National Healthcare Quality and Disparities Report
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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
76 to 100 of 145 Research Studies DisplayedTuran B, Rogers AJ, Rice WS
Association between perceived discrimination in healthcare settings and HIV medication adherence: mediating psychosocial mechanisms.
There is insufficient research on the impact of perceived discrimination in healthcare settings on adherence to antiretroviral therapy (ART), particularly among women living with HIV, and even less is known about psychosocial mechanisms that may mediate this association. Cross-sectional analyses were conducted in a sample of diverse women living with HIV enrolled in the Women's Interagency HIV Study (WIHS), a multi-center cohort study to investigate these issues.
AHRQ-funded; HS013852.
Citation: Turan B, Rogers AJ, Rice WS .
Association between perceived discrimination in healthcare settings and HIV medication adherence: mediating psychosocial mechanisms.
AIDS Behav 2017 Dec;21(12):3431-39. doi: 10.1007/s10461-017-1957-5..
Keywords: Human Immunodeficiency Virus (HIV), Medication, Patient Adherence/Compliance, Social Stigma
Badawy SM, Morrone K, Thompson A
Computer and mobile technology interventions to promote medication adherence and disease management in people with thalassemia.
This study aims to identify and assess the effects of computer and mobile technology interventions designed to facilitate medication adherence and disease management in individuals with thalassemia.
AHRQ-funded; HS023011.
Citation: Badawy SM, Morrone K, Thompson A .
Computer and mobile technology interventions to promote medication adherence and disease management in people with thalassemia.
Cochrane Database Syst Rev 2017 Dec;2017(12)..
Keywords: Health Information Technology (HIT), Medication, Patient Adherence/Compliance, Patient-Centered Healthcare, Patient Self-Management
Taira DA, Seto BK, Davis JW
Examining factors associated with nonadherence and identifying providers caring for nonadherent subgroups.
This study examined racial/ethnic and regional differences in medication adherence in patients with diabetes taking oral anti-diabetic, anti-hypertensive, and cholesterol lowering medications and to identify the pharmacies and prescribers who serve these communities. After adjustment for other factors, Filipinos, Native Hawaiians, and people of other race were significantly less adherent to anti-diabetic and anti-hypertensive medications than Japanese.
AHRQ-funded; HS023185.
Citation: Taira DA, Seto BK, Davis JW .
Examining factors associated with nonadherence and identifying providers caring for nonadherent subgroups.
J Pharm Health Serv Res 2017 Dec;8(4):247-53. doi: 10.1111/jphs.12193.
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Keywords: Diabetes, Medication, Patient Adherence/Compliance, Patient-Centered Healthcare, Racial and Ethnic Minorities
Flory J, Gerhard T, Stempniewicz N
Comparative adherence to diabetes drugs: an analysis of electronic health records and claims data.
The objective of this brief report is to compare adherence rates for 6 major classes of diabetes medications: metformin, sulfonylurea, thiazolidinedione, basal insulin, DPP-4 inhibitors, and GLP-1 receptor agonists. The authors note that the rates at which diabetes drugs are prescribed, and the rates at which patients actually take them, differ substantially. The authors also note that the physicians should be aware of potentially significant challenges concerning adherence to newer agents.
AHRQ-funded; HS023898.
Citation: Flory J, Gerhard T, Stempniewicz N .
Comparative adherence to diabetes drugs: an analysis of electronic health records and claims data.
Diabetes Obes Metab 2017 Aug;19(8):1184-87. doi: 10.1111/dom.12931..
Keywords: Diabetes, Electronic Health Records (EHRs), Patient Adherence/Compliance, Practice Patterns, Medication
Bandi P, Goldmann E, Parikh NS
Age-related differences in antihypertensive medication adherence in Hispanics: a cross-sectional community-based survey in New York City, 2011-2012.
US Hispanics, particularly younger adults in New York City, have a higher prevalence of uncontrolled hypertension than do people of other racial/ethnic groups. This study found that in younger adults, heavy alcohol consumption, a longer duration of hypertension, and recent poor physical health were negatively associated with high adherence. In older adults, advancing age, higher education level, high knowledge of hypertension control, and insurance status were positively associated with high adherence.
AHRQ-funded; HS022961.
Citation: Bandi P, Goldmann E, Parikh NS .
Age-related differences in antihypertensive medication adherence in Hispanics: a cross-sectional community-based survey in New York City, 2011-2012.
Prev Chronic Dis 2017 Jul 13;14:E57. doi: 10.5888/pcd14.160512.
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Keywords: Blood Pressure, Medication, Patient Adherence/Compliance, Racial and Ethnic Minorities
Grove LR, Olesiuk WJ, Ellis AR
Evaluating the potential for primary care to serve as a mental health home for people with schizophrenia.
This study examined the annual primary care and specialty mental health service utilization of adult North Carolina Medicaid enrollees with schizophrenia and at least one comorbid chronic condition who were in a medical home during 2007-2010. It concluded that medical home enrollment was associated with increased use of primary care and specialty mental health care, as well as increased medication adherence.
AHRQ-funded; HS019659; HS000032.
Citation: Grove LR, Olesiuk WJ, Ellis AR .
Evaluating the potential for primary care to serve as a mental health home for people with schizophrenia.
Gen Hosp Psychiatry 2017 Jul;47:14-19. doi: 10.1016/j.genhosppsych.2017.03.002.
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Keywords: Medication, Behavioral Health, Patient-Centered Healthcare, Patient Adherence/Compliance, Primary Care
Turan B, Hatcher AM, Weiser SD
Framing mechanisms linking HIV-related stigma, adherence to treatment, and health outcomes.
The authors present a conceptual framework that highlights how unique dimensions of individual-level HIV-related stigma (perceived community stigma, experienced stigma, internalized stigma, and anticipated stigma) might differently affect the health of those living with HIV. Their conceptual framework posits that, in the context of intersectional and structural stigmas, individual-level dimensions of HIV-related stigma operate through interpersonal factors, mental health, psychological resources, and biological stress pathways.
AHRQ-funded; HS013852.
Citation: Turan B, Hatcher AM, Weiser SD .
Framing mechanisms linking HIV-related stigma, adherence to treatment, and health outcomes.
Am J Public Health 2017 Jun;107(6):863-69. doi: 10.2105/ajph.2017.303744.
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Keywords: Human Immunodeficiency Virus (HIV), Medication, Patient Adherence/Compliance, Patient-Centered Outcomes Research, Social Stigma
Maciejewski ML, Hammill BG, Bayliss EA
Prescriber continuity and disease control of older adults.
The objective of this study was to examine whether glycemic control or lipid control was associated with the number of prescribers of cardiometabolic medications. It concluded that multiple prescribers were associated with worse disease control, possibly because patients with more severe diabetes or dyslipidemia have multiple prescribers or because care fragmentation is associated with worse disease control.
AHRQ-funded; HS023085.
Citation: Maciejewski ML, Hammill BG, Bayliss EA .
Prescriber continuity and disease control of older adults.
Med Care 2017 Apr;55(4):405-10. doi: 10.1097/mlr.0000000000000658.
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Keywords: Elderly, Medication, Diabetes, Patient Adherence/Compliance, Healthcare Delivery
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
Marcum ZA, Hanlon JT, Murray MD
Improving medication adherence and health outcomes in older adults: an evidence-based review of randomized controlled trials.
The objective of this review was to provide an updated summary of evidence from randomized controlled studies to determine whether interventions aimed at improving medication adherence also improve the health outcomes of older adults residing in community-based settings. This evidence-based review of medication adherence interventions in older adults revealed promising strategies in the larger context of a largely mixed body of literature.
AHRQ-funded; HS022982; HS023779.
Citation: Marcum ZA, Hanlon JT, Murray MD .
Improving medication adherence and health outcomes in older adults: an evidence-based review of randomized controlled trials.
Drugs Aging 2017 Mar;34(3):191-201. doi: 10.1007/s40266-016-0433-7.
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Keywords: Elderly, Medication, Patient Adherence/Compliance, Patient-Centered Outcomes Research, Education: Patient and Caregiver
Marcum ZA, Gellad WF
Improving medication adherence: keep your eyes on the prize.
In this commentary, the authors discuss a paper published by Reddy, et al. published in 2017 in the Journal of General Internal Medicine, entitled “Patient and partner feedback reports to improve statin medication adherence: a randomized control trial.”
AHRQ-funded; HS022982.
Citation: Marcum ZA, Gellad WF .
Improving medication adherence: keep your eyes on the prize.
J Gen Intern Med 2017 Mar;32(3):236-37. doi: 10.1007/s11606-016-3927-4..
Keywords: Medication, Patient Adherence/Compliance
Tiruneh YM, Wilson IB
What time is it? Adherence to antiretroviral therapy in Ethiopia.
This study assessed adherence to antiretroviral therapy (ART) among people living with HIV/AIDS in Ethiopia and explored the sociocultural context in which they relate to their regimen requirements. Its findings indicate that study participants are highly adherent to dose but less adherent to dose schedule. Strict dose time instructions were reported as stressful and unrealistic.
AHRQ-funded; HS000011.
Citation: Tiruneh YM, Wilson IB .
What time is it? Adherence to antiretroviral therapy in Ethiopia.
AIDS Behav 2016 Nov;20(11):2662-73. doi: 10.1007/s10461-016-1322-0.
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Keywords: Patient Adherence/Compliance, Human Immunodeficiency Virus (HIV), Medication
Doll JA, Hellkamp AS, Goyal A
Treatment, outcomes, and adherence to medication regimens among dual Medicare-Medicaid-eligible adults with myocardial infarction.
The purpose of the study was to examine the association of dual-eligible status with clinical outcomes and adherence to medication regimens among older adults after MI. The investigators found that compared with Medicare-only patients, older adults with dual Medicare-Medicaid eligibility presenting with MI had superior rates of medication adherence but higher rates of postdischarge readmission and adverse cardiovascular outcomes.
AHRQ-funded; HS021092.
Citation: Doll JA, Hellkamp AS, Goyal A .
Treatment, outcomes, and adherence to medication regimens among dual Medicare-Medicaid-eligible adults with myocardial infarction.
JAMA Cardiol 2016 Oct 1;1(7):787-94. doi: 10.1001/jamacardio.2016.2724..
Keywords: Elderly, Medicaid, Medicare, Medication, Heart Disease and Health, Outcomes, Patient Adherence/Compliance
Albrecht JS, Park Y, Hur P
Adherence to maintenance medications among older adults with chronic obstructive pulmonary disease. the role of depression.
The objective of this study was to assess the impact of depression on COPD maintenance medication adherence among of Medicare beneficiaries newly diagnosed with COPD. Average monthly adherence to COPD maintenance medications was low, peaking at 57 percent in the month after first fill and decreasing to 35 percent within 6 months. In the adjusted regression model, depression was associated with decreased adherence to COPD maintenance medications.
AHRQ-funded; HS024560.
Citation: Albrecht JS, Park Y, Hur P .
Adherence to maintenance medications among older adults with chronic obstructive pulmonary disease. the role of depression.
Ann Am Thorac Soc 2016 Sep;13(9):1497-504. doi: 10.1513/AnnalsATS.201602-136OC.
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Keywords: Respiratory Conditions, Elderly, Medication, Patient Adherence/Compliance, Depression
Tajeu GS, Kent ST, Kronish IM
Trends in antihypertensive medication discontinuation and low adherence among Medicare beneficiaries initiating treatment from 2007 to 2012.
The authors analyzed a 5% sample of Medicare beneficiaries initiating antihypertensive medication between 2007 and 2012 to assess whether reductions occurred in discontinuation and low adherence. They found that low adherence decreased and was more common among racial/ethnic minorities, beneficiaries with Medicaid buy-in, and those with polypharmacy, and was less common among females, beneficiaries initiating antihypertensive medication with multiple classes or a 90-day prescription fill, with dementia, a history of stroke, and those who reached the Medicare Part D coverage gap in the previous year. They concluded that although low adherence has decreased, rates of discontinuation and low adherence remain high.
AHRQ-funded; HS024262.
Citation: Tajeu GS, Kent ST, Kronish IM .
Trends in antihypertensive medication discontinuation and low adherence among Medicare beneficiaries initiating treatment from 2007 to 2012.
Hypertension 2016 Sep;68(3):565-75. doi: 10.1161/hypertensionaha.116.07720.
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Keywords: Blood Pressure, Medication, Medicare, Patient Adherence/Compliance
Wu AC, Butler MG, Li L
Primary adherence to controller medications for asthma is poor.
The objective of this study was to compare real-world adherence, including both primary and secondary adherence, to the major controller regimens (inhaled corticosteroids (ICSs), leukotriene antagonists (LTRAs), or ICS/long-acting b-agonists (ICS/LABAs) in diverse, insured populations. It found that adherence to controller medications is poor and many patients do not ever fill prescriptions for controller medications. However, primary adherence to ICSs was better than to LTRAs and ICS/LABAs.
AHRQ-funded; HS019669.
Citation: Wu AC, Butler MG, Li L .
Primary adherence to controller medications for asthma is poor.
Ann Am Thorac Soc 2015 Feb;12(2):161-6. doi: 10.1513/AnnalsATS.201410-459OC..
Keywords: Asthma, Patient Adherence/Compliance, Medication, Comparative Effectiveness
Tiruneh YM, Galarraga O, Genberg B
Retention in care among HIV-infected adults in Ethiopia, 2005- 2011: a mixed-methods study.
This study assessed how well patients stay in care and explored factors associated with retention in the context of an initial antiretroviral therapy (ART) rollout at a teaching hospital in Addis Ababa, Ethiopia. The researchers found that fear of stigma, care dissatisfaction, use of holy water, and economic constraints discouraged retention in care, while social support and restored health and functional ability motivated retention.
AHRQ-funded; HS000011.
Citation: Tiruneh YM, Galarraga O, Genberg B .
Retention in care among HIV-infected adults in Ethiopia, 2005- 2011: a mixed-methods study.
PLoS One 2016 Jun 7;11(6):e0156619. doi: 10.1371/journal.pone.0156619.
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Keywords: Medication, Human Immunodeficiency Virus (HIV), Patient Adherence/Compliance
Curtis JR, Bharat A, Chen L
Agreement between rheumatologist and patient-reported adherence to methotrexate in a US rheumatoid arthritis registry.
To determine the extent to which methotrexate (MTX) adherence is overestimated by rheumatologists, the researchers deployed an Internet survey to patients with rheumatoid arthritis (RA) participating in a US registry. They found that MTX use was misclassified for 13-20 percent of patients, mainly because of 1 or more missed doses rather than overt discontinuation. Clinicians should be aware of suboptimal adherence when assessing MTX response.
AHRQ-funded; HS018517.
Citation: Curtis JR, Bharat A, Chen L .
Agreement between rheumatologist and patient-reported adherence to methotrexate in a US rheumatoid arthritis registry.
J Rheumatol 2016 Jun;43(6):1027-9. doi: 10.3899/jrheum.151136.
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Keywords: Arthritis, Patient Adherence/Compliance, Medication, Registries
Osborn CY, Mayberry LS, Kim JM
Medication adherence may be more important than other behaviours for optimizing glycaemic control among low-income adults.
The authors sought to identify which behaviors are most important for HbA1c among low-socioeconomic status patients with type 2 diabetes mellitus. They found that only medication adherence was significantly associated with lower HbA1c after adjusting for the other self-care behaviours and further adjusting for demographic and diabetes characteristics. They suggested that focused efforts to improve medication adherence among low-socioeconomic status patient populations may improve glycemic control.
AHRQ-funded; HS022990.
Citation: Osborn CY, Mayberry LS, Kim JM .
Medication adherence may be more important than other behaviours for optimizing glycaemic control among low-income adults.
J Clin Pharm Ther 2016 Jun;41(3):256-9. doi: 10.1111/jcpt.12360.
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Keywords: Diabetes, Low-Income, Medication, Patient Adherence/Compliance, Patient-Centered Outcomes Research
Kahwati L, Viswanathan M, Golin CE
Identifying configurations of behavior change techniques in effective medication adherence interventions: a qualitative comparative analysis.
The researchers aimed to extend the results from an existing systematic review of interventions to improve medication adherence by using qualitative comparative analysis (QCA) to identify necessary or sufficient configurations of behavior change techniques among effective interventions. They were able to identify seven configurations of behavior change techniques sufficient for improving adherence, which together accounted for 26 (76 percent) of the effective studies.
AHRQ-funded; HS022563.
Citation: Kahwati L, Viswanathan M, Golin CE .
Identifying configurations of behavior change techniques in effective medication adherence interventions: a qualitative comparative analysis.
Syst Rev 2016 May 4;5:83. doi: 10.1186/s13643-016-0255-z.
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Keywords: Medication, Patient Adherence/Compliance, Research Methodologies, Comparative Effectiveness, Behavioral Health
Kahwati L, Jacobs S, Kane H
Using qualitative comparative analysis in a systematic review of a complex intervention.
The objective of this study was to describe in detail and examine the suitability of using qualitative comparative analysis (QCA) within the context of a systematic review. It concluded that QCA was suitable for use within a systematic review of medication adherence interventions and offered insights beyond the single dimension stratifications used in the original completed review.
AHRQ-funded; HS022563.
Citation: Kahwati L, Jacobs S, Kane H .
Using qualitative comparative analysis in a systematic review of a complex intervention.
Syst Rev 2016 May 4;5:82. doi: 10.1186/s13643-016-0256-y.
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Keywords: Medication, Patient Adherence/Compliance, Research Methodologies, Comparative Effectiveness, Behavioral Health
Johnson KB, Patterson BL, Ho YX
The feasibility of text reminders to improve medication adherence in adolescents with asthma.
The goal of this study was to assess the impact of MyMediHealth (MMH) - a website and a short messaging service (SMS)-based reminder system - on medication adherence and perceived self-efficacy in adolescents with asthma. The investigators found that MMH was associated with improved medication adherence, perceived quality of life, and self-efficacy.
AHRQ-funded; HS018168.
Citation: Johnson KB, Patterson BL, Ho YX .
The feasibility of text reminders to improve medication adherence in adolescents with asthma.
J Am Med Inform Assoc 2016 May;23(3):449-55. doi: 10.1093/jamia/ocv158..
Keywords: Asthma, Children/Adolescents, Health Information Technology (HIT), Medication, Patient Adherence/Compliance
Faridi KF, Peterson ED, McCoy LA
Timing of first postdischarge follow-up and medication adherence after acute myocardial infarction.
The investigators sought to determine whether earlier outpatient follow-up after acute myocardial infarction (AMI) is associated with higher rates of medication adherence. They found that delayed outpatient follow-up beyond the first 6 weeks after AMI is associated with worse short-term and long-term patient medication adherence. They concluded that medication adherence is modifiable via improved care transitions.
AHRQ-funded; HS021092.
Citation: Faridi KF, Peterson ED, McCoy LA .
Timing of first postdischarge follow-up and medication adherence after acute myocardial infarction.
JAMA Cardiol 2016 May 1;1(2):147-55. doi: 10.1001/jamacardio.2016.0001.
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Keywords: Hospital Discharge, Medication, Heart Disease and Health, Patient Adherence/Compliance, Patient-Centered Healthcare
Farris KB, Salgado TM, Aneese N
Effect of clinical and attitudinal characteristics on obtaining comprehensive medication reviews.
The researchers sought to quantify the association between attitudinal and clinical factors with intention and predict future behavior to obtain a comprehensive medication reviews (CMR) among Medicare Part D beneficiaries. They found that worrying about medications doing more harm than good, number of pharmacies where participants obtained their medications from, number of medications, and number of medical conditions predicted intention to obtain a CMR.
AHRQ-funded; HS018353.
Citation: Farris KB, Salgado TM, Aneese N .
Effect of clinical and attitudinal characteristics on obtaining comprehensive medication reviews.
J Manag Care Spec Pharm 2016 Apr;22(4):388-95. doi: 10.18553/jmcp.2016.22.4.388.
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Keywords: Medication, Medicare, Elderly, Medication: Safety, Patient Adherence/Compliance
Lyles CR, Seligman HK, Parker MM
Financial strain and medication adherence among diabetes patients in an integrated health care delivery system: The Diabetes Study of Northern California (DISTANCE).
The researchers examined self-reported financial strain in relation to pharmacy utilization adherence data. Their analysis of survey, administrative, and electronic medical data from Kaiser Permanente Northern California found that 8 percent and 9 percent reported general and medication-specific financial strain. In adjusted models, general strain was significantly associated with primary nonadherence and refilling late and medication-specific strain was ssociated with primary nonadherence.
AHRQ-funded; HS022408.
Citation: Lyles CR, Seligman HK, Parker MM .
Financial strain and medication adherence among diabetes patients in an integrated health care delivery system: The Diabetes Study of Northern California (DISTANCE).
Health Serv Res 2016 Apr;51(2):610-24. doi: 10.1111/1475-6773.12346.
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Keywords: Diabetes, Medication, Patient Adherence/Compliance, Healthcare Costs, Healthcare Delivery