This study sought to determine whether nonpersistent use of generic drugs among patients with cardiovascular disease after a heart attack is associated with the different shapes or colors of generic medications. It found that patients who subsequently discontinued treatment with their cardiovascular medications were 30 percent more likely to have had a change in pill shape or color preceding the discontinuation.
AHRQ-funded; HS018465
Citation: Kesselheim AS, Bykov K, Avorn J .
Burden of changes in pill appearance for patients receiving generic cardiovascular medications after myocardial infarction: cohort and nested case-control studies.
Ann Intern Med. 2014 Jul 15;161(2):96-103. doi: 10.7326/M13-2381..
Keywords: Cardiovascular Conditions, Medication, Chronic Conditions, Patient Adherence/Compliance