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
101 to 122 of 122 Research Studies DisplayedYawn BP, Rank MA, Bertram SL
Obesity, low levels of physical activity and smoking present opportunities for primary care asthma interventions: an analysis of baseline data from the asthma tools study.
The researchers calculated cross-sectional frequencies of activity levels, smoking, secondhand smoke exposure and the presence of obesity, as well as rates of out-of-control asthma and asthma exacerbations. They found that tobacco smoke exposure, obesity, low activity levels, poverty, inadequately controlled asthma and high asthma-related health-care utilization were common. Across all age groups, obesity was associated with poorer asthma outcomes.
AHRQ-funded; HS018431.
Citation: Yawn BP, Rank MA, Bertram SL .
Obesity, low levels of physical activity and smoking present opportunities for primary care asthma interventions: an analysis of baseline data from the asthma tools study.
NPJ Prim Care Respir Med 2015 Oct 1;25:15058. doi: 10.1038/npjpcrm.2015.58..
Keywords: Asthma, Obesity, Tobacco Use, Primary Care, Outcomes
Rangachari P, Mehta R, Rethemeyer RK
Short or long end of the lever? Associations between provider communication of the "asthma-action plan" and outpatient revisits for pediatric asthma.
This study addresses the gap in understanding the extent of leverage that healthcare providers may have in preventing hospital revisits for asthma through effective communication of the Asthma-Action Plan (AAP) in the outpatient setting. The Children's Hospital of Georgia survey results suggest limited potential of effective provider communication of AAP in reducing outpatient revisits for pediatric asthma and indicate a need for broader community-based interventions to address patient life variables impacting self-management and hospital revisits for pediatric asthma.
AHRQ-funded; HS019785.
Citation: Rangachari P, Mehta R, Rethemeyer RK .
Short or long end of the lever? Associations between provider communication of the "asthma-action plan" and outpatient revisits for pediatric asthma.
J Hosp Adm 2015 Oct;4(5):26-39. doi: 10.5430/jha.v4n5p26.
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Keywords: Asthma, Children/Adolescents, Ambulatory Care and Surgery, Clinician-Patient Communication, Patient Self-Management
Lu CY, Zhang F, Lakoma MD
Asthma treatments and mental health visits after a Food and Drug Administration label change for leukotriene inhibitors.
This study investigated how a label change to include neuropsychiatric adverse events (e.g., depression and suicidality) affected the use of leukotriene inhibitors (LTIs) and other asthma controller medications, mental health visits, and suicide attempts. The label change was associated with abrupt reductions in LTI use among all age groups.
AHRQ-funded; HS019669.
Citation: Lu CY, Zhang F, Lakoma MD .
Asthma treatments and mental health visits after a Food and Drug Administration label change for leukotriene inhibitors.
Clin Ther 2015 Jun;37(6):1280-91. doi: 10.1016/j.clinthera.2015.03.027..
Keywords: Adverse Drug Events (ADE), Asthma, Children/Adolescents, Medication, Behavioral Health
Butz AM, Ogborn J, Mudd S
Factors associated with high short-acting beta2-agonist use in urban children with asthma.
The investigators examined factors associated with high short-acting β₂ agonist (SABA) use in inner-city children with asthma. They found that high SABA users were more than 5 times more likely to have an asthma hospitalization, almost 3 times more likely to have an asthma intensive care unit admission, and more than 3 times more likely to have prior specialty asthma care or positive cockroach sensitization than low to moderate SABA users.
AHRQ-funded; HS000029.
Citation: Butz AM, Ogborn J, Mudd S .
Factors associated with high short-acting beta2-agonist use in urban children with asthma.
Ann Allergy Asthma Immunol 2015 May;114(5):385-92. doi: 10.1016/j.anai.2015.03.002.
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Keywords: Asthma, Children/Adolescents, Medication, Urban Health
Kuhn L, Reeves K, Taylor Y
Planning for action: the impact of an asthma action plan decision support tool integrated into an electronic health record (EHR) at a large health care system.
This project aimed to embed an electronic asthma action plan decision support tool (eAAP) into the medical record to streamline evidence-based guidelines for providers at the point of care, create individualized patient handouts, and evaluate effects on disease outcomes. Its findings supports existing evidence that patient self-management plays an important role in reducing asthma exacerbations.
AHRQ-funded; HS019946.
Citation: Kuhn L, Reeves K, Taylor Y .
Planning for action: the impact of an asthma action plan decision support tool integrated into an electronic health record (EHR) at a large health care system.
J Am Board Fam Med 2015 May-Jun;28(3):382-93. doi: 10.3122/jabfm.2015.03.140248..
Keywords: Electronic Health Records (EHRs), Clinical Decision Support (CDS), Asthma, Patient Self-Management, Evidence-Based Practice
Fiks AG, Mayne SL, Karavite DJ
Parent-reported outcomes of a shared decision-making portal in asthma: a practice-based RCT.
This study evaluated the feasibility, acceptability, and impact of MyAsthma, an EHR-linked patient portal supporting shared decision-making for pediatric asthma. It found that parents of children with moderate to severe persistent asthma used the portal more than others; 92 percent were satisfied with MyAsthma. Parents reported that use improved their communication with the office, ability to manage asthma, and awareness of the importance of ongoing attention to treatment.
AHRQ-funded; HS021645.
Citation: Fiks AG, Mayne SL, Karavite DJ .
Parent-reported outcomes of a shared decision-making portal in asthma: a practice-based RCT.
Pediatrics 2015 Apr;135(4):e965-73. doi: 10.1542/peds.2014-3167..
Keywords: Asthma, Children/Adolescents, Shared Decision Making, Electronic Health Records (EHRs), Health Information Technology (HIT)
Rust G, Zhang S, McRoy L
Potential savings from increasing adherence to inhaled corticosteroid therapy in Medicaid-enrolled children.
This study simulated the cost impact of achieving various levels of increase in inhaled corticosteroid therapy (ICS-Rx) adherence levels among elementary school–aged children (5-12 years) initially receiving a new ICS-Rx for asthma. It found that increasing the proportion of children who maintain higher adherence to 40 percent would generate savings of $95 per child per year.
AHRQ-funded; HS022444.
Citation: Rust G, Zhang S, McRoy L .
Potential savings from increasing adherence to inhaled corticosteroid therapy in Medicaid-enrolled children.
Am J Manag Care 2015 Mar;21(3):173-80..
Keywords: Children/Adolescents, Asthma, Patient Adherence/Compliance, Healthcare Costs, Medicaid
Ejebe IH, Jacobs EA, Wisk LE
Persistent differences in asthma self-efficacy by race, ethnicity, and income in adults with asthma.
The objective of this population-based study was to determine if and to what extent there are differences in asthma self-efficacy by race/ethnicity and income, and whether health status, levels of acculturation, and health care factors may explain these differences. It found that racial/ethnic minorities and individuals living in poverty have the lowest levels of asthma self-efficacy.
AHRQ-funded; HS000063.
Citation: Ejebe IH, Jacobs EA, Wisk LE .
Persistent differences in asthma self-efficacy by race, ethnicity, and income in adults with asthma.
J Asthma 2015 Feb;52(1):105-13. doi: 10.3109/02770903.2014.947429..
Keywords: Asthma, Patient Self-Management, Social Determinants of Health, Low-Income, Racial and Ethnic Minorities
Valet RS, Gebretsadik T, Minton PA
Prevalence and characteristics of medication sharing behavior in a pediatric Medicaid population with asthma.
The researchers described features surrounding the sharing and borrowing of nonprescription medications and examine the effects of this behavior on adverse asthma outcomes among children with asthma. They found a trend toward decreased Asthma Control Test (ACT) score and a higher proportion of patients with ACT scores of 19 or lower among those who shared or borrowed medication.
AHRQ-funded; HS019669.
Citation: Valet RS, Gebretsadik T, Minton PA .
Prevalence and characteristics of medication sharing behavior in a pediatric Medicaid population with asthma.
Ann Allergy Asthma Immunol 2015 Feb;114(2):151-3. doi: 10.1016/j.anai.2014.11.007..
Keywords: Medication, Children/Adolescents, Medicaid, Asthma, Adverse Drug Events (ADE)
Rust G, Zhang S, Holloway K
Timing of emergency department visits for childhood asthma after initial inhaled corticosteroid use.
This study measured the incidence and timing of emergency department (ED) visits in the first 90 days after an initial inhaled corticosteroid prescription (ICS-Rx). It found that one in 5 children with asthma had at least 1 ED visit in the first 90 days after initial ICS-Rx; 10 percent of these visits occurred within the first 48 hours, and 25 percent occurred within the first week.
AHRQ-funded; HS022444; HS019470.
Citation: Rust G, Zhang S, Holloway K .
Timing of emergency department visits for childhood asthma after initial inhaled corticosteroid use.
Popul Health Manag 2015 Feb;18(1):54-60. doi: 10.1089/pop.2013.0126..
Keywords: Asthma, Children/Adolescents, Emergency Department, Medication
Mowrer JL, Tapp H, Ludden T
Patients' and providers' perceptions of asthma and asthma care: a qualitative study.
The primary goal of this qualitative study was to further explore patient and provider perceptions of asthma and asthma care as part of a larger Asthma Comparative Effectiveness Study. Three overarching themes, with a variety of subthemes, emerged as the main findings of this study. The three main themes were Cost/Economic Barriers/Process, Self-Governance/Adherence and Education.
AHRQ-funded; HS019946.
Citation: Mowrer JL, Tapp H, Ludden T .
Patients' and providers' perceptions of asthma and asthma care: a qualitative study.
J Asthma 2015;52(9):949-56. doi: 10.3109/02770903.2015.1010731..
Keywords: Asthma, Comparative Effectiveness, Patient Adherence/Compliance, Chronic Conditions
Malhotra K, Baltrus P P, Zhang S
Geographic and racial variation in asthma prevalence and emergency department use among Medicaid-enrolled children in 14 southern states.
Using 2007 Medicaid claims data from 556 counties in 14 southern states, the researchers described the local area variation in 1-year asthma prevalence rates, emergency department visit rates, and racial disparity rate ratios. They found much local area variation in asthma prevalence and asthma ED visit rates among Medicaid-enrolled children. Between black and white children, more counties had higher prevalence of asthma and higher ED visit rates among blacks.
AHRQ-funded; HS022444; HS019470
Citation: Malhotra K, Baltrus P P, Zhang S .
Geographic and racial variation in asthma prevalence and emergency department use among Medicaid-enrolled children in 14 southern states.
J Asthma. 2014 Nov;51(9):913-21. doi: 10.3109/02770903.2014.930479..
Keywords: Asthma, Medicaid, Social Determinants of Health, Emergency Department, Emergency Medical Services (EMS)
Mohanan S, Tapp H, McWilliams A
Obesity and asthma: pathophysiology and implications for diagnosis and management in primary care.
This review summarizes existing data that support the pathophysiologic mechanisms underlying the association between obesity and asthma, as well as the current and future state of treatment for the obese patient with asthma. It suggests that evidence of chronic inflammatory response linking obesity and asthma indicates a need to address obesity during asthma management, possibly by using patient-centered approaches such as shared decisionmaking.
AHRQ-funded; HS019946
Citation: Mohanan S, Tapp H, McWilliams A .
Obesity and asthma: pathophysiology and implications for diagnosis and management in primary care.
Exp Biol Med. 2014 Nov;239(11):1531-40. doi: 10.1177/1535370214525302..
Keywords: Obesity, Asthma, Diagnostic Safety and Quality, Primary Care, Chronic Conditions
Wu AC, Li L, Fung V
Use of leukotriene receptor antagonists are associated with a similar risk of asthma exacerbations as inhaled corticosteroids.
The researchers compared the effectiveness of different controller medication regimens under real-life conditions. They found that the risk of emergency department visits, hospitalizations, and oral corticosteroids did not differ between children who initiated leukotriene antagonist and those who initiated inhaled corticosteroid. These findings may be explainable by leukotriene antagonist having similar effectiveness as inhaled corticosteroid in real-life usage.
AHRQ-funded; HS019669.
Citation: Wu AC, Li L, Fung V .
Use of leukotriene receptor antagonists are associated with a similar risk of asthma exacerbations as inhaled corticosteroids.
J Allergy Clin Immunol Pract 2014 Sep-Oct;2(5):607-13. doi: 10.1016/j.jaip.2014.05.009..
Keywords: Comparative Effectiveness, Medication, Children/Adolescents, Asthma, Risk
Gillette C, Blalock SJ, Rao JK
Provider-caregiver-child discussions about risks associated with asthma control medications: content and prevalence.
The objectives of the study were to: (1) describe the extent to which primary care pediatric providers discuss risks associated with asthma control medications with families and (2) examine the relationship between child, caregiver, provider, and clinic visit characteristics and discussions about risks associated with asthma control medications. It found that providers discussed asthma control medication risks during 23% of visits.
AHRQ-funded; HS020534.
Citation: Gillette C, Blalock SJ, Rao JK .
Provider-caregiver-child discussions about risks associated with asthma control medications: content and prevalence.
Pediatr Pulmonol 2014 Aug;49(8):727-33. doi: 10.1002/ppul.22892..
Keywords: Medication, Asthma, Children/Adolescents, Clinician-Patient Communication, Primary Care
Sarpong EM
AHRQ Author: Sarpong EM
The impact of obesity on medication use and expenditures among nonelderly adults with asthma.
The author examined the impact of obesity on medication use and expenditures among nonelderly adults with asthma using the Medical Expenditure Panel Survey. He found that obese classes II/III individuals were more likely to have current asthma, seek treatment for asthma, use more medications, and have higher medication and health care expenditures compared with normal weight individuals. His results suggested that reduction in body weight may help reduce health resource use and expenditures for nonelderly adults with asthma.
AHRQ-authored.
Citation: Sarpong EM .
The impact of obesity on medication use and expenditures among nonelderly adults with asthma.
J Health Care Poor Underserved 2014 Aug;25(3):1245-61. doi: 10.1353/hpu.2014.0142.
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Keywords: Asthma, Healthcare Costs, Medical Expenditure Panel Survey (MEPS), Medication, Obesity
Fung V, Graetz I, Galbraith A
Financial barriers to care among low-income children with asthma: health care reform implications.
This study examined the associations between cost-sharing, income, and care seeking and financial stress among children with asthma. It found that cost-related barriers to care among children with asthma were concentrated among low-income families with higher cost-sharing levels.
AHRQ-funded; HS019669
Citation: Fung V, Graetz I, Galbraith A .
Financial barriers to care among low-income children with asthma: health care reform implications.
JAMA Pediatr. 2014 Jul;168(7):649-56. doi: 10.1001/jamapediatrics.2014.79..
Keywords: Children/Adolescents, Asthma, Low-Income, Access to Care, Healthcare Costs
Jackson DJ, Hartert TV, Martinez FD
Asthma: NHLBI workshop on the primary prevention of chronic lung diseases.
This article reports on the state of primary prevention research in asthma, with emphasis on specific recommendations for research priorities and interventions that could be undertaken now. The emphasis of this work was on prevention of disease onset, and because the majority of asthma begins during preschool years, this document focuses on childhood asthma.
AHRQ-funded; HS018454, HS022093
Citation: Jackson DJ, Hartert TV, Martinez FD .
Asthma: NHLBI workshop on the primary prevention of chronic lung diseases.
Ann Am Thorac Soc. 2014 Apr;11 Suppl 3:S139-45. doi: 10.1513/AnnalsATS.201312-448LD..
Keywords: Asthma, Prevention, Children/Adolescents, Chronic Conditions
Li L, Vollmer WM, Butler MG
A comparison of confounding adjustment methods for assessment of asthma controller medication effectiveness.
Using three confounding adjustment procedures—covariate-adjusted regression, propensity score regression, and high-dimemsional propensity score regression—on a population of 24,680 children with asthma, researchers found that patients treated with leukotriene antagonists were no more likely than those treated with inhaled corticosteroids to experience adverse outcomes.
AHRQ-funded; HS019669
Citation: Li L, Vollmer WM, Butler MG .
A comparison of confounding adjustment methods for assessment of asthma controller medication effectiveness.
Am J Epidemiol. 2014 Mar 1;179(5):648-59. doi: 10.1093/aje/kwt323..
Keywords: Comparative Effectiveness, Outcomes, Children/Adolescents, Asthma, Medication
Kuzniewicz MW, Wickremasinghe AC, Newman TB
Invited commentary: does neonatal hyperbilirubinemia cause asthma?
The researchers examined whether an association between neonatal total serum bilirubin levels and childhood asthma is causal. They found that the results do not appear to be due to chance or any obvious biases. It is likely that the observed association is the result of a common cause of both hyperbilirubinemia and asthma confounding. Polymorphisms in the glutathione S-transferase gene are a potential genetic confounder.
AHRQ-funded; HS020618
Citation: Kuzniewicz MW, Wickremasinghe AC, Newman TB .
Invited commentary: does neonatal hyperbilirubinemia cause asthma?
Am J Epidemiol 2013 Dec 15;178(12):1698-701. doi: 10.1093/aje/kwt249..
Keywords: Asthma, Children/Adolescents, Children/Adolescents
Nkoy FL, Stone BL, Fassl BA
Longitudinal validation of a tool for asthma self-monitoring.
The purpose of this study was to show longitudinal validation of a new tool, the Asthma Symptom Tracker (AST). The study established longitudinal validation of the AST, a novel tool designed for use by children or their parents to facilitate ongoing monitoring of patients’ asthma symptoms and proactive medical decision-making to prevent acute exacerbations.
AHRQ-funded; HS018166; HS018678.
Citation: Nkoy FL, Stone BL, Fassl BA .
Longitudinal validation of a tool for asthma self-monitoring.
Pediatrics 2013 Dec;132(6):e1554-61. doi: 10.1542/peds.2013-1389..
Keywords: Asthma, Children/Adolescents, Chronic Conditions, Shared Decision Making, Patient Self-Management
Sarpong EM, Miller GE
AHRQ Author: Sarpong EM, Miller GE
Racial and ethnic differences in childhood asthma treatment in the United States.
The authors examined racial-ethnic differences in asthma controller medication use among insured U.S. children. They found that non-Hispanic black and Hispanic children were less likely to use controllers than non-Hispanic white children. They concluded that the large observed differences in controller use highlight the continuing challenges of ensuring that all U.S. children have access to quality asthma care.
AHRQ-authored.
Citation: Sarpong EM, Miller GE .
Racial and ethnic differences in childhood asthma treatment in the United States.
Health Serv Res 2013 Dec;48(6 Pt 1):2014-36. doi: 10.1111/1475-6773.12077.
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Keywords: Asthma, Children/Adolescents, Medical Expenditure Panel Survey (MEPS), Medication, Racial and Ethnic Minorities