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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
151 to 175 of 281 Research Studies DisplayedGiardina TD, Baldwin J, Nystrom DT
Patient perceptions of receiving test results via online portals: a mixed-methods study.
The researchers conducted a mixed-methods study to explore patients' experiences and preferences when accessing their test results via online portals. They found that nearly two-thirds (63 percent) did not receive any explanatory information or test result interpretation at the time they received the result. Patients experienced negative emotions often with abnormal results, but sometimes even with normal results.
AHRQ-funded; HS023602; HS022087.
Citation: Giardina TD, Baldwin J, Nystrom DT .
Patient perceptions of receiving test results via online portals: a mixed-methods study.
J Am Med Inform Assoc 2018 Apr;25(4):440-46. doi: 10.1093/jamia/ocx140.
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Keywords: Electronic Health Records (EHRs), Patient Experience, Patient and Family Engagement, Clinician-Patient Communication, Web-Based
Trivedi M, Fung V, Kharbanda EO
Racial disparities in family-provider interactions for pediatric asthma care.
The purpose of this study was to investigate differences in family-provider interactions for pediatric asthma, based on race/ethnicity and using parent surveys of asthmatic children within the Population-Based Effectiveness in Asthma and Lung Diseases Network. 647 parents provided survey response data and self-reported race/ethnicity of the child. The outcomes studied were responses to questions about family-provider interactions in the previous 12 months including number of visits with asthma provider, number of times provider reviewed asthma medications with patient/family, review of written asthma treatment plans, and preferences about asthma care decisionmaking. The study concludes that black children with asthma have fewer visits with their providers than white children and are less likely to have a written asthma treatment plan. The authors suggest that asthma providers could focus on improving these specific family-provider interactions.
AHRQ-funded; HS019669.
Citation: Trivedi M, Fung V, Kharbanda EO .
Racial disparities in family-provider interactions for pediatric asthma care.
J Asthma 2018 Apr;55(4):424-29. doi: 10.1080/02770903.2017.1337790..
Keywords: Asthma, Children/Adolescents, Clinician-Patient Communication, Disparities, Racial and Ethnic Minorities
Swetz KM, Kamal AH
Palliative Care
This article reviews the basics of effective communication, symptom management, and end-of-life care and provides an overview of current evidence to support patient-centered palliative care.
AHRQ-funded; HS023681.
Citation: Swetz KM, Kamal AH .
Palliative Care
Ann Intern Med 2018 Mar 6;168(5):Itc33-itc48. doi: 10.7326/aitc201803060..
Keywords: Clinician-Patient Communication, Communication, Palliative Care, Patient-Centered Healthcare
Wisk LE, Gray SH, Gooding HC
I thought you said this was confidential?-Challenges to protecting privacy for teens and young adults.
In this opinion paper, the authors discuss challenges to protecting privacy for teens and young adults. They specifically examine the implications of the dependent coverage expansion provision of the Affordable Care Act.
AHRQ-funded; HS022986.
Citation: Wisk LE, Gray SH, Gooding HC .
I thought you said this was confidential?-Challenges to protecting privacy for teens and young adults.
JAMA Pediatr 2018 Mar;172(3):209-10. doi: 10.1001/jamapediatrics.2017.3927..
Keywords: Caregiving, Children/Adolescents, Clinician-Patient Communication, Communication, Policy, Young Adults
Feder SL, Britton MC, Chaudhry SI
"They need to have an understanding of why they're coming here and what the outcomes might be." Clinician perspectives on goals of care for patients discharged from hospitals to skilled nursing facilities.
This study examined how clinicians view goals of care (GoC) for hospitalized patients discharged to skilled nursing facilities (SNFs). A variety of clinicians were interviewed: 22% were nurses, 20% physicians, 15% from care management, and 15% from social services. Many respondents felt that patients and their families had unrealistic GoCs. However, conversations on GoCs were infrequent during hospitalizations which contribute to unrealistic expectations for SNF care and poor patient outcomes. The researchers recommend interventions to ensure that GoC conversations and are held regularly and in a timely manner before transfer occurs.
AHRQ-funded; HS023554.
Citation: Feder SL, Britton MC, Chaudhry SI .
"They need to have an understanding of why they're coming here and what the outcomes might be." Clinician perspectives on goals of care for patients discharged from hospitals to skilled nursing facilities.
J Pain Symptom Manage 2018 Mar;55(3):930-37. doi: 10.1016/j.jpainsymman.2017.10.013..
Keywords: Care Coordination, Clinician-Patient Communication, Communication, Hospital Discharge, Nursing Homes, Patient and Family Engagement, Provider: Clinician, Provider: Nurse, Provider: Physician
Egan M, Greenhawt M
Common questions in food allergy avoidance.
Allergists must be able to provide avoidance advice while suggesting age and nutritionally appropriate substitutions. This review therefore focuses on providing an understanding of identifying potential myths that may surround certain aspects of food allergy management, with a focus on redirecting misconceptions, and enhancing communications that can improve how patients live life with disease.
AHRQ-funded; HS024599.
Citation: Egan M, Greenhawt M .
Common questions in food allergy avoidance.
Ann Allergy Asthma Immunol 2018 Mar;120(3):263-71. doi: 10.1016/j.anai.2017.09.078.
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Keywords: Chronic Conditions, Nutrition, Patient and Family Engagement, Clinician-Patient Communication, Patient Self-Management
Alexander GL, Olden HA, Troy T
Overweight adolescents and asthma: revealing motivations and challenges with adolescent-provider communication.
This mixed-methods study assessed teens' awareness of the link between weight and asthma management, and perspectives on how medical providers might open a discussion about managing weight. The investigators found that most teens responded favorably to initiating weight loss if it impacted asthma management, valued their provider addressing weight and family participation in weight management efforts.
AHRQ-funded; HS022417.
Citation: Alexander GL, Olden HA, Troy T .
Overweight adolescents and asthma: revealing motivations and challenges with adolescent-provider communication.
J Asthma 2018 Mar;55(3):266-74. doi: 10.1080/02770903.2017.1323921..
Keywords: Asthma, Children/Adolescents, Clinician-Patient Communication, Communication, Obesity, Obesity: Weight Management
Holmes-Rovner M, Srikanth A, Henry SG
Decision aid use during post-biopsy consultations for localized prostate cancer.
The purpose of this study was to characterize the content and communicative function of high-quality decision aids during diagnostic clinic visits for prostate cancer. Results showed that good decision aids, systematically provided to patients, appeared to function not to open up deliberations about how to balance benefits and harms of competing treatments, but rather to allow patients to ask narrow technical questions about recommended treatments.
AHRQ-funded; HS021764.
Citation: Holmes-Rovner M, Srikanth A, Henry SG .
Decision aid use during post-biopsy consultations for localized prostate cancer.
Health Expect 2018 Feb;21(1):279-87. doi: 10.1111/hex.12613..
Keywords: Cancer: Prostate Cancer, Decision Making, Evidence-Based Practice, Patient and Family Engagement, Patient-Centered Healthcare, Clinician-Patient Communication
Bhise V, Meyer AND, Menon S
Patient perspectives on how physicians communicate diagnostic uncertainty: an experimental vignette study.
This study evaluated the effects of three different strategies for communicating diagnostic uncertainty on patient perceptions of physician competence and visit satisfaction. It concluded that parents may react less negatively in terms of perceived competence, physician confidence and trust, and intention to adhere when diagnostic uncertainty is communicated using implicit strategies, such as using broad differential diagnoses or most likely diagnoses.
AHRQ-funded; HS022087; HS023602.
Citation: Bhise V, Meyer AND, Menon S .
Patient perspectives on how physicians communicate diagnostic uncertainty: an experimental vignette study.
Int J Qual Health Care 2018 Feb;30(1):2-8. doi: 10.1093/intqhc/mzx170.
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Keywords: Communication, Patient Experience, Patient Experience, Clinician-Patient Communication
Tamirisa NP, Goodwin JS, Kandalam A
Patient and physician views of shared decision making in cancer.
The aim of the study was to explore patient and physician perceptions of shared decision making in clinical encounters for cancer care. Among the study’s multiple conclusions was that most physicians reported providing patients with written information, however, most patients reported that written information was too detailed and felt that the physicians did not assess the level of information they wished to receive.
AHRQ-funded; HS022134.
Citation: Tamirisa NP, Goodwin JS, Kandalam A .
Patient and physician views of shared decision making in cancer.
Health Expect 2017 Dec;20(6):1248-53. doi: 10.1111/hex.12564..
Keywords: Cancer, Decision Making, Patient-Centered Healthcare, Patient Experience, Clinician-Patient Communication
Slota C, Davis SA, Blalock SJ
Patient-physician communication on medication cost during glaucoma visits.
The aim of this secondary analysis was to describe the frequency and nature of patient-physician communication regarding medication cost during glaucoma office visits. Most participants did not discuss medication cost during their glaucoma office visit. The majority of the subjects who discussed cost had mild disease severity (51 percent), took one glaucoma medication (63 percent), and had Medicare (49 percent) as well as a form of prescription insurance (78 percent).
AHRQ-funded; HS023054.
Citation: Slota C, Davis SA, Blalock SJ .
Patient-physician communication on medication cost during glaucoma visits.
Optom Vis Sci 2017 Dec;94(12):1095-101. doi: 10.1097/opx.0000000000001139.
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Keywords: Eye Disease and Health, Healthcare Costs, Medication, Patient and Family Engagement, Clinician-Patient Communication
Colla CH, Mainor AJ
Choosing Wisely Campaign: valuable for providers who knew about it, but awareness remained constant, 2014-17.
The Choosing Wisely campaign has codified recommendations of which health care services' use should be questioned and discussed with patients. The ABIM Foundation administered surveys in 2014 and 2017 to examine physicians' attitudes toward and awareness of the use of low-value care. There were no significant changes between 2014 and 2017 in awareness of the campaign among physicians or physician-reported difficulty in talking to patients about avoiding a low-value service.
AHRQ-funded; HS023812.
Citation: Colla CH, Mainor AJ .
Choosing Wisely Campaign: valuable for providers who knew about it, but awareness remained constant, 2014-17.
Health Aff 2017 Nov;36(11):2005-11. doi: 10.1377/hlthaff.2017.0945.
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Keywords: Decision Making, Guidelines, Quality of Care, Health Services Research (HSR), Clinician-Patient Communication
Wolinsky FD, Lou Y, Edmonds SW
Activating patients with a tailored bone density test results letter and educational brochure: the PAADRN Randomized Controlled Trial.
This study examined whether a tailored patient-activation letter communicating bone mineral density (BMD) test results plus an educational brochure improved patient activation scores and levels at 12 and 52 wk post-baseline as the mechanism leading to enhanced bone healthcare.
AHRQ-funded; HS023009.
Citation: Wolinsky FD, Lou Y, Edmonds SW .
Activating patients with a tailored bone density test results letter and educational brochure: the PAADRN Randomized Controlled Trial.
J Clin Densitom 2017 Oct/Dec;20(4):464-71. doi: 10.1016/j.jocd.2016.08.012..
Keywords: Education: Patient and Caregiver, Health Literacy, Patient-Centered Healthcare, Patient and Family Engagement, Clinician-Patient Communication
Mogul DB, Nagy PG, Bridges JFP
Building stronger online communities through the creation of Facebook-integrated health applications.
Social media, such as Facebook, provides a powerful mechanism to connect individuals with similar diseases, but current platforms do not achieve their full potential to help patients communicate with one another or with the medical community. The authors of this viewpoint article believe that an opportunity exists for health care professionals to strengthen online communities by creating apps that use the Facebook platform or a programming interface. Development of such apps are discussed, with an eye toward the needs of the patient, parent, or caregiver as end-users and involving their input.
AHRQ-funded; HS023876.
Citation: Mogul DB, Nagy PG, Bridges JFP .
Building stronger online communities through the creation of Facebook-integrated health applications.
JAMA Pediatr 2017 Oct;171(10):933-34. doi: 10.1001/jamapediatrics.2017.2300..
Keywords: Clinician-Patient Communication, Communication, Education: Patient and Caregiver, Health Information Technology (HIT), Social Media, Web-Based
Chung S, Panattoni L, Chi J
Can secure patient-provider messaging improve diabetes care?
The authors examined whether messaging with physicians for medical advice is associated with fewer face-to-face visits and better diabetes management. Patients with diabetes using an online portal were studied; 72% used messaging, and those who made frequent visits were also more likely to message. No messaging at all was negatively associated with the likelihood of meeting an HbA1c target. Among message users, additional messages were associated with better outcome, with a stronger relationship for noninsulin users. Physician-initiated messages had effects similar to those for patient-initiated messages.
AHRQ-funded; HS019815.
Citation: Chung S, Panattoni L, Chi J .
Can secure patient-provider messaging improve diabetes care?
Diabetes Care 2017 Oct;40(10):1342-48. doi: 10.2337/dc17-0140.
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Keywords: Communication, Diabetes, Clinician-Patient Communication, Electronic Health Records (EHRs)
Liang L, Brach C
AHRQ Author: Liang L, Brach C
Health literacy universal precautions are still a distant dream: analysis of U.S. data on health literate practices.
This study sought to examine whether there has been an increase in the delivery of health literate care and whether recommendations for health literacy universal precautions are being followed. It found that the proportion of adults in the U.S. who reported receiving health literate care increased from 2011 to 2014, but fell far short of health literacy universal precautions recommendations of delivering health literate care to everyone.
AHRQ-authored.
Citation: Liang L, Brach C .
Health literacy universal precautions are still a distant dream: analysis of U.S. data on health literate practices.
Health Lit Res Pract 2017 Oct;1(4):e216-e30. doi: 10.3928/24748307-20170929-01.
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Keywords: Healthcare Delivery, Health Literacy, Medical Expenditure Panel Survey (MEPS), Clinician-Patient Communication
Khan A, Furtak SL, Melvin P
Parent-provider miscommunications in hospitalized children.
The objectives of this study were to: (1) examine characteristics of parent-provider miscommunications about hospitalized children; (2) describe associations among parent-provider miscommunications, parent-reported errors, and hospital experience; and (3) compare parent and attending physician reports of parent-provider miscommunications. The investigators found that parent-provider miscommunications were associated with parent-reported errors and suboptimal hospital experience. Parents reported parent-provider miscommunications more often than attending physicians did.
AHRQ-funded; HS022986; HS000063.
Citation: Khan A, Furtak SL, Melvin P .
Parent-provider miscommunications in hospitalized children.
Hosp Pediatr 2017 Sep;7(9):505-15. doi: 10.1542/hpeds.2016-0190..
Keywords: Adverse Events, Caregiving, Children/Adolescents, Clinician-Patient Communication, Communication, Hospitalization, Hospitals, Medical Errors, Patient Safety
Cook SC, Gunter KE, Lopez FY
Establishing effective health care partnerships with sexual and gender minority patients: recommendations for obstetrician gynecologists.
Sexual and gender minority patients have historically experienced high rates of inappropriate and low-quality care, disrespect, and discrimination in health care settings, as well as significant health disparities. This article documented multiple suggestions and resources that health care teams can use to improve the health and health care of their sexual and gender minority patients.
AHRQ-funded; HS023050.
Citation: Cook SC, Gunter KE, Lopez FY .
Establishing effective health care partnerships with sexual and gender minority patients: recommendations for obstetrician gynecologists.
Semin Reprod Med 2017 Sep;35(5):397-407. doi: 10.1055/s-0037-1604464..
Keywords: Racial and Ethnic Minorities, Patient-Centered Healthcare, Clinician-Patient Communication, Women
Squires A
Evidence-based approaches to breaking down language barriers.
This article provides background information about language barriers between nurses and patients and some strategies for addressing these gaps. After detailing how these barriers affect patient outcomes, practice-based strategies are offered to improve outcomes and reduce readmissions. Although the article doesn’t address barriers to communicating with patients with hearing loss, many of the same principles apply to these patients.
AHRQ-funded; HS023593.
Citation: Squires A .
Evidence-based approaches to breaking down language barriers.
Nursing 2017 Sep;47(9):34-40. doi: 10.1097/01.NURSE.0000522002.60278.ca.
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Keywords: Communication, Cultural Competence, Evidence-Based Practice, Nursing, Clinician-Patient Communication
Grande SW, Castaldo MG, Carpenter-Song E
A digital advocate? Reactions of rural people who experience homelessness to the idea of recording clinical encounters.
This study examines the reactions of homeless people to the idea of using a smartphone to record their own clinical encounter, either covertly or with permission from their physician. The researchers conducted semi-structured interviews with individuals at a temporary housing shelter in Northern New England. The study found that while many rural, disadvantaged individuals felt marginalized by the wide social distance between themselves and their clinicians, recording technology may serve as an advocate by holding both patients and doctors accountable and by permitting the burden of clinical proof to be shared.
AHRQ-funded; HS021695.
Citation: Grande SW, Castaldo MG, Carpenter-Song E .
A digital advocate? Reactions of rural people who experience homelessness to the idea of recording clinical encounters.
Health Expect 2017 Aug;20(4):618-25. doi: 10.1111/hex.12492..
Keywords: Health Information Exchange (HIE), Clinician-Patient Communication, Rural Health, Vulnerable Populations
Squires A, Peng TR, Barrón-Vaya Y
An exploratory analysis of patient-provider language-concordant home health care visit patterns.
In a 2-year period, this study showed that among the 238,513 visits with 18,132 limited English proficiency patients, only 20 percent of visits were language concordant. The study suggests that home health care services may not be meeting the demand for language services, but more research is needed to determine the right “dose” of bilingual home care visits to optimize home care outcomes and establish a standard for care.
AHRQ-funded; HS023593.
Citation: Squires A, Peng TR, Barrón-Vaya Y .
An exploratory analysis of patient-provider language-concordant home health care visit patterns.
Home Health Care Management & Practice 2017 Aug 1;29(3):161-67. doi: 10.1177/1084822317696706.
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Keywords: Cultural Competence, Home Healthcare, Clinician-Patient Communication, Racial and Ethnic Minorities, Urban Health
Berger ZD, Boss EF, Beach MC
Communication behaviors and patient autonomy in hospital care: a qualitative study.
Researchers conducted an observational study of patient-doctor communication on an inpatient medicine service among 18 hospitalized patients and 9 physicians. They concluded that shared decision-making may not be the norm in hospital care. Although physicians do explain treatment plans, many hospitalized patients do not understand enough to share in decisions. When patients do assert their opinion, it can result in conflict.
AHRQ-funded; HS022932.
Citation: Berger ZD, Boss EF, Beach MC .
Communication behaviors and patient autonomy in hospital care: a qualitative study.
Patient Educ Couns 2017 Aug;100(8):1473-81. doi: 10.1016/j.pec.2017.03.006.
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Keywords: Communication, Decision Making, Inpatient Care, Clinician-Patient Communication
Wong MS, Showell NN, Bleich SN
The association between parent-reported provider communication quality and child obesity status: variation by parent obesity and child race/ethnicity.
This study examined the association between healthcare provider communication quality and child obesity status, and the role of parent obesity and child race/ethnicity regarding this association. It found that parents of obese children experienced better communication if parents were non-obese or children were non-Hispanic Black or Asian.
AHRQ-funded; HS000029.
Citation: Wong MS, Showell NN, Bleich SN .
The association between parent-reported provider communication quality and child obesity status: variation by parent obesity and child race/ethnicity.
Patient Educ Couns 2017 Aug;100(8):1588-97. doi: 10.1016/j.pec.2017.03.015.
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Keywords: Children/Adolescents, Medical Expenditure Panel Survey (MEPS), Obesity, Clinician-Patient Communication, Racial and Ethnic Minorities
Bush RA, Connelly CD, Perez A
Physician perception of the role of the patient portal in pediatric health.
Little information regarding physician opinion of the patient portal is available, with almost no information gathered in the pediatric environment. Using a mixed-methods approach, physicians in a large pediatric medical facility and integrated delivery network were surveyed by online quantitative questionnaire and structured interviews. Physicians reported the portal's role in more communication efficiency for patients, parents, and providers.
AHRQ-funded; HS022404.
Citation: Bush RA, Connelly CD, Perez A .
Physician perception of the role of the patient portal in pediatric health.
J Ambul Care Manage 2017 Jul/Sep;40(3):238-45. doi: 10.1097/jac.0000000000000175.
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Keywords: Children/Adolescents, Electronic Health Records (EHRs), Provider: Health Personnel, Clinician-Patient Communication, Web-Based
Berry ABL, Lim C, Hartzler AL
Creating conditions for patients' values to emerge in clinical conversations: perspectives of health care team members.
The researchers sought to inform the design of interventions to support conversations about patient values between patients with multiple chronic conditions and their health care providers. Their paper contributes a practice-based account of ways in which providers engage with patient values, and discusses how future work in interactive systems design might extend and enrich these engagements.
AHRQ-funded; HS022364.
Citation: Berry ABL, Lim C, Hartzler AL .
Creating conditions for patients' values to emerge in clinical conversations: perspectives of health care team members.
DIS (Des Interact Syst Conf) 2017 Jun;2017:1165-74. doi: 10.1145/3064663.3064669.
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Keywords: Chronic Conditions, Clinician-Patient Communication, Patient Self-Management, Patient and Family Engagement