National Healthcare Quality and Disparities Report
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Topics
- Adverse Events (1)
- Asthma (1)
- Behavioral Health (1)
- Blood Pressure (1)
- Cancer (5)
- Cancer: Breast Cancer (3)
- Cancer: Prostate Cancer (2)
- Cardiovascular Conditions (2)
- Caregiving (1)
- Children/Adolescents (3)
- Chronic Conditions (5)
- (-) Clinician-Patient Communication (37)
- Communication (15)
- Decision Making (17)
- Diabetes (2)
- Diagnostic Safety and Quality (1)
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- Education: Patient and Caregiver (3)
- Elderly (1)
- Electronic Health Records (EHRs) (2)
- Emergency Department (1)
- Evidence-Based Practice (3)
- Genetics (1)
- Healthcare Delivery (1)
- Healthcare Utilization (1)
- Health Information Technology (HIT) (5)
- Health Literacy (2)
- Hospital Discharge (1)
- Hospitalization (2)
- Human Immunodeficiency Virus (HIV) (1)
- Medical Errors (1)
- Medical Liability (1)
- Medication (1)
- Nursing (1)
- Obesity (1)
- Obesity: Weight Management (1)
- Outcomes (1)
- Palliative Care (1)
- (-) Patient-Centered Healthcare (37)
- Patient-Centered Outcomes Research (6)
- Patient and Family Engagement (15)
- Patient Experience (5)
- Patient Safety (2)
- Patient Self-Management (1)
- Primary Care (5)
- Primary Care: Models of Care (1)
- Provider: Physician (1)
- Quality Improvement (1)
- Quality of Care (1)
- Racial and Ethnic Minorities (1)
- Skin Conditions (1)
- Substance Abuse (1)
- Surgery (1)
- Telehealth (1)
- Web-Based (1)
- Women (3)
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 37 Research Studies DisplayedZisman-Ilani Y, Thompson KD, Siegel LS
Crohn's disease shared decision making intervention leads to more patients choosing combination therapy: a cluster randomised controlled trial.
The purpose of this multi-site cluster randomised controlled trial was to test the impact of standard Crohn's disease care and compare with the impact of shared decision making (SDM) on the provider’s choice of therapy, quality of decisions, and provider trust. A total of 158 adult patients with Crohn's disease within 15 years of their diagnosis, with no prior Crohn's disease complications, and who were candidates to receive immunomodulators or biologics, from 14 diverse gastroenterology practices in the US, participated in the study. 99 of those participants received the intervention and 59 received standard care. The study found that participants in the intervention group chose combination therapy more frequently, had a significantly lower decisional conflict, and had greater trust in their provider.
AHRQ-funded; HS021747.
Citation: Zisman-Ilani Y, Thompson KD, Siegel LS .
Crohn's disease shared decision making intervention leads to more patients choosing combination therapy: a cluster randomised controlled trial.
Aliment Pharmacol Ther 2023 Jan;57(2):205-14. doi: 10.1111/apt.17286..
Keywords: Digestive Disease and Health, Chronic Conditions, Decision Making, Patient-Centered Healthcare, Clinician-Patient Communication
Schuttner L, Hockett Sherlock S, Simons CE
My goals are not their goals: barriers and facilitators to delivery of patient-centered care for patients with multimorbidity.
This study’s goal was to clarify facilitators and barriers perceived by primary care physicians in the Veterans Health Administration to delivering patient-centered care for high-risk or complex patients with multimorbidity. The authors conducted semi-structured telephone interviews from April to July 2020 with 23 physicians across 20 clinical sites, with most being female (61%). Facilitators included: effective physician-patient communication to individualize care, prioritize among multiple needs, and elicit goals to improve patient engagement; access to care, enabled by interdisciplinary teams, and dictating personalized care planning; effortful but worthwhile care coordination and continuity; meeting complex needs through effective teamwork; and integrating medical and non-medical care aspects in recognition of patients' psychosocial contexts. Barriers included: intra- and interpersonal (e.g., perceived patient reluctance to engage in care); organizational (e.g., limited encounter time); and community or policy impediments (e.g., state decisional capacity laws) to patient-centered care.
AHRQ-funded; HS026369.
Citation: Schuttner L, Hockett Sherlock S, Simons CE .
My goals are not their goals: barriers and facilitators to delivery of patient-centered care for patients with multimorbidity.
J Gen Intern Med 2022 Dec;37(16):4189-96. doi: 10.1007/s11606-022-07533-1..
Keywords: Patient-Centered Healthcare, Healthcare Delivery, Chronic Conditions, Clinician-Patient Communication, Communication, Patient and Family Engagement
Khullar D, Prasad K, Neprash H
Factors associated with patient trust in their clinicians: results from the healthy work place study.
The goal of this study was to determine workplace, clinician, and patient correlates of patient trust in their clinician. The sample used baseline data from the Healthy Work Place trial, a randomized trial of Midwest and East Coast primary care practices. Trust was found to relate mainly to several aspects of care variables (including satisfaction with explanations, overall satisfaction with provider, learning about medical conditions, and the clinician's personal manner), with lesser association with patient characteristics and clinician work conditions. Findings showed that trust was primarily related to what happens between clinicians and patients in the examination room.
AHRQ-funded; HS018160.
Citation: Khullar D, Prasad K, Neprash H .
Factors associated with patient trust in their clinicians: results from the healthy work place study.
Health Care Manage Rev 2022 Oct-Dec;47(4):289-96. doi: 10.1097/hmr.0000000000000336..
Keywords: Patient-Centered Healthcare, Patient Experience, Clinician-Patient Communication
Rosenberg SM, Gierisch JM, Revette AC
"Is it cancer or not?" A qualitative exploration of survivor concerns surrounding the diagnosis and treatment of ductal carcinoma in situ.
This study investigated the impact of a ductal carcinoma in situ (DCIS) diagnosis by engaging self-identified patients regarding their experience. Findings showed that, in a large, national sample, participants with a history of DCIS reported confusion and concern about the diagnosis and treatment, which caused worry and significant uncertainty.
AHRQ-funded; HS023680.
Citation: Rosenberg SM, Gierisch JM, Revette AC .
"Is it cancer or not?" A qualitative exploration of survivor concerns surrounding the diagnosis and treatment of ductal carcinoma in situ.
Cancer 2022 Apr 15;128(8):1676-83. doi: 10.1002/cncr.34126..
Keywords: Cancer: Breast Cancer, Cancer, Decision Making, Women, Patient-Centered Healthcare, Clinician-Patient Communication, Patient and Family Engagement, Communication
Kunneman M, Branda ME, Ridgeway JL
Making sense of diabetes medication decisions: a mixed methods cluster randomized trial using a conversation aid intervention.
The purpose of this trial was to determine the effectiveness of a shared decision-making (SDM) tool versus guideline-informed usual care in translating evidence into primary care, and to explore how use of the tool changed patient perspectives about diabetes medication decision making. Findings showed that using an SDM conversation aid improved patient knowledge and involvement in SDM without impacting treatment choice, encounter length, medication adherence, or improved diabetes control in patients with type 2 diabetes.
AHRQ-funded; HS018339.
Citation: Kunneman M, Branda ME, Ridgeway JL .
Making sense of diabetes medication decisions: a mixed methods cluster randomized trial using a conversation aid intervention.
Endocrine 2022 Feb;75(2):377-91. doi: 10.1007/s12020-021-02861-4..
Keywords: Diabetes, Medication, Decision Making, Patient-Centered Healthcare, Clinician-Patient Communication, Chronic Conditions
Howland C, Despins L, Sindt J
Primary care clinic nurse activities with a telehealth monitoring system.
The purpose of this study was to evaluate differences in the types of nursing activities and communication processes reported in a primary care clinic between patients using a home-based monitoring system to electronically communicate self-monitored blood glucose and blood pressure values and those assuming usual care. Significant differences were identified for the direct care nursing activities of providing lifestyle and health education, medication adjustments, and patient follow-up, providing evidence of greater nursing activity reported in a primary care clinic in patients who utilized a home-based monitoring system.
AHRQ-funded; HS017035.
Citation: Howland C, Despins L, Sindt J .
Primary care clinic nurse activities with a telehealth monitoring system.
West J Nurs Res 2021 Jan;43(1):5-12. doi: 10.1177/0193945920923082..
Keywords: Telehealth, Health Information Technology (HIT), Blood Pressure, Primary Care, Clinician-Patient Communication, Communication, Patient Self-Management, Nursing, Patient-Centered Healthcare, Diabetes
Rising KL, Powell RE, Cameron KA
Development of the uncertainty communication checklist: a patient-centered approach to patient discharge from the emergency department.
Acad Med 2020 Jul;95(7):1026-34. doi: 10.1097/acm.0000000000003231.
AHRQ-funded; HS025651.
Citation: Rising KL, Powell RE, Cameron KA .
Development of the uncertainty communication checklist: a patient-centered approach to patient discharge from the emergency department.
Acad Med 2020 Jul;95(7):1026-34. doi: 10.1097/acm.0000000000003231..
Keywords: Patient-Centered Healthcare, Hospital Discharge, Emergency Department, Clinician-Patient Communication, Communication
Gressler LE, Natafgi NM, DeForge BR
What motivates people with substance use disorders to pursue treatment? A patient-centered approach to understanding patient experiences and patient-provider interactions.
The purpose of this study was to identify and define potential positive and negative factors in patient experiences and patient-provider interactions that are associated with the pursuit and maintenance of treatment by those suffering from substance use disorders (SUD). The investigators conducted two focus groups with patients in treatment for SUD and four in-depth interviews with healthcare providers involved in the treatment of patients with SUD.
AHRQ-funded; HS022135.
Citation: Gressler LE, Natafgi NM, DeForge BR .
What motivates people with substance use disorders to pursue treatment? A patient-centered approach to understanding patient experiences and patient-provider interactions.
J Subst Use 2019;24(6):587-99. doi: 10.1080/14659891.2019.1620891..
Keywords: Clinician-Patient Communication, Decision Making, Healthcare Utilization, Patient-Centered Healthcare, Patient Experience, Patient and Family Engagement, Substance Abuse
Ronis SD, Kleinman LC, Stange KC
A learning loop model of collaborative decision-making in chronic illness.
In this article, the authors discuss their learning loop model, which posits the relationship between pediatric patients, their parents, and their clinicians as central to the collaborative decision-making process in the setting of chronic illness. The model incorporates the evolution of both context and developmental capacity over time. It suggests that "meta-learning" from the experience of and outcomes from iterative decision is a key factor that may influence relationships and thus continued engagement in collaboration by patients, their parents, and their clinicians.
AHRQ-funded; HS024433.
Citation: Ronis SD, Kleinman LC, Stange KC .
A learning loop model of collaborative decision-making in chronic illness.
Acad Pediatr 2019 Jul;19(5):497-503. doi: 10.1016/j.acap.2019.04.006..
Keywords: Children/Adolescents, Chronic Conditions, Decision Making, Patient-Centered Healthcare, Primary Care: Models of Care, Primary Care, Clinician-Patient Communication, Communication
Johnston FM, Beckman M
Navigating difficult conversations.
In this paper, the authors discussed breaking bad news and navigating difficult conversations in surgical oncology practice. They note that mounting evidence supports a patient-centered communication approach and models of shared decisionmaking. Physician training in patient-centered cancer communication also continues to evolve.
AHRQ-funded; HS024736.
Citation: Johnston FM, Beckman M .
Navigating difficult conversations.
J Surg Oncol 2019 Jul;120(1):23-29. doi: 10.1002/jso.25472..
Keywords: Cancer, Clinician-Patient Communication, Communication, Decision Making, Patient-Centered Healthcare, Patient and Family Engagement, Provider: Physician, Surgery
Hall TL, Knierim KE, Nease DE
Primary care practices' implementation of patient-team partnership: findings from EvidenceNOW Southwest.
The authors reported on practice characteristics associated with greater patient-team partnership scores. Using EvidenceNOW Southwest data, they found that practices can improve efforts to partner with patients to assess social needs, gather meaningful input on practice improvement and patient experience, and offer resource connections. These findings supplement recent evidence that patient registries and evidence-based guidelines may effectively prevent and manage cardiovascular disease.
AHRQ-funded; HS023904.
Citation: Hall TL, Knierim KE, Nease DE .
Primary care practices' implementation of patient-team partnership: findings from EvidenceNOW Southwest.
J Am Board Fam Med 2019 Jul-Aug;32(4):490-504. doi: 10.3122/jabfm.2019.04.180361..
Keywords: Cardiovascular Conditions, Clinician-Patient Communication, Evidence-Based Practice, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Patient and Family Engagement, Primary Care, Quality of Care, Quality Improvement
Patel MR, Smith A, Leo H
Improving patient-provider communication and therapeutic practice through better integration of electronic health records in the exam room: a pilot study.
This study assessed the effectiveness of providing physicians who use electronic health records (EHRs) education for communication strategies and its impact on patient outcomes. The evidence-based Physician Asthma Care Education (PACE) program was extended in a pilot program using 18 providers and 126 adult patients with persistent asthma. Outcomes were assessed at baseline and 3- and 6-month postintervention intervals. Providers who completed the EHR-PACE program felt more confident in communicating with their patients, but there was no significant changes in patient asthma outcomes or their perceptions of their provider’s communication skills.
AHRQ-funded; HS023786.
Citation: Patel MR, Smith A, Leo H .
Improving patient-provider communication and therapeutic practice through better integration of electronic health records in the exam room: a pilot study.
Health Educ Behav 2019 Jun;46(3):484-93. doi: 10.1177/1090198118796879..
Keywords: Asthma, Clinician-Patient Communication, Communication, Electronic Health Records (EHRs), Evidence-Based Practice, Health Information Technology (HIT), Outcomes, Patient-Centered Healthcare, Patient-Centered Outcomes Research
Pavlo AJ, O'Connell M, Olsen S
Missing ingredients in shared decision-making?
This article discusses the practice of shared decision making (SDM) for clinicians when making decisions in health care. This widespread practice is considered the best approach for person-centered care, but for individuals diagnosed with serious mental illness there are still many barriers to effective collaboration. The authors suggest that more emphasis needs to be placed on the doctor-patient relationship itself conducting SDM.
AHRQ-funded; HS023000.
Citation: Pavlo AJ, O'Connell M, Olsen S .
Missing ingredients in shared decision-making?
Psychiatr Q 2019 Jun;90(2):333-38. doi: 10.1007/s11126-019-9624-9..
Keywords: Chronic Conditions, Clinician-Patient Communication, Communication, Decision Making, Behavioral Health, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Patient and Family Engagement
Fisher KA, Tan ASL, Matlock DD
Keeping the patient in the center: common challenges in the practice of shared decision making.
This study examines the practice of shared-decision making (SDM) to achieve patient-centered decisions. It was determined that not all circumstances make it possible for that to happen and there have to be some basic elements present. Those elements include the patients’ health literacy, their emotional state, their relationship with the clinician and the nature of the decision.
AHRQ-funded; HS024596.
Citation: Fisher KA, Tan ASL, Matlock DD .
Keeping the patient in the center: common challenges in the practice of shared decision making.
Patient Educ Couns 2018 Dec;101(12):2195-201. doi: 10.1016/j.pec.2018.08.007..
Keywords: Clinician-Patient Communication, Decision Making, Health Literacy, Patient-Centered Healthcare, Patient and Family Engagement
Quintana Y, Crotty B, Fahy D
Information sharing across generations and environments (InfoSAGE): study design and methodology protocol.
This open prospective cohort study aimed to assess a novel, Internet based, family-centric communication and collaboration platform created to address the information needs of elders and their informal caregivers in a community setting. It used a mixed methods approach, utilizing qualitative survey data along with website usage analytic data.
AHRQ-funded; HS021495.
Citation: Quintana Y, Crotty B, Fahy D .
Information sharing across generations and environments (InfoSAGE): study design and methodology protocol.
BMC Med Inform Decis Mak 2018 Nov 20;18(1):105. doi: 10.1186/s12911-018-0697-4.
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BMC Med Inform Decis Mak 2018 Nov 20;18(1):105. doi: 10.1186/s12911-018-0697-4.
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Keywords: Caregiving, Communication, Decision Making, Elderly, Health Information Technology (HIT), Patient-Centered Healthcare, Clinician-Patient Communication, Web-Based
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
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
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
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
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
Bossick AS, Barone C, Alexander GL
Teen, parent, and clinician expectations about obesity and related conditions during the annual well-child visit.
This study examined family (patient and parent/guardian) and clinician preferences for identification and management of obesity and obesity-related conditions during the well-child visit. Teens and parents expect weight to be discussed at well-child visits, and prefer discussions to come from a trusted clinician who uses serious, consistent language. Providers recognize several challenges and barriers to discussing weight management in the well-child visit.
AHRQ-funded; HS022417.
Citation: Bossick AS, Barone C, Alexander GL .
Teen, parent, and clinician expectations about obesity and related conditions during the annual well-child visit.
J Patient Cent Res Rev 2017 Summer;4(3):114-24. doi: 10.17294/2330-0698.1444.
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Keywords: Children/Adolescents, Clinician-Patient Communication, Obesity, Obesity: Weight Management, Patient-Centered Healthcare
Khan A, Baird J, Rogers JE
Parent and provider experience and shared understanding after a family-centered nighttime communication intervention.
This study assessed parent and provider experience and shared understanding after a family-centered, multidisciplinary nighttime communication intervention (nurse-physician brief, family huddle, family update sheet). It concluded that a family-centered, multidisciplinary nighttime communication intervention was associated with improvements in some, but not all, domains of parent/provider experience and shared understanding, particularly provider experience and nurse-family shared understanding.
AHRQ-funded; HS022986; HS000063.
Citation: Khan A, Baird J, Rogers JE .
Parent and provider experience and shared understanding after a family-centered nighttime communication intervention.
Acad Pediatr 2017 May - Jun;17(4):389-402. doi: 10.1016/j.acap.2017.01.012.
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Keywords: Children/Adolescents, Hospitalization, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Clinician-Patient Communication
Scherr KA, Fagerlin A, Hofer T
Physician recommendations trump patient preferences in prostate cancer treatment decisions.
This study assessed the influence of patient preferences and urologist recommendations in treatment decisions for clinically localized prostate cancer. It found that patients' initial treatment preferences did not predict receipt of active treatment versus surveillance. Instead, receipt of active treatment was predicted primarily by urologists' recommendations.
AHRQ-funded; HS021764.
Citation: Scherr KA, Fagerlin A, Hofer T .
Physician recommendations trump patient preferences in prostate cancer treatment decisions.
Med Decis Making 2017 Jan;37(1):56-69. doi: 10.1177/0272989x16662841.
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Keywords: Cancer: Prostate Cancer, Decision Making, Patient and Family Engagement, Patient-Centered Healthcare, Clinician-Patient Communication
Gallagher TH, Etchegaray JM, Bergstedt B
Improving communication and resolution following adverse events using a patient-created simulation exercise.
The HealthPact Patient and Family Advisory Council (PFAC) created and led a five-stage simulation exercise to help stakeholders understand what patients experience following an adverse event. Take-homes from these exercises included the fact that the response to adverse events can be complex, siloed, and uncoordinated. Participating in this simulation exercise led stakeholders and patient advocates to express interest in continued collaboration.
AHRQ-funded; HS019531.
Citation: Gallagher TH, Etchegaray JM, Bergstedt B .
Improving communication and resolution following adverse events using a patient-created simulation exercise.
Health Serv Res 2016 Dec;51 Suppl 3:2537-49. doi: 10.1111/1475-6773.12601.
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Keywords: Adverse Events, Clinician-Patient Communication, Medical Errors, Medical Liability, Patient-Centered Healthcare, Patient Safety
Prochaska MT, Press VG, Meltzer DO
Patient perceptions of wearable face-mounted computing technology and the effect on the doctor-patient relationship.
The authors aimed to determine patients' perception of and their privacy concerns with Google Glass. They found that the majority, 64% of respondents, appeared open to and would want their doctor to use face-mounted wearable computers such as Google Glass, even when they were unfamiliar with this technology. Although some patients expressed concerns about privacy, the authors found that patients were much less concerned about wearable technologies affecting the trust they have in their physician.
AHRQ-funded; HS023007.
Citation: Prochaska MT, Press VG, Meltzer DO .
Patient perceptions of wearable face-mounted computing technology and the effect on the doctor-patient relationship.
Appl Clin Inform 2016 Oct 12;7(4):946-53. doi: 10.4338/aci-2016-06-le-0094.
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Keywords: Health Information Technology (HIT), Hospitalization, Patient-Centered Healthcare, Patient Experience, Clinician-Patient Communication