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Research Studies is a monthly compilation of research articles funded by AHRQ or authored by AHRQ researchers and recently published in journals or newsletters.
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1 to 25 of 405 Research Studies Displayed
Bierman AS, Tong ST, McNellis RJ
Realizing the dream: the future of primary care research.
In this article, the authors discussed the primary care research central to successful primary care transformation and to realizing the vision of a high-performing US health system to serve effectively all Americans and their communities while advancing health equity.
AHRQ-authored.
Citation:
Bierman AS, Tong ST, McNellis RJ .
Realizing the dream: the future of primary care research.
Ann Fam Med 2022 Mar-Apr;20(2):170-74. doi: 10.1370/afm.2788..
Keywords:
Primary Care, Healthcare Delivery, Evidence-Based Practice, Healthcare Systems, Learning Health Systems, Patient-Centered Healthcare
Graber J, Lockhart S, Matlock DD
"This is not negotiable. You need to do this…": a directed content analysis of decision making in rehabilitation after knee arthroplasty.
In this qualitative study, researchers sought to understand patients' and physical therapists' perspectives related to decision making during outpatient rehabilitation after total knee arthroplasty (TKA) and further to describe potential barriers and opportunities for shared decision making (SDM) in this setting. They found that physical therapists described using decision-making strategies with varying levels of patient involvement, while both patients and physical therapists described barriers to routine use of SDM in the outpatient setting. They also presented actionable strategies for overcoming these barriers for providers and organizations seeking consistently to use SDM in outpatient TKA rehabilitation.
AHRQ-funded; HS025692.
Citation:
Graber J, Lockhart S, Matlock DD .
"This is not negotiable. You need to do this…": a directed content analysis of decision making in rehabilitation after knee arthroplasty.
J Eval Clin Pract 2022 Feb;28(1):99-107. doi: 10.1111/jep.13591..
Keywords:
Decision Making, Rehabilitation, Orthopedics, Surgery, Patient-Centered Healthcare
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
Dy SM, Acton RM, Yuan CT
Association of implementation and social network factors with patient safety culture in medical homes: a coincidence analysis.
This cross-case analysis study's objective was to explore which patient-centered medical home (PCMH) and patient safety implementation and social network factors may be necessary or sufficient for higher patient safety culture using 25 diverse US PCMHs. Findings suggested that PCMH safety culture is higher when clinicians and staff perceive that leadership prioritizes patient safety and when high reciprocity among staff exists.
AHRQ-funded; HS024859.
Citation:
Dy SM, Acton RM, Yuan CT .
Association of implementation and social network factors with patient safety culture in medical homes: a coincidence analysis.
J Patient Saf 2022 Jan;18(1):e249-e56. doi: 10.1097/pts.0000000000000752..
Keywords:
Patient-Centered Healthcare, Surveys on Patient Safety Culture, Patient Safety
Ahern J, Singer S, Bhanja A
Considering dentists within the healthcare team: a cross-sectional, multi-state analysis of primary care provider and staff perspectives.
The authors used novel survey data to examine the extent to which primary care providers, other providers, and staff consider dentists part of the healthcare team, and assessed associated practice and individual characteristics. Their findings indicated that dentists are frequently not considered part of the healthcare team in primary care settings. Further, varied responses within practices suggested that provider and staff perceptions may pose challenges to integrating dentists into primary care. Respondents in practices with more integrated diabetes care management processes were more likely to consider dentists as part of the healthcare team, reflecting dental care recommendations made by the American Diabetes Association.
AHRQ-funded; HS024067.
Citation:
Ahern J, Singer S, Bhanja A .
Considering dentists within the healthcare team: a cross-sectional, multi-state analysis of primary care provider and staff perspectives.
J Gen Intern Med 2022 Jan;37(1):246-48. doi: 10.1007/s11606-020-06564-w..
Keywords:
Primary Care, Provider: Health Personnel, Patient-Centered Healthcare, Care Coordination
Schnock KO, Snyder JE, Gershanik E
Unique patient-reported hospital safety concerns with online tool: MySafeCare.
This study evaluated the MySafeCare (MSC) application at six acute care units for 18 months as part of a patient-centered health information technology intervention to promote engagement and safety in the acute care setting. This web-based application allowed hospitalized patients to submit safety concerns anonymously and in real time. The authors evaluated rates of submissions to MSC and compared them to the hospital’s submissions to the Patient Family Relations Department. They received 46 submissions to MSC, and 33% of them were received anonymously. The overall rate of submissions was 0.6 submissions per 1000 patient-days, which was considerably lower than the rate of submissions to the Patient Family Relations Department during the same time period (4.1 per 1000 patient-days). MSC did capture important content concerning unmet care needs and preferences, inadequate communication, and concerns about safety of care.
AHRQ-funded; HS023535.
Citation:
Schnock KO, Snyder JE, Gershanik E .
Unique patient-reported hospital safety concerns with online tool: MySafeCare.
J Patient Saf 2022 Jan;18(1):e33-e39. doi: 10.1097/pts.0000000000000697..
Keywords:
Patient Safety, Health Information Technology (HIT), Hospitals, Patient-Centered Healthcare, Patient and Family Engagement
Peipert JD, Lad T, Khosla PG
A low literacy, multimedia health information technology intervention to enhance patient-centered cancer care in safety net settings increased cancer knowledge in a randomized controlled trial.
In this study, the investigators tested whether a low-literacy-friendly, multimedia information and assessment system used in daily clinical practice enhanced patient-centered care and improved patient outcomes. This was a prospective, parallel-group, randomized controlled trial with 2 arms, CancerHelp-Talking Touchscreen (CancerHelp-TT) versus control, among adults with Stage I-III breast or colorectal cancer receiving chemotherapy and/or radiation therapy in safety net settings.
AHRQ-funded; HS017300.
Citation:
Peipert JD, Lad T, Khosla PG .
A low literacy, multimedia health information technology intervention to enhance patient-centered cancer care in safety net settings increased cancer knowledge in a randomized controlled trial.
Cancer Control 2021 Jan-Dec;28:10732748211036783. doi: 10.1177/10732748211036783..
Keywords:
Health Literacy, Patient-Centered Healthcare, Cancer, Safety Net, Education: Patient and Caregiver, Health Information Technology (HIT)
Tobin JN, Cassells A, Weiss E
Integrating cancer screening and mental health services in primary care: protocol and baseline results of a patient-centered outcomes intervention study.
AHRQ-funded; HS021667.
Citation:
Tobin JN, Cassells A, Weiss E .
Integrating cancer screening and mental health services in primary care: protocol and baseline results of a patient-centered outcomes intervention study.
J Health Care Poor Underserved 2021;32(4):1907-34. doi: 10.1353/hpu.2021.0173..
Keywords:
Patient-Centered Healthcare, Cancer, Behavioral Health, Primary Care, Depression, Women, Screening
Oberlander T, Scholle SH, Marsteller J
Implementation of patient safety structures and processes in the patient-centered medical home.
This study's objectives were to identify patient-centered medical home (PCMH) standards relevant to patient safety, to construct a measure of patient safety activity implementation, and to examine differences in adoptions of these activities by practice and community characteristics. Findings showed that implementation of patient safety activities varied; the few military practices studied had the highest, and community clinics the lowest, patient safety score, both overall and across specific domains, while other practice and community characteristics were not associated with the patient safety score.
AHRQ-funded; HS024859.
Citation:
Oberlander T, Scholle SH, Marsteller J .
Implementation of patient safety structures and processes in the patient-centered medical home.
J Healthc Qual 2021 Nov-Dec;43(6):324-39. doi: 10.1097/jhq.0000000000000312..
Keywords:
Patient-Centered Healthcare, Patient Safety, Implementation, Primary Care
Lasser EC, Heughan JA, Lai AY
Patient perceptions of safety in primary care: a qualitative study to inform care.
The authors sought to understand the patient perspective on patient safety in patient-centered medical homes (PCMHs). Using focus groups/interviews, they found overarching themes focused on (1) clear and timely communication with and between clinicians and (2) trust in the care team, including being heard, respected, and treated as a whole person. Other themes included sharing of and access to information, patient education and patient-centered medication reconciliation process, clear documentation for the diagnostic process, patient-centered comprehensive visits, and timeliness of care.
AHRQ-funded; HS024859.
Citation:
Lasser EC, Heughan JA, Lai AY .
Patient perceptions of safety in primary care: a qualitative study to inform care.
Curr Med Res Opin 2021 Nov;37(11):1991-99. doi: 10.1080/03007995.2021.1976736..
Keywords:
Patient Safety, Patient Experience, Primary Care, Patient-Centered Healthcare
Swietek KE, Domino ME, Grove LR
Duration of medical home participation and quality of care for patients with chronic conditions.
The objective of this study was to examine whether the length of participation in a patient-centered medical home (PCMH), an evidence-based practice, led to higher quality care for Medicaid enrollees with multiple co-morbid chronic conditions and major depressive disorder (MDD). The investigators concluded that the PCMH model was associated with higher quality of care for patients with multiple chronic conditions and MDD over time, and these benefits increased the longer a patient was enrolled.
AHRQ-funded; HS000032; HS019659.
Citation:
Swietek KE, Domino ME, Grove LR .
Duration of medical home participation and quality of care for patients with chronic conditions.
Health Serv Res 2021 Oct;56(Suppl 1):1069-79. doi: 10.1111/1475-6773.13710..
Keywords:
Chronic Conditions, Patient-Centered Healthcare, Quality of Care, Evidence-Based Practice, Depression, Behavioral Health
Savitz LA, Bayliss EA
Emerging models of care for individuals with multiple chronic conditions.
The objective of this study was to characterize emerging and current practice models to more effectively treat and support patients with multiple chronic conditions (MCC). The investigators concluded that integrating care for MCC patient populations requires processes for determining different subpopulation needs in various settings and lived experiences. Innovation should be anchored at the nexus of payment systems, social risks, medical needs, and community-based resources.
AHRQ-funded; 290201600001B.
Citation:
Savitz LA, Bayliss EA .
Emerging models of care for individuals with multiple chronic conditions.
Health Serv Res 2021 Oct;56(Suppl 1):980-89. doi: 10.1111/1475-6773.13774..
Keywords:
Chronic Conditions, Patient-Centered Healthcare, Primary Care: Models of Care, Primary Care
Parikh K, Richmond M, Lee M
Outcomes from a pilot patient-centered hospital-to-home transition program for children hospitalized with asthma.
The purpose of this study was to evaluate a multi-component hospital-to-home (H2H) transition program for children hospitalized with an asthma exacerbation. A pilot prospective randomized clinical trial of guideline-based asthma care with and without a patient-centered multi-component H2H program was conducted among children enrolled in K-8(th) grade on Medicaid hospitalized for an asthma exacerbation. The investigators concluded that the pilot data suggested that comprehensive care coordination initiated during the inpatient stay was feasible and acceptable.
AHRQ-funded; HS024554.
Citation:
Parikh K, Richmond M, Lee M .
Outcomes from a pilot patient-centered hospital-to-home transition program for children hospitalized with asthma.
J Asthma 2021 Oct;58(10):1384-94. doi: 10.1080/02770903.2020.1795877..
Keywords:
Children/Adolescents, Patient-Centered Healthcare, Transitions of Care, Asthma, Hospital Discharge, Care Coordination, Chronic Conditions
Chen H, Upadhyay N, Lyu N
Association of primary and behavioral health integrated care upon pediatric mental disorder treatment.
This study’s objective was to examine whether linkage with mental health (MH) treatment differed across 3 different integrated care agreements (ICAs) following diagnosis for Attention Deficit Hyperactive Disorder (ADHD) or Major Depressive Disorder (MDD) given by primary care providers (PCPs) in the pediatric setting. The ICAs were categorized as PCPs who practiced alone (non-co-located); PCPs practiced with specialist outside the practice but co-located at the practice site; and employed specialists who were co-located. A total of 4203 incident ADHD and 298 incident MDD diagnoses were identified, of which 74% of ADHD cases and 67% of MDD cases received treatment within 90 days of diagnosis. Children with ADHD were twice as likely to receive treatment if they were diagnosed by non-co-located or co-affiliated PCPs than those diagnosed by non-co-located PCPs. Those treated children were also 2 times more likely to receive guideline recommended psychotherapy and treated at the diagnosing site versus elsewhere.
AHRQ-funded; HS025251.
Citation:
Chen H, Upadhyay N, Lyu N .
Association of primary and behavioral health integrated care upon pediatric mental disorder treatment.
Acad Pediatr 2021 Sep-Oct;21(7):1187-94. doi: 10.1016/j.acap.2021.05.021..
Keywords:
Children/Adolescents, Behavioral Health, Patient-Centered Healthcare, Primary Care, Healthcare Delivery, Depression
Parish MB, Gonzalez A, Hilty D
Asynchronous telepsychiatry interviewer training recommendations: a model for interdisciplinary, integrated behavioral health care.
Asynchronous telepsychiatry (ATP) is an integrative model of behavioral health service delivery that is applicable in a variety of settings and populations, particularly consultation in primary care. This article outlined the development of a training model for ATP clinician skills. The training needs for ATP clinicians were assessed on a limited convenience sample of experts and clinicians. The authors suggested that more rigorous studies of training for ATP and other technology-focused, behavioral health services are needed.
AHRQ-funded; HS021477.
Citation:
Parish MB, Gonzalez A, Hilty D .
Asynchronous telepsychiatry interviewer training recommendations: a model for interdisciplinary, integrated behavioral health care.
Telemed J E Health 2021 Sep;27(9):982-88. doi: 10.1089/tmj.2020.0076..
Keywords:
Telehealth, Health Information Technology (HIT), Behavioral Health, Primary Care, Patient-Centered Healthcare, Training
Smith BM, Sharma R, Das A
Patient and family engagement strategies for children and adolescents with chronic diseases: a review of systematic reviews.
Patient and family engagement is important for family-centered care, particularly for children and adolescents with chronic disease. In this study the investigators aimed to 1) identify available evidence from systematic reviews on engagement strategies used to help children, adolescents, and their caregivers manage chronic conditions, and 2) identify gaps in the literature. They searched PubMed and CINAHL from January 2015 to January 2020 for systematic reviews on patient and family engagement strategies in the pediatrics population (<18 years).
AHRQ-funded; 290201500006I.
Citation:
Smith BM, Sharma R, Das A .
Patient and family engagement strategies for children and adolescents with chronic diseases: a review of systematic reviews.
Patient Educ Couns 2021 Sep;104(9):2213-23. doi: 10.1016/j.pec.2021.02.026..
Keywords:
Children/Adolescents, Patient and Family Engagement, Chronic Conditions, Patient-Centered Healthcare, Evidence-Based Practice, Patient Self-Management
Quigley DD, Slaughter M, Qureshi N
Practices and changes associated with patient-centered medical home transformation.
Knowing which patient-centered medical home (PCMH) care delivery changes and quality improvement (QI) practices further PCMH implementation is essential. In this study, the investigators used the 2008-2017 National Committee of Quality Assurance (NCQA) PCMH directory of 15,188 primary care practices that received Level 1, 2, or 3 NCQA PCMH recognition to: 1.) construct a stratified national sample of 105 practices engaged in PCMH transformation and 2.) examine their QI practices and PCMH changes associated with PCMH transformation.
AHRQ-funded; HS016980; HS025920.
Citation:
Quigley DD, Slaughter M, Qureshi N .
Practices and changes associated with patient-centered medical home transformation.
Am J Manag Care 2021 Sep;27(9):386-93. doi: 10.37765/ajmc.2021.88740..
Keywords:
Patient-Centered Healthcare, Primary Care, Practice Improvement, Healthcare Delivery, Quality Improvement, Quality of Care
Quigley DD, Qureshi N, AlMasarweh L
Using CAHPS patient experience data for patient-centered medical home transformation.
The purpose of this study was to examine how primary care practices used the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey and its patient-centered medical home (PCMH) items during their PCMH transition. The investigators concluded that CAHPS surveys were considered actionable for PCMH transformation and used in standardizing and coordinating care. The CAHPS PCMH items were considered integral to the continuous QI needed for moving beyond formal PCMH recognition and maximizing transformation.
AHRQ-funded; HS016980; HS025920.
Citation:
Quigley DD, Qureshi N, AlMasarweh L .
Using CAHPS patient experience data for patient-centered medical home transformation.
Am J Manag Care 2021 Sep;27(9):e322-e29. doi: 10.37765/ajmc.2021.88745..
Keywords:
Consumer Assessment of Healthcare Providers and Systems (CAHPS), Patient Experience, Patient-Centered Healthcare, Primary Care, Practice Improvement, Healthcare Delivery, Quality Improvement, Quality of Care
Klawetter S, Glaze K, Sward A
Warm Connections: integration of infant mental health services into WIC.
Warm Connections is an innovative integrated behavioral health program delivered in the Special Supplemental Nutrition Program for Women, Infants, and Children and rooted in an infant and early childhood mental health framework. This exploratory study describes Warm Connections and provides evaluation results from its pilot implementation. Findings suggest Warm Connections may reduce distress and increase parenting efficacy among low-income mothers and support further research of this program's feasibility.
AHRQ-funded; HS026370.
Citation:
Klawetter S, Glaze K, Sward A .
Warm Connections: integration of infant mental health services into WIC.
Community Ment Health J 2021 Aug;57(6):1130-41. doi: 10.1007/s10597-020-00744-y..
Keywords:
Newborns/Infants, Maternal Care, Behavioral Health, Patient-Centered Healthcare, Low-Income, Vulnerable Populations
Aiyegbusi OL, Nair D, Peipert JD
A narrative review of current evidence supporting the implementation of electronic patient-reported outcome measures in the management of chronic diseases.
This review discusses and summarizes evidence of the impact of electronic patient-reported outcomes measures (ePROMs) on clinical parameters and outcomes relevant to chronic diseases. Various studies have demonstrated the feasibility of ePROMs in routine clinical practice with patients increasing expressing a preference for an electronic mode of administration. These ePROMs could have significant impacts on outcomes valued by patients, healthcare providers, and researchers. Recently published literature.
AHRQ-funded; HS026395.
Citation:
Aiyegbusi OL, Nair D, Peipert JD .
A narrative review of current evidence supporting the implementation of electronic patient-reported outcome measures in the management of chronic diseases.
Ther Adv Chronic Dis 2021 May 24;12:20406223211015958. doi: 10.1177/20406223211015958..
Keywords:
Chronic Conditions, Patient Experience, Health Information Technology (HIT), Outcomes, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Evidence-Based Practice
Grove LR, Gertner AK, Swietek KE
Effect of enhanced primary care for people with serious mental illness on service use and screening.
This retrospective cohort study compared healthcare use and screening receipt of people with serious mental illness (SMI) newly receiving enhanced primary care to people with SMI newly receiving usual primary care. Outcome measures included outpatient visits, emergency department (ED) visits, inpatient stays and dates, and recommended screenings 18 months after the initial visit. Enhanced primary care was associated with an increase of 1.2 primary care visits in the 18 months after the initial visit and decreases of 0.33 non-psychiatric inpatient days and 3.0 non-psychiatric inpatient days. There was no significant effect on psychiatric service and ED visits. Enhanced primary care increased the probability of preventive screenings such as glucose and HIV, decreased the probability of lipid screening, and had no effect on hemoglobin A1c and colorectal cancer screening.
AHRQ-funded; HS000032.
Citation:
Grove LR, Gertner AK, Swietek KE .
Effect of enhanced primary care for people with serious mental illness on service use and screening.
J Gen Intern Med 2021 Apr;36(4):970-77. doi: 10.1007/s11606-020-06429-2..
Keywords:
Behavioral Health, Primary Care: Models of Care, Primary Care, Patient-Centered Healthcare, Screening, Healthcare Utilization, Healthcare Delivery
Peahl AF, Powell A, Berlin H
Patient and provider perspectives of a new prenatal care model introduced in response to the coronavirus disease 2019 pandemic.
The authors evaluated institutional-level adoption and patient and provider experiences with a coronavirus disease 2019 prenatal care model. They found that reduced visit schedules and virtual visits were rapidly integrated into real-world care, with positive experiences for many patients and providers. They recommended future research to understand the health outcomes and care experience associated with alternative approaches to prenatal care delivery across more diverse patient populations outside of the coronavirus disease 2019 pandemic to inform broader health policy decisions.
AHRQ-funded; HS025465.
Citation:
Peahl AF, Powell A, Berlin H .
Patient and provider perspectives of a new prenatal care model introduced in response to the coronavirus disease 2019 pandemic.
Am J Obstet Gynecol 2021 Apr;224(4):384.e1-84.e11. doi: 10.1016/j.ajog.2020.10.008..
Keywords:
Maternal Care, Pregnancy, Patient-Centered Healthcare, Telehealth, Health Information Technology (HIT), Healthcare Delivery, COVID-19
Hill SC, Zuvekas SH
Patient-centered medical homes and pediatric preventive counseling.
The authors sought to measure pediatric preventive counseling at patient-centered medical homes (PCMHs) compared with practices that reported undertaking some or no quality-related activities. Using MEPS data, they found that PCMHs were associated with substantially greater receipt of pediatric preventive counseling. They recommended that evaluations of PCMHs account for the quality-related activities of comparison practices.
AHRQ-authored.
Citation:
Hill SC, Zuvekas SH .
Patient-centered medical homes and pediatric preventive counseling.
Acad Pediatr 2021 Apr 1;21(3):488-96. doi: 10.1016/j.acap.2020.07.001..
Keywords:
Medical Expenditure Panel Survey (MEPS), Children/Adolescents, Patient-Centered Healthcare, Prevention
Peahl AF, Smith RD, Moniz MN
Prenatal care redesign: creating flexible maternity care models through virtual care.
Each year, over 98% of the almost 4 million pregnant patients in the United States receive prenatal care-a crucial preventive service to improve outcomes for moms and babies. In this paper, the authors outline their experience rapidly transitioning prenatal care to a new model with 4 in-person visits, 1 ultrasound visit, and 4 virtual visits (the 4-1-4 prenatal plan). They then explore how lessons from this implementation can inform patient-centered prenatal care redesign during and beyond the COVID-19 pandemic.
AHRQ-funded; HS025465.
Citation:
Peahl AF, Smith RD, Moniz MN .
Prenatal care redesign: creating flexible maternity care models through virtual care.
Am J Obstet Gynecol 2020 Sep;223(3):389.e1-89.e10. doi: 10.1016/j.ajog.2020.05.029..
Keywords:
Maternal Care, Telehealth, Health Information Technology (HIT), Pregnancy, Women, Healthcare Delivery, Patient-Centered Healthcare
Handley SC, Bell S, Nembhard IM
A systematic review of surveys for measuring patient-centered care in the hospital setting.
The objective of this study was to identify surveys for assessing patient-centered care (PCC) in hospitals, assess PCC dimensions that they capture, report their psychometric properties, and evaluate applicability to individual and/or dyadic patients. Nine surveys were identified, psychometric properties were reported infrequently, and all surveys applied to individual patients, none to dyadic patients. The researchers concluded that multiple surveys for measuring PCC in hospitals are available, but opportunities exist to improve survey comprehensiveness regarding dimensions of PCC, reporting of psychometric properties, and development of measures to capture PCC for dyadic patients.
AHRQ-funded; HS016978.
Citation:
Handley SC, Bell S, Nembhard IM .
A systematic review of surveys for measuring patient-centered care in the hospital setting.
Med Care 2021 Mar;59(3):228-37. doi: 10.1097/mlr.0000000000001474.
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Keywords:
Patient-Centered Healthcare, Hospitals, Patient Experience
