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Research Studies is a compilation of published research articles funded by ´óÏóAPPor authored by ´óÏóAPPresearchers.

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1 to 25 of 737 Research Studies Displayed
Reedy J, Thompson T, Begum A
Challenges of managing pediatric polypharmacy in a pediatric complex care program: a qualitative pilot study.
This study assessed the results of an intervention to comprehensively manage pediatric polypharmacy. The authors conducted the intervention at a large outpatient pediatric complex care program for children with medical complexity (CMC). They sought to understand 1) how pediatric polypharmacy is managed by a multidisciplinary team, 2) associated challenges, and 3) opportunities for improvement. They interviewed 16 clinicians representing prescribing (n=9) and non-prescribing (n=7) clinicians. Three overarching themes emerged from these interviews: 1) pediatric polypharmacy poses unique safety risks for CMC; 2) polypharmacy management requires careful collaboration between distinct clinical roles to accomplish numerous medication-related tasks; and 3) multiple prescribers across subspecialties complicates polypharmacy management, including challenges in identifying responsibility for certain medications.
AHRQ-funded; HS028979.
Citation: Reedy J, Thompson T, Begum A . Challenges of managing pediatric polypharmacy in a pediatric complex care program: a qualitative pilot study. J Am Pharm Assoc 2025 Jul-Aug; 65(4):102391. doi: 10.1016/j.japh.2025.102391..
Keywords: Children/Adolescents, Medication, Chronic Conditions, Medication: Safety, Patient Safety, Adverse Drug Events (ADE), Adverse Events
Morrow EL, Spieker AJ, Greevy RA
Demographic, clinical, psychosocial, and behavioral predictors of continuous glucose monitor use in adults with type 2 diabetes.
This study examined demographic, clinical, psychosocial, and behavioral predictors of continuous glucose monitors (CGM) use in adults with type 2 diabetes. The authors conducted a longitudinal observational study comprised of a secondary analysis of data collected in a larger trial with 245 community-dwelling adults with type 2 diabetes recruited from primary care. Over a 15-month period, 37.1% of participants started CGM. Predictors in bivariate models included younger age, higher socioeconomic status, insulin use, higher HbA1c, and more diabetes distress. Using a single multivariable model, only younger age, insulin use, and higher socioeconomic status were significant predictors. Neither diabetes self-care behaviors nor diabetes self-efficacy significantly predicted CGM use. Of participants who tried a CGM, 14.3% stopped, with cost being the most-cited reason.
AHRQ-funded; HS026122.
Citation: Morrow EL, Spieker AJ, Greevy RA . Demographic, clinical, psychosocial, and behavioral predictors of continuous glucose monitor use in adults with type 2 diabetes. J Gen Intern Med 2025 May; 40(6):1333-39. doi: 10.1007/s11606-024-09101-1.
Keywords: Diabetes, Chronic Conditions, Patient Self-Management
Plombon S, Rudin RS, Rodriguez J
Real-time symptom monitoring using electronic patient-reported outcomes: a prospective study protocol to improve safety during care transitions for patients with multiple chronic conditions.
The authors developed and validated a prediction model of postdischarge adverse events using validated symptoms, patient-reported outcomes, and electronic health record data. This intervention may enable timely detection of harm for patients with multiple chronic conditions during transitions from hospitals to ambulatory settings. A randomized controlled trial will be conducted to compare the effect of this intervention versus usual care.
AHRQ-funded; HS028662.
Citation: Plombon S, Rudin RS, Rodriguez J . Real-time symptom monitoring using electronic patient-reported outcomes: a prospective study protocol to improve safety during care transitions for patients with multiple chronic conditions. J Hosp Med 2025 May; 20(5):534-43. doi: 10.1002/jhm.70013.
Keywords: Chronic Conditions, Patient Safety, Electronic Health Records (EHRs), Health Information Technology (HIT), Transitions of Care
Treadwell JR, Tsou AY, Rouse B
Behavioral interventions for migraine prevention: a systematic review and meta-analysis.
This systematic review and meta-analysis synthesized evidence on the benefits and harms of behavioral interventions for migraine prevention in children and adults. An expert panel was convened to review the literature. For adults, they found that any of three components (CBT, relaxation training, mindfulness-based therapies) may reduce migraine/headache attack frequency (strength of evidence (SOE): low). SOE was also low for education alone that targets behavior although it may improve migraine-related disability. They also found that mindfulness-based therapies may reduce migraine disability more than education, and relaxation + education may improve migraine-related quality of life more than propranolol (SOE: low). For children/adolescents, they included 13 trials (16 publications, N = 1444 children), but the evidence was only sufficient to conclude that CBT + biofeedback + relaxation training may reduce migraine attack frequency and disability more than education alone (SOE: low).
AHRQ-funded; 75Q80120D00002.
Citation: Treadwell JR, Tsou AY, Rouse B . Behavioral interventions for migraine prevention: a systematic review and meta-analysis. Headache 2025 Apr; 65(4):668-84. doi: 10.1111/head.14914..
Keywords: Chronic Conditions, Neurological Disorders, Prevention, Evidence-Based Practice, Behavioral Health
McMenamin A, Turi E, Liu J
Nurse practitioner care environments and provider shortages among patients with multiple chronic conditions.
This study examined the effect of nurse practitioners (NPs) care environments on the relationship between health professional shortage area (HPSA) status and hospitalizations or emergency department visits among patients with multiple chronic conditions (MCCs). Researchers analyzed merged Medicare claims, NP survey data, and Health Resources and Services Administration data of Medicare beneficiaries aged 65 or over with at least two chronic conditions. Results indicated that NP care environments moderate the association between HPSA status and hospitalization, but not emergency department use.
AHRQ-funded; HS02943.
Citation: McMenamin A, Turi E, Liu J . Nurse practitioner care environments and provider shortages among patients with multiple chronic conditions. Res Nurs Health 2025 Apr; 48(2):271-80. doi: 10.1002/nur.22446..
Keywords: Chronic Conditions, Workforce, Provider: Clinician
Chokkara S, Hermsen MG, Bonomo M
Comparison of chart review and administrative data in developing predictive models for readmissions in chronic obstructive pulmonary disease.
This research compared machine learning models for predicting COPD patient readmissions using either administrative data or chart review data. Analyzing 4,327 patient encounters at the University of Chicago Medicine, researchers developed two random forest models to predict 90-day readmission risk following acute COPD exacerbations. Data was split 70/30 for training and validation. Despite different data sources, both models showed similar predictive accuracy (administrative data AUC = 0.67, chart review AUC = 0.64). These findings suggest administrative data, though less precise for identifying COPD admissions, may offer a more efficient alternative to labor-intensive chart reviews when developing readmission prediction tools.
AHRQ-funded; HS027804.
Citation: Chokkara S, Hermsen MG, Bonomo M . Comparison of chart review and administrative data in developing predictive models for readmissions in chronic obstructive pulmonary disease. Chronic Obstr Pulm Dis 2025 Mar 27; 12(2):175-83. doi: 10.15326/jcopdf.2024.0542..
Keywords: Hospital Readmissions, Chronic Conditions, Respiratory Conditions, Health Information Technology (HIT)
Davis J, Perkins R, Bailey J
Acceptability of telehealth post-pandemic among clinicians across the United States caring for people with cystic fibrosis.
The purpose of this study was to assess the endurance of clinicians’ positive perceptions of the use of telehealth by cystic fibrosis center providers after the pandemic. The study found that Clinicians largely continued to support telehealth for cystic fibrosis care post-pandemic, citing convenience and reduced disruptions despite decreased provider satisfaction compared to pandemic levels.
AHRQ-funded; HS000063.
Citation: Davis J, Perkins R, Bailey J . Acceptability of telehealth post-pandemic among clinicians across the United States caring for people with cystic fibrosis. Pediatr Pulmonol 2025 Feb; 60(2):e70000. doi: 10.1002/ppul.70000..
Keywords: Telehealth, Health Information Technology (HIT), Chronic Conditions
Narindrarangkura P, Dejhansathit S, Khan U
Developing and evaluating SEE-Diabetes: a patient-centered educational decision support system for diabetes care.
This feasibility study evaluated the effectiveness of Support-Engage-Empower-Diabetes (SEE-Diabetes), a patient-centered educational tool that was designed to promote shared decision-making for diabetes management in older adults. SEE-Diabetes showed considerable promise in improving interactions between patients and providers and presented an innovative approach to diabetes management for older adults.
AHRQ-funded; HS028032.
Citation: Narindrarangkura P, Dejhansathit S, Khan U . Developing and evaluating SEE-Diabetes: a patient-centered educational decision support system for diabetes care. J Eval Clin Pract 2025 Feb; 31(1):e14234. doi: 10.1111/jep.14234.
Keywords: Diabetes, Patient-Centered Healthcare, Chronic Conditions, Shared Decision Making, Patient and Family Engagement, Patient Self-Management
Perry LM, Mohindra NA, Coughlin A
Implementation of patient-reported outcome dashboards within the electronic health record to support shared decision-making in serious chronic illness.
This pilot study verified the clinical feasibility of an electronic health record-integrated, patient-reported outcomes dashboard for advanced cancer and chronic kidney disease. In the 6-month post-visit survey, patients endorsed the dashboard's acceptability and appropriateness. Study results also indicated areas for improvement, including strategies that supported patient and clinician engagement.
AHRQ-funded; HS026385.
Citation: Perry LM, Mohindra NA, Coughlin A . Implementation of patient-reported outcome dashboards within the electronic health record to support shared decision-making in serious chronic illness. BMJ Open Qual 2025 Jan 11; 14(1). doi: 10.1136/bmjoq-2024-002837..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Shared Decision Making, Chronic Conditions, Patient-Centered Healthcare, Patient-Centered Outcomes Research
Le P, Tatar M, Dasarathy S
Estimated burden of metabolic dysfunction-associated steatotic liver disease in US adults, 2020 to 2050.
The objective of this analytical modeling study was to project the burden of metabolic dysfunction-associated steatotic liver disease (MASLD) in U.S. adults from 2020 to 2050. The model forecast a substantial increase in clinical burden of MASLD over the next three decades in the absence of effective treatments.
AHRQ-funded; HS026937.
Citation: Le P, Tatar M, Dasarathy S . Estimated burden of metabolic dysfunction-associated steatotic liver disease in US adults, 2020 to 2050. JAMA Netw Open 2025 Jan 2; 8(1):e2454707. doi: 10.1001/jamanetworkopen.2024.54707..
Keywords: Healthcare Costs, Chronic Conditions
Cheng AL, DeFranco AR, Furman M
Shared medical appointments to improve equitable access to rehabilitative care for Long COVID.
The purpose of this study was to present an innovative approach using Shared Medical Appointments (SMAs) to improve equitable access to rehabilitative care for Long COVID patients. While rehabilitative care is crucial for managing Long COVID symptoms and functional impairments, many patients face financial barriers to accessing individual therapy sessions, particularly those with Medicaid or safety net insurance plans. The researchers developed a six-session SMA curriculum covering physical activity, daily living activities, and cognitive-communication functions. The program includes functional assessment, goal-setting, rehabilitation strategies, and troubleshooting implementation challenges.
AHRQ-funded; HS029911.
Citation: Cheng AL, DeFranco AR, Furman M . Shared medical appointments to improve equitable access to rehabilitative care for Long COVID. Cardiopulm Phys Ther J 2025 Jan; 36(1):50-57. doi: 10.1097/cpt.0000000000000266.
Keywords: COVID-19, Chronic Conditions, Access to Care
Encinosa W, Bernard D, Valdez RB
´óÏóAPPAuthor: Encinosa W, Bernard D, Valdez RB
The association between smoking, chronic pain, and prescription opioid use: 2013-2021.
This study examined relationships between smoking, chronic pain, and prescription opioid use using nationally representative data from 36,796 adults. Though smokers constituted only 16% of the population, they accounted for 30% of all opioid prescriptions and 40% of total Morphine Milligram Equivalents (MME), with 1% of the population—smokers with severe work limitations due to pain—using 20% of all MMEs. Compared to never-smokers, smoking adults were 24% more likely to report chronic pain and, among those with pain, had 46% higher risk of starting opioids and 6.6 times higher risk of continuing opioids the following year. Notably, individuals who quit smoking experienced 20% reduced opioid use and 7% pain reduction within one year, suggesting significant benefits from integrating smoking cessation into pain management programs.
AHRQ-authored.
Citation: Encinosa W, Bernard D, Valdez RB . The association between smoking, chronic pain, and prescription opioid use: 2013-2021. J Pain 2025 Jan; 26:104707. doi: 10.1016/j.jpain.2024.104707..
Keywords: Medical Expenditure Panel Survey (MEPS), Tobacco Use, Chronic Conditions, Opioids, Substance Abuse, Behavioral Health
Warnick JL, Darling KE, Swartz Topor L
Barriers to healthy behaviors: perspectives from teens with comorbid type 1 diabetes and overweight/obesity, caregivers, and pediatric endocrinologists.
This study’s objective was to understand barriers to engaging in healthy lifestyle behaviors among adolescents with comorbid Type 1 diabetes (T1D) and overweight/obesity, their caregivers, and pediatric endocrinologists. Participants completed individual, semi-structured interviews. The results revealed three thematic barriers to healthy lifestyle behaviors and identified perceived limitations to engaging in recommended healthy behaviors concurrent with diabetes management.
AHRQ-funded; HS02707.
Citation: Warnick JL, Darling KE, Swartz Topor L . Barriers to healthy behaviors: perspectives from teens with comorbid type 1 diabetes and overweight/obesity, caregivers, and pediatric endocrinologists. J Pediatr Psychol 2024 Dec; 49(12):874-81. doi: 10.1093/jpepsy/jsae086..
Keywords: Children/Adolescents, Diabetes, Chronic Conditions, Obesity, Caregiving
McKenna KJ, Fiori KP, Chambers EC
Children with chronic health conditions and social needs: investigating outcomes to drive health system improvements.
Researchers used logistic regression to evaluate chronic health conditions diagnoses in this cross-sectional study of pediatric patients screened for social needs in an urban health system. Results indicated that children with autism/developmental delay were most likely to have a social need; children with autism/developmental delay, anxiety/depression, and asthma were most likely to report specific social needs. The researchers concluded that health systems should screen for these needs to improve health outcomes.
AHRQ-authored; HS026396.
Citation: McKenna KJ, Fiori KP, Chambers EC . Children with chronic health conditions and social needs: investigating outcomes to drive health system improvements. Clin Pediatr 2024 Dec; 63(12):1698-707. doi: 10.1177/00099228241241896.
Keywords: Children/Adolescents, Chronic Conditions, Social Determinants of Health, Health Systems, Outcomes
Encinosa W, Bernard D, Valdez RB
´óÏóAPPAuthor: Encinosa W, Bernard D, Valdez RB
Heavy versus light smoking: its association with opioid use, chronic pain, and mental health.
This AHRQ-authored paper presents the connection between heavy vs. light smoking and the opioid epidemic. The authors used the 2013-2021 MEPS linked to the National Health Interview Survey with 81,400 adult years to estimate the impact of heavy vs. light smoking on opioid use, chronic pain, work limitations due to pain, and poor mental health. They found that only 37% of the population has ever smoked, but they used 69% of the nation's annual prescription opioids. Adults who smoked more than 5 cigarettes a day only comprised 12% of the population but used about the same number of opioids as the 63% of the population who never smoked. Adults who formerly smoked used 16% fewer opioids than adults who currently smoked. The percent with chronic pain during the year varied from 12.2% for adults who never smoked to 14.2% for light smoking, to 16.5% for those smoking more than a pack a day. Severe work limitations due to pain varied from 7.3% for adults who never smoked to 16.9% for those smoking more than a pack a day. Adults smoking more than a pack a day were twice as likely to report fair or poor mental health compared to those who never smoked.
AHRQ-funded; HS000063.
Citation: Encinosa W, Bernard D, Valdez RB . Heavy versus light smoking: its association with opioid use, chronic pain, and mental health. Am J Prev Med 2024 Dec; 67(6):859-66. doi: 10.1016/j.amepre.2024.07.010.
Keywords: Tobacco Use, Pain, Chronic Conditions, Behavioral Health
Nasrallah C, Schmajuk G, Hamblin A
Leveraging the Consolidated Framework for Implementation Research to develop the American College of Rheumatology's Toolkit for Implementation of Rheumatoid Arthritis Outcome Measures in Clinical Practice: a qualitative study.
The authors conducted semi-structured interviews with rheumatologists and practice personnel to identify critical gaps in collecting rheumatoid arthritis (RA) outcome measures. With the findings from these interviews, they developed the RA Measures Toolkit, which featured guidelines, best practices, and educational resources to improve the efficiency of workflows and to enhance patient care.
AHRQ-funded; HS025638.
Citation: Nasrallah C, Schmajuk G, Hamblin A . Leveraging the Consolidated Framework for Implementation Research to develop the American College of Rheumatology's Toolkit for Implementation of Rheumatoid Arthritis Outcome Measures in Clinical Practice: a qualitative study. Arthritis Care Res 2024 Dec; 76(12):1647-56. doi: 10.1002/acr.25410.
Keywords: Arthritis, Chronic Conditions, Implementation, Outcomes, Patient-Centered Outcomes Research, Evidence-Based Practice
Morrow EL, Nelson LA, Duff MC
An ecological momentary assessment and intervention tool for memory in chronic traumatic brain injury: development and usability of memory ecological momentary intervention.
This study aimed to develop and test the usability of memory ecological momentary intervention (MEMI), a text message-based assessment and intervention tool for memory in daily life for patients suffering from memory loss due to traumatic brain injury (TBI). The authors developed MEMI by recruiting 14 adults with chronic, moderate-severe TBI from the Vanderbilt Brain Injury Patient Registry to participate in 3 rounds of usability testing: one round of ThinkAloud sessions using the platform and providing real-time feedback to an experimenter (n=4) and 2 rounds of real-world usability testing in which participants used MEMI in their daily lives for a week and provided feedback (n=5/round). They analyzed engagement and quantitative and qualitative user feedback to assess MEMI's usability and acceptability. Participants rated MEMI as highly usable, with scores on the System Usability Scale across all rounds equivalent to an A+ on a standardized scale. Semi-structured interviews were conducted, where participants stated that MEMI was simple and easy to use, that daily retrieval sessions were not burdensome, and that they perceived MEMI as helpful for memory.
AHRQ-funded; HS026122.
Citation: Morrow EL, Nelson LA, Duff MC . An ecological momentary assessment and intervention tool for memory in chronic traumatic brain injury: development and usability of memory ecological momentary intervention. JMIR Rehabil Assist Technol 2024 Nov 26; 11:e59630. doi: 10.2196/59630.
Keywords: Brain Injury, Trauma, Chronic Conditions
Morrow EL, Duff MC
Sleep disruption persists and relates to memory disability after traumatic brain injury: a cross-sectional study of adults in the chronic phase of injury.
The objective of this study was to examine sleep disruption in chronic traumatic brain injury (TBI) across 3 aims. Community-dwelling participants completed self-report sleep and memory surveys as part of their participation in a larger patient registry. Their responses indicated that individuals with TBI had significantly higher rates of sleep disruption than those without TBI; exploratory analysis also indicated that sleep disruption was related to memory failure in daily life in the TBI sample.
AHRQ-funded; HS026122.
Citation: Morrow EL, Duff MC . Sleep disruption persists and relates to memory disability after traumatic brain injury: a cross-sectional study of adults in the chronic phase of injury. J Head Trauma Rehabil 2024 Nov-Dec; 39(6):E543-e49. doi: 10.1097/htr.0000000000000957.
Keywords: Sleep Problems, Brain Injury, Chronic Conditions, Neurological Disorders
Aguilera A, Arévalo Avalos M, Xu J
Effectiveness of a digital health intervention leveraging reinforcement learning: results from the Diabetes and Mental Health Adaptive Notification Tracking and Evaluation (DIAMANTE) randomized clinical trial.
A digital health study examined whether individualized text messages guided by reinforcement learning could boost physical activity among adults with diabetes and depression symptoms. Between January 2020 and June 2022, participants were recruited from four San Francisco clinics and online venues, then randomly divided into three groups: one receiving a weekly mood message, another receiving randomly assigned daily messages, and an adaptive group whose daily texts were tailored using reinforcement learning. Over the 24-week study, the adaptive group’s daily step counts increased, while control and random messaging groups showed smaller gains or declines, including individuals recruited both in person and online.
AHRQ-funded; HS025429.
Citation: Aguilera A, Arévalo Avalos M, Xu J . Effectiveness of a digital health intervention leveraging reinforcement learning: results from the Diabetes and Mental Health Adaptive Notification Tracking and Evaluation (DIAMANTE) randomized clinical trial. J Med Internet Res 2024 Oct 8; 26:e60834. doi: 10.2196/60834..
Keywords: Diabetes, Behavioral Health, Health Information Technology (HIT), Patient Self-Management, Chronic Conditions
Watson BN, Estenson L, Eden AR
´óÏóAPPAuthor: Eden AR, Gerstein MT, Dotson VM, Bierman AS
Person-centered care planning for people living with or at risk for multiple chronic conditions.
This AHRQ-authored paper analyzed the comments received after an ´óÏóAPPRequest for Information (RFI) published in the Federal Register on person-centered care planning (PCCP) for people living with or at risk for multiple chronic conditions (MCC). Comments were received between September 16, 2022, and November 15, 2022. A total of 58 comments were received, including clinicians, researchers, patients, caregivers, and representatives from health care payer, practitioner, health system, advocacy, professional, and supporting nonprofit and industry organizations. The authors identified 9 themes: (1) suboptimal quality of care; (2) person-centered, goal-concordant care; (3) multidisciplinary team-based care and care coordination; (4) prevention across the life course; (5) digital health solutions; (6) workflow; (7) education and self-management support; (8) payment; and (9) achieving community, health system, and payer goals.
AHRQ-authored.
Citation: Watson BN, Estenson L, Eden AR . Person-centered care planning for people living with or at risk for multiple chronic conditions. JAMA Netw Open 2024 Oct; 7(10):e2439851. doi: 10.1001/jamanetworkopen.2024.39851.
Keywords: Patient-Centered Healthcare, Chronic Conditions, Risk
Williams FS, Garofalo R, Karnik NS
Universal substance use care for adolescents with chronic medical conditions: a protocol to examine equitable implementation determinants and strategies for SBIRT at a pediatric hospital.
A research protocol explores implementing Screening, Brief Intervention, and Referral to Treatment services for adolescents with chronic medical conditions in pediatric hospitals. The study highlights that these youth face equal or greater substance use risks compared to peers, with notable rates of alcohol and marijuana use. Using implementation science frameworks, the research aims to identify factors affecting program adoption through interviews and focus groups with hospital staff, patients, and caregivers. The study emphasizes health equity considerations in developing implementation strategies.
AHRQ-funded; HS026385.
Citation: Williams FS, Garofalo R, Karnik NS . Universal substance use care for adolescents with chronic medical conditions: a protocol to examine equitable implementation determinants and strategies for SBIRT at a pediatric hospital. Addict Sci Clin Pract 2024 Sep 11; 19(1):67. doi: 10.1186/s13722-024-00492-4..
Keywords: Children/Adolescents, Substance Abuse, Behavioral Health, Chronic Conditions, Hospitals, Implementation
McMenamin A, Turi E, Dixon J
Acute care use among patients with multiple chronic conditions receiving care from nurse practitioner practices in health professional shortage areas.
This study’s purpose was to examine differences in hospitalization and emergency department use among patients with multiple chronic conditions who receive care from practices that employ nurse practitioners in health professional shortage areas compared to practices that employ nurse practitioners in non-health professional shortage areas. The authors performed an analysis of Medicare claims, merged with Health Resources and Services Administration data on health professional shortage area status in five states. Their sample included 394,424 community-dwelling Medicare beneficiaries aged ≥65 years, with at least two of 15 common chronic conditions who received care in 779 practices that employ nurse practitioners. They used logistic regression to assess the relationship between health professional shortage area status and emergency department visits or hospitalizations. They found a higher likelihood of emergency department visits among patients in health professional shortage areas compared to those in non-health professional shortage areas and no difference in the likelihood of hospitalization.
AHRQ-funded; HS029435.
Citation: McMenamin A, Turi E, Dixon J . Acute care use among patients with multiple chronic conditions receiving care from nurse practitioner practices in health professional shortage areas. Nurs Res 2024 Sep-Oct; 73(5):E212-e20. doi: 10.1097/nnr.0000000000000758..
Keywords: Chronic Conditions, Medicare, Provider: Nurse
McKernan LC, McGonigle T, Vandekar SN
A randomized-controlled pilot trial of telemedicine-delivered cognitive-behavioral therapy tailored for interstitial cystitis/bladder pain syndrome.
This paper is a randomized controlled trial (RCT) of comprehensive psychological interventions for interstitial cystitis/bladder pain syndrome (IC/BPS) which can cause severe psychological distress. Urological symptoms including those in the Genitourinary Pain Index (GUPI), pain-related symptoms, affective distress, and quality of life were evaluated before, immediately after, and 3 months posttreatment. The authors conducted a 2:1 RCT of an 8-session patient-informed cognitive-behavioral therapy (CBT) intervention designed for IC/BPS for reducing pain-related symptoms and improving quality of life, delivered through telemedicine. Individuals in both groups reported significant but similar reductions in the a priori primary outcome of genitourinary symptoms at posttreatment (GUPI reduction = 6.6 vs 4.8, for CBT and control, respectively) and long-term follow-up (8.1 vs 6.6, for CBT and control). However, the CBT group had significantly greater improvement in Patient Global Impression of Change (PGIC) scores and was significantly more likely to be treatment responders (PGIC ≥ 6) (37% vs 8%), with a large relative effect size (OR = 6.68). A subgroup analysis of CBT recipients showed that responders (PGIC ≥ 6) displayed significant reductions in genitourinary symptoms, pain intensity, and pain interference posttreatment.
AHRQ-funded; HS022990.
Citation: McKernan LC, McGonigle T, Vandekar SN . A randomized-controlled pilot trial of telemedicine-delivered cognitive-behavioral therapy tailored for interstitial cystitis/bladder pain syndrome. Pain 2024 Aug; 165(8):1748-60. doi: 10.1097/j.pain.0000000000003188..
Keywords: Telehealth, Health Information Technology (HIT), Pain, Chronic Conditions
Eddelbuettel JCP, Kennedy-Hendricks A, Meiselbach MK
Changes in healthcare spending attributable to high deductible health plan offer among enrollees with comorbid substance use disorder and cardiovascular disease.
The objective of this study was to examine changes in spending attributable to high deductible health plans (HDHPs) for enrollees with comorbid substance use disorder (SUD) and cardiovascular disease (CVD). Researchers used de-identified administrative claims data from 2007 to 2017 and assessed both total and out-of-pocket (OOP) spending. The findings suggested that HDHPs do not change overall levels of annual spending among enrollees with comorbid CVD and SUD, but may increase the financial burden of healthcare services by raising OOP costs.
AHRQ-funded; HS000029.
Citation: Eddelbuettel JCP, Kennedy-Hendricks A, Meiselbach MK . Changes in healthcare spending attributable to high deductible health plan offer among enrollees with comorbid substance use disorder and cardiovascular disease. J Gen Intern Med 2024 Aug; 39(11):1993-2000. doi: 10.1007/s11606-024-08700-2..
Keywords: Substance Abuse, Cardiovascular Conditions, Healthcare Costs, Behavioral Health, Health Insurance, Chronic Conditions
Rockwell MS, Funk AJ, Huffstetler AN
Screening for unhealthy alcohol use among patients with multiple chronic conditions in primary care.
This study investigated the impact of multiple chronic conditions on screening for unhealthy alcohol use in primary care. Analyzing electronic health records from 67 Virginia practices (2020-2023), the results showed that 58% of 11,789 patients had multiple chronic conditions. While 69% were screened for alcohol use, only 16% used a U.S. Preventive Services Task Force-recommended instrument. Patients with physical and mental health conditions were less likely to receive screening, despite being more likely to screen positive for unhealthy alcohol use. The findings highlight the need for improved alcohol-related preventive services in primary care, especially for patients with complex health issues.
AHRQ-funded; HS027077.
Citation: Rockwell MS, Funk AJ, Huffstetler AN . Screening for unhealthy alcohol use among patients with multiple chronic conditions in primary care. AJPM Focus 2024 Aug; 3(4):100233. doi: 10.1016/j.focus.2024.100233..
Keywords: Screening, Alcohol Use, Chronic Conditions, Primary Care, Substance Abuse, Behavioral Health, U.S. Preventive Services Task Force (USPSTF)

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