Chronic Care

Research Findings

Research Activities, August 2008:
Family medicine physicians suggest ways to improve management of chronic pain in primary care patients
Direct-to-consumer advertising of antidepressants aims to increase pool of users
Individuals with more depressive symptoms are more likely to benefit from training in chronic illness self-management
Low-income adults with physical disabilities face transportation, accessibility, and privacy barriers

Research Activities, July 2008:
Urban, low-income adults with high blood pressure are reasonably knowledgeable about their condition
Quality of care for patients with coronary heart disease is not strongly influenced by medical practice characteristics
Most American adults have at least one chronic medical condition
New toolkit can help improve care for patients with chronic care conditions

Research Activities, June 2008:
Patient factors, not physician or clinic factors, account for most of the variance in blood sugar levels among adults with diabetes
Severe memory impairment substantially reduces employability of persons with systemic lupus erythematosus

Research Activities, May 2008:
Physicians could improve end-of-life communication and decision-making for elderly patients with advanced heart failure
Studies examine disease self-management and quality of life of individuals with multiple chronic illnesses
Patients with diabetes have better glucose control when they receive care at primary care clinics that adhere to the chronic care model

Research Activities, April 2008:
Work-sponsored weight management programs offer losses for employees and gains for employers

Research Activities, March 2008:
Parents of hospitalized children with chronic illnesses report fewer care-related problems than other parents
Patients with diabetes and depression tend to skip self-care behaviors that would help keep their diabetes in check
Sensitization to indoor allergens is not linked to increased asthma problems among inner-city adults
Varied regional rates of chronic obstructive pulmonary disease episodes may be due to medical system factors
Hospitalists can reduce hospital stays and costs for children with common pediatric conditions like asthma

Research Activities, February 2008:
Study of young Head Start children links overweight to worsened asthma

Research Activities, January 2008:
Antibiotics to prevent children's recurrent urinary tract infections have unclear benefits and potential risks
Informal caregiving for survivors of critical illness takes a toll on the health and lifestyle of caregivers

Research Activities, December 2007:
Common medications provide equal blood pressure control
Treatments for pediatric Crohn's disease cases vary widely in North America
Primary care practices face competing demands, not clinical inertia, in providing quality care to patients with diabetes
Severe food insecurity among low-income adults is linked to an increased rate of diabetes
Adults with food allergies tend to have more severe asthma

Research Activities, November 2007:
Premature infants with chronic lung disease can be safely cared for by community-based providers coordinating with a nurse specialist
Postdischarge care management that integrates medical and social care can improve outcomes of the low-income elderly
Cancer and other chronic conditions affect patients' lives differently during various phases of care
Low income middle-aged Americans have higher 10-year death rates even after controlling for their worse health at baseline
California Medicaid managed care plans would like to increase chronic disease care management programs
Patients who were uninsured use more medical services once they enroll in Medicare

Research Activities, October 2007:
Studies funded by AHRQ's Primary Care Practice-Based Research Networks (PBRNs) identify ways to improve patient care and report medical errors
Elderly blacks' higher hospitalization rates for certain conditions suggest worse quality of outpatient care
Studies examine medication adherence and group medical visits among persons with high blood pressure
One-third of patients with acute coronary syndrome and diabetes do not have their blood sugar assessed before hospital discharge

Research Activities, September 2007:
Children with complex chronic conditions are more likely to die in their homes than in the hospital
Parents of children with cancer are overly optimistic about a cure, but not about other outcomes of cancer therapy

Research Activities, August 2007:
Pediatricians recognize most overweight or obese children without using proportional weight curves
How well dialysis patients view their current health at the start of hemodialysis is related to subsequent outcomes and utilization
Patients infected with both HIV and hepatitis C virus lose more weight than those with only one of the infections
Medication therapy management programs varied widely after initial implementation of the Medicare Part D drug benefit
Socioeconomically disadvantaged patients with lupus have less access to and use of health care

Research Activities, July 2007:
While most diabetes drugs provide similar glucose control, some offer important advantages
Infliximab is a safe and effective therapeutic option for children with sever ulcerative colitis
Studies examine the impact of rheumatic diseases on the ability to work
Patients suffering from arthritis or depression may have worse health-related quality of life than those with other chronic conditions

Research Activities, June 2007:
Information about health plans should be tailored to meet the diverse needs of people with disabilities
Parents prefer as much information as possible about the prognosis of their child's cancer
The State Children's Health Insurance Program can improve care access, use, and quality for children with special health care needs and adolescents
A managed care model and care coordination can reduce emergency department use among children with special health care needs
Better outpatient care processes can improve the quality of life for patients with chronic disease
Patients find it difficult to adhere to warfarin therapy even when monitored at anticoagulation clinics

Research Activities, April 2007:
Community health centers provide poorer quality of care to the uninsured with chronic disease

Research Activities, March 2007:
Efforts to improve chronic disease management quality yield better care delivery but not better intermediate outcomes
Stimulation of the subthalamic nucleus of the brain improves quality of life for patients with advanced Parkinson's disease
One-third of U.S. veterans suffer from arthritis, perhaps due to orthopedic injuries sustained in the military

Research Activities, January 2007:
Depression worsens the health and quality of life of people with diabetes
Most quality improvement strategies produce only small to modest improvements in glycemic control among patients with diabetes
People with significant health needs or barriers to care access are more likely to use the Internet for health information

Research Activities, December 2006:
Older American Indians often have a poorer view of their own health than their doctors
Journal supplement reviews evidence for the efficacy of telemedicine and telecare

Research Activities, November 2006:
HMOs do not appear to adversely affect the health of the near-elderly and may benefit those with chronic health conditions

Research Activities, October 2006:
Prescription drug benefits limits for Medicare beneficiaries are associated with less use of prescription drugs, worse clinical outcomes, and higher hospitalization costs
Patients with more chronic conditions increase hospital costs

Research Activities, July 2006:
Primary care of patients with type 2 diabetes can be improved

Research Activities, June 2006:
A year after leaving jail, half of women lack health insurance or use primary care
Even modest rates of physical activity can improve the functioning of middle-age adults with arthritis

Research Activities, May 2006
Ethnicity, age, and living arrangements affect the use of assistive devices by people with impaired mobility

Research Activities, March 2006
Minority children living in public housing are more likely to suffer from chronic health problems
Better communication and coordination of care could reduce frustration experienced by patients with chronic diseases

Research Activities, February 2006:
Changes in the delivery of care are needed to reduce the burden of diabetes among ethnic minorities
People with diabetes take less diabetes medication when costs increase

Research Activities, January 2006:
Cognitive behavioral therapy offers adolescents with depression some benefit over treatment with antidepressants alone
Individual characteristics, complications, and treatments influence quality of life among adults with diabetes
Few cardiology fellowship programs offer advanced congenital heart disease training

Research Activities, December 2005:
Studies examine barriers to self-management for patients with chronic illness and interventions that improve care

Research Activities, October 2005:
Telephone advice on how to manage eating behavior can improve adherence to a cholesterol-lowering diet
Osteoarthritis impairs recovery from stroke
White patients are more likely than black patients to receive opioids to relieve chronic nonmalignant pain
The type of dialysis used by patients with end-stage renal disease may affect their survival
Study highlights the training and practices of licensed acupuncturists

Research Activities, September 2005:
Medical groups want to improve chronic disease care but many feel constrained by limited resources and lack of financial incentives
Certain factors predict chronic pelvic pain after pelvic inflammatory disease
Collaboration between gastroenterologists and pharmacists improves the management of patients with chronic acid-related symptoms

Research Activities, August 2005:
Few adolescents with special health care needs receive adequate transition from pediatric to adult-oriented health care
Certain managed care organization characteristics can increase specialty care use among chronically ill low-income children
Patients' beliefs are not an important barrier to effective pain management

Research Activities, June 2005:
Veterans Health Administration clinics provide better overall quality of care than many other sites
Poor diets of urban men with paraplegia underscore the importance of screening these patients for chronic diseases

Research Activities, May 2005:
Rates of coronary angiography are inappropriately low in older cardiac patients who have chronic kidney disease

Research Activities, April 2005:
Dialysis patients are more likely to accept a higher dose of dialysis than to switch dialysis mode to increase survival

Research Activities, March 2005:
Preventing diabetes complications could save $2.5 billion annually
Significant exposure to tobacco smoke and underuse of controller medications exacerbate asthma symptoms among Head Start children
Primary care providers miss opportunities during office visits for adult preventive care

Research Activities, February 2005:
People with diabetes who have chronic hyperglycemia are at increased risk for cardiovascular disease
Organizational research can help clinicians make decisions about staff and IT systems

Research Activities, January 2005:
Many chronic diseases and mental disorders that affect adults have their roots in childhood
Elderly people who lack prescription drug coverage may not get needed medications for chronic conditions

Research Activities, December 2004:
Researchers identify features of primary care practice that enhance the quality of pediatric asthma care
Experts focus on prognosis, symptom management, and supportive care for patients with advanced heart failure

Research Activities, November 2004:
About 13 percent of U.S. children and 26 percent of those with disabilities or chronic illness see a specialist in a year

Research Activities, September 2004:
Many diabetes patients at high risk for kidney failure are not receiving medication to slow its development

Research Activities, July 2004:
Most people who have chronic fatigue syndrome are underemployed or unemployed, and some can be considered disabled