Read more about the work that clinicians, patients, and researchers are developing, get resources for you and your patients, and learn how to put new findings into practice. For example, you can learn how a research team empowered the “Marshallese Community in Managing Type 2 Diabetes” project by creating culturally adapted training on type 2 diabetes management.

1. Evidence Updates such as “Daily Blood Sugar Tests May Not Be Beneficial for Some Patients”
   For people with type 2 diabetes, maintaining their blood sugar at a healthy level is important. But checking their blood sugar every day may not help them manage the condition. This PCORI-funded study found people with type 2 diabetes who don’t use insulin did not benefit from daily self-testing. Study participants who checked their blood sugar each day for a year had the same A1c and quality of life as people who didn’t test daily. An Evidence Update is available that can help clinicians and patients work together to make informed decisions regarding patient care.
2. Study results that support informed decisions such as “Developing and Testing a Type 2 Diabetes Education Program Adapted for Marshallese Culture ”
   Read more about the work that clinicians, patients, and researchers are developing, get resources for you and your patients, and learn how to put the new findings into practice. For example, learn how a research team empowered the Marshallese community in managing type 2 diabetes through creating culturally adapted training. The material incorporates knowledge of patients’ backgrounds, cultures, ethnicities, and belief systems to increase their understanding of health topics. PAs can find patient materials, watch videos, learn more about why culturally adapted materials are important, and how the research team implemented the project on the project page for “Developing and Testing a Type 2 Diabetes Education Program Adapted for Marshallese Culture” at PCORI.
3. Find study spotlights such as “Including Patient Traits in Benchmarks for Diabetes Care”
   In “Including Patient Traits in Benchmarks for Diabetes Care,” you can read more about how creating benchmarks that compare quality of care across clinics can help clinicians recognize performance gaps and improve diabetes care. Professional medical organizations recommend using glycemic target goals based on average glycosylated hemoglobin (HbA1c) levels to guide clinical care. Although these goals serve as a benchmark for the average patient, they do not account for patient-specific clinical, demographic, and socioeconomic factors that may affect treatment response. The research team created online benchmark calculators for doctors and patients to compare quality of care across clinics. Doctors can use the results to compare quality of care and inform treatment decisions for diabetes care.What were the results?
   Many traits affected how well patients responded to diabetes treatments, including:
   • Personal traits, such as age, race, ethnicity, education, and income
   • Physical traits, such as blood pressure or HbA1c results before treatment
   • Patients’ quality of life, such as mental stress or how much symptoms affect the patient
   • How satisfied patients were with their treatment

4. Find all of the additional projects related to diabetes such as “Comparing the Safety and Effectiveness of Metformin With Other Medicines for Patients with Type 2 Diabetes and Chronic Kidney Disease”
   In “Comparing the Safety and Effectiveness of Metformin With Other Medicines for Patients With Type 2 Diabetes and Chronic Kidney Disease,” among patients with type 2 diabetes and mild to moderate CKD, metformin appeared to be effective and did not appear to be associated with an increased risk of acidosis or reduction in kidney function.
   You can find all the additional projects PCORI has related to diabetes in one place.

PCORI has curated all of their resources related to mental and behavioral health to support patients, communities, and clinicians to make informed healthcare choices. You can find many materials such as:

1. Evidence Updates such as “Treating Depression in Patients With Kidney Failure Receiving Dialysis”
   Depression is common in people who are on dialysis and can affect kidney health, as well as overall well-being. This PCORI-funded study found that patients with depression who received sertraline, compared with patients with depression who received CBT, had modestly better depression scores and improvements in other patient-reported outcomes – but also reported more frequent mild to moderate adverse events. Two Evidence Updates are available for patient and for clinicians to help them work together to make informed decisions regarding patient care.
2. Study results that supports better informed decisions such as “Testing a Peer-Support Program for Parents of Infants Going Home From the NICU”
   In “Testing a Peer-Support Program for Parents of Infants Going Home From the NICU,” the research team tested a peer navigator program to improve parents’ mental health and confidence in caring for their infants. Peer navigators were parents with experience having a child in the NICU. The team compared parents who were in the peer support program with parents who weren’t in the program. In this study, the parent navigator program and care notebook did not improve parental self-efficacy or mental health, or infant health outcomes more than the care notebook alone.
3. Find study spotlights such as “Comparing Two Telehealth Approaches for Treating Complex Psychiatric Disorders in Primary Care – The SPIRIT Study”
   Federally Qualified Health Centers, or FQHCs, are community clinics that provide primary care in rural and other underserved areas. FQHCs often don’t have enough mental health specialists to treat patients with complex mental health conditions, such as patients with both posttraumatic stress disorder and bipolar disorder.In “Comparing Two Telehealth Approaches for Treating Complex Psychiatric Disorders in Primary Care – The SPIRIT Study,” the research team compared two telehealth approaches for patients with complex mental health conditions who received care at rural clinics. Telehealth is a way to provide care to patients remotely using phone or video calls. The two approaches were:
   • Telepsychiatry collaborative care, or TCC. In TCC, patients met with care managers in person or by phone. Care managers taught patients about their mental health, checked their symptoms, and provided therapy. Care managers also had weekly meetings with off-site mental health doctors to review and adjust patients’ treatment plans. Primary care doctors prescribed all medicines for mental health.
   • Telepsychiatry-enhanced referral, or TER. In TER, patients had video calls at their clinic with an off-site therapist or mental health doctor. Remote therapists provided therapy and remote doctors prescribed medicine to patients who needed it. TER required more time from therapists and mental health doctors than TCC.

   In both approaches, patients first had a video call with a mental health doctor to develop a treatment plan.

   What were the results?
   After one year, patients in both TCC and TER reported that their quality of life, mental health symptoms, and side effects had greatly improved. Patients in TCC and TER didn’t differ in reports of:

   • Quality of life
   • Severity of mental health symptoms
   • Satisfaction with care
   • Access to care
   • Medicine side effects

   Patients didn’t differ in adherence to their mental health medicines.

4. Find all of the additional projects related to mental and behavioral health such “Comparing Two Ways of Combining Behavioral Health Care and Primary Care for Adults”
   In “Comparing Two Ways of Combining Behavioral Health Care and Primary Care for Adults,” an ongoing project, the research team is working with 40 healthcare practices in the United States including family medicine clinics, internal medicine clinics, and community health centers. All of the practices offer basic behavioral-health services at the clinic or nearby (colocation). Half of the practices also receive an intensive program to help them add integrated behavioral health services, including:
   • Online training about integrated behavioral health for behavioral health providers, doctors, nurses, and staff
   • A toolkit to help make integrated behavioral health work at their practice
   • A workbook to help the practice staff change their current processes to help integrated behavioral health run smoothly

   You can find all the additional projects PCORI has related to mental and behavioral health in one place.

PCORI has curated all of their resources related to pain care and opioids to support patients, communities, and clinicians to make informed healthcare choices. You can find many materials such as:

1. Study results that supports better informed decisions such as “Comparing Ways to Treat Back Pain Using a Stratified Risk Approach”
   “Comparing Ways to Treat Back Pain Using a Stratified Risk Approach” aimed to test whether a risk-stratified approach to treatment in primary care settings would result in lower rates of patients with acute back pain developing chronic back pain. To assess chronic pain risk, researchers at the University of Pittsburgh asked patients how they were coping with back pain and assigned them to either low-, medium-, or high-risk groups. Patients who scored high risk were placed into two groups: usual care or usual care plus psychologically informed physical therapy, which also teaches patients coping skills to manage back pain. As reported in EClinical Medicine, among patients at high risk, 50% developed chronic back pain regardless of type of care, while 20% of low-risk and 33% of medium-risk patients developed chronic low back pain. Read more about the study today.
   
2. Find study spotlights such as “Evaluating a Program to Lower Prescription Opioid Doses for Patients With Chronic Pain”
   A network of clinics in Washington State started a program to reduce opioid doses prescribed for patients with chronic pain. The program had two phases:
   • Dose-lowering. Doctors prescribed lower doses of opioids for many patients with chronic pain using opioids long-term. This phase started in 2007.
   • Monitoring. Starting in 2010, clinics increased monitoring of patients taking opioids long-term and created care plans for them. Clinic pharmacies also changed the way patients refilled opioid prescriptions

   In “Evaluating a Program to Lower Prescription Opioid Doses for Patients With Chronic Pain,” the research team wanted to learn if the program reduced the risks that go along with long-term opioid use. The study compared patients who received care at clinics with and without the program. Read more about the study today.

   What were the results?
   Patients who received care at clinics with and without the program had similar:

   • Rates of opioid overdoses
   • Ratings of pain severity
   • Rates of injuries and car crashes

   During the dose-lowering phase, the rate of opioid overdoses decreased at clinics with the program, but not more than it did for clinics without the program. Read more about the study today.

3. Find all of the additional projects related to mental and behavioral health such “Treating Chronic Pain Using Approaches Adapted for Patients With Limited Reading Skills”
   In “Treating Chronic Pain Using Approaches Adapted for Patients With Limited Reading Skills,” the research team compared two types of group treatment with usual care alone. People who got either pain education or CBT along with usual care had less pain than people who had only usual care. They also reported that pain got in the way of doing everyday things less than it did for those who had only usual care. People experienced these improvements slightly more with CBT than with pain education. There were no differences in depression between the groups.You can find all the additional projects PCORI has related to chronic pain in one place.

PCORI has curated all of their resources on obesity to support patients, communities, and clinicians to make informed healthcare choices. You can find many materials such as:

1. Evidence Updates such as “Comparing Two Types of Weight Loss Surgery”
   Bariatric surgery can help people with obesity lose weight and improve problems related to obesity, like diabetes. But surgery can also cause harm, and outcomes may vary across different procedures. A PCORI-funded study compared the benefits and harms of the two most common types of bariatric surgery: Roux-en-Y gastric bypass, or gastric bypass, and sleeve gastrectomy, or sleeve surgery. A pair of Evidence Updates is now available that can help clinicians and patients work together to make informed decisions regarding patient care.
2. Find study spotlights such as “Comparing Ways to Treat People With Obesity in Rural United States”
   People living in rural areas are more likely to have obesity than those living in cities, and they are also less likely to have access to weight loss programs. This PCORI-funded study compared three ways to treat obesity in rural populations: regular in-person clinic sessions, in-person group sessions, and phone-based group sessions. In a paper published January 2021 in JAMA, the study reported that people in the in-person group sessions averaged greater weight loss after 24 months than the other two groups.What were the results?
   After two years, in all three ways, patients lost weight and had improved physical activity, diet, weight-related quality of life, and sleep quality. Compared with in-person visits that were one-on-one, patients who had in-person group visits
   • Lost 1.9 more kilograms (4.2 pounds) and a greater percentage of weight
   • Had greater decreases in triglycerides, or fat levels, in the blood
   • Had greater increases in physical activity

   Patients who had in-person visits that were one-on-one and in-person group visits didn’t differ in

   • Whether patients lost at least 5 or 10% of their weight
   • Blood pressure or cholesterol
   • Quality of life, sleep, or stress
   • Symptoms of anxiety and depression

   Patients who had remote group visits didn’t differ in weight loss or other health outcomes from patients who had in-person group or one-on-one visits.

3. Find all of the additional projects related to obesity such “Testing a Health Coaching Program to Help Patients With Obesity Lose Weight – The PROPEL Study”
   In “Testing a Health Coaching Program to Help Patients With Obesity Lose Weight – The PROPEL Study,” in medically underserved patients, intensive lifestyle intervention delivered by health coaches resulted in clinically significant weight loss maintained at two years and greater improvements in cardiometabolic risk factors and quality of life compared to usual care. Read more about the study today.You can find all the additional projects PCORI has related to obesity in one place.

PCORI has curated all of their resources related to cardiovascular disease to support patients, communities, and clinicians to make informed healthcare choices. You can find many materials such as:

1. Evidence Updates such as “Reducing Risk of Stroke in Patients With Atrial Fibrillation”
   People with atrial fibrillation (AFib) have a higher risk for stroke compared with people who have a normal heart rhythm. Anticoagulants, lower the risk of stroke but can also cause serious bleeding. A recent review of research found that some newer anticoagulants do better at reducing the risk of stroke, and some also reduce the risk of serious bleeding compared to traditional therapies. Two Evidence Updates are available for patients and for clinicians to help them work together to make informed decisions regarding patient care.
2. Study results that supports better informed decisions such as “Aspirin Dosing Study Highlights Benefits, Effectiveness for People With Heart Disease”
   Whether they took a high or low dose of aspirin, people with cardiovascular disease who took aspirin to lower their chances of having a heart attack or stroke experienced similar health benefits according to findings from the PCORI-funded ADAPTABLE Study, the largest aspirin dosing trial conducted in routine care and clinical settings. The results were presented at ACC.21, the American College of Cardiology’s 70th Annual Scientific Session, and simultaneously published in the New England Journal of Medicine.
3. Find study spotlights such as “Comparing the Effectiveness of Home, Clinic, and Kiosk Blood Pressure Checks for Diagnosing High Blood Pressure – The BP-CHECK Study”
   In “Comparing the Effectiveness of Home, Clinic, and Kiosk Blood Pressure Checks for Diagnosing High Blood Pressure – The BP-CHECK Study,” the research team wanted to learn if other methods to check blood pressure worked as well as the 24-hour monitor to diagnose high blood pressure. The team compared the 24-hour monitor with three methods:
   • Clinic: Patients returned to the clinic once and staff checked their blood pressure
   • Home: For five days, patients took their blood pressure at home, twice in the morning and twice at night
   • Kiosk: For three days, patients took their blood pressure three times, a minute apart, at a kiosk in a clinic or pharmacy

   The research team also looked at patient health outcomes after six months.

   What were the results?

   • Overall, the home method had the best results
   • The home and kiosk methods had more accurate readings than the clinic method
   • The clinic method missed high blood pressure more than half of the time
   • At home, more patients checked their blood pressure as planned than at the clinic or kiosk
   • Patients preferred checking their blood pressure at home to the clinic or kiosk

   After six months, across the three methods, patients had lower blood pressure. Patients didn’t differ in how much their blood pressure went down, changes in their physical health, or whether they made lifestyle changes like eating less salt.

   Among patients with high blood pressure according to the 24-hour monitor, only 40% had the diagnosis recorded in their health record six months later.

4. Find all of the additional projects related to cardiovascular disease such as “Comparing Telehealth and Clinic-Based Care for Lowering Uncontrolled High Blood Pressure”
   In “Comparing Telehealth and Clinic-Based Care for Lowering Uncontrolled High Blood Pressure,” the CBC and telehealth care approach safely reduced systolic BP in patients with uncontrolled hypertension. Patients were more satisfied with telehealth care and its convenience.You can find all the additional projects PCORI has related to cardiovascular disease in one place.

PCORI has curated all of their resources related to multiple chronic conditions to support patients, communities, and clinicians to make informed healthcare choices. You can find many materials such as:

1. 1. Study results that supports better informed decisions such as “Patients With Complex Chronic Conditions: Health Care Use and Clinical Events Associated With Access to a Patient Portal”
      For patients with diabetes, many with multiple complex chronic conditions, using a patient portal can support self-management and coordination of health care services, and may impact the frequency of in-person health care visits. In “Patients With Complex Chronic Conditions: Health Care Use and Clinical Events Associated With Access to a Patient Portal,” the research team found that access to a patient portal can increase engagement in outpatient visits, potentially addressing unmet clinical needs, and reduce downstream health events that lead to emergency and hospital care, particularly among patients with multiple complex conditions. You can read the results in PLOS ONE.
   2. Find study spotlights such as “Examining the Effectiveness of Case Management Programs on Preventing Hospital Stays in Older Adults With Multiple Chronic Health Problems – A PCORnet® Study”
      In “Examining the Effectiveness of Case Management Programs on Preventing Hospital Stays in Older Adults With Multiple Chronic Health Problems – A PCORnet® Study,” the research team wanted to find out if having help from case managers kept patients with chronic health problems from going to the ER or hospital. The team compared patients with and without case managers.What were the results?
      A year after patients started getting help from case managers, patients with and without case managers didn’t differ in the number of ER visits or days they stayed in the hospital.
   3. Find all of the additional projects related to multiple chronic conditions such as “Evaluating Different Types of Cancer Survivorship Care”
      In “Evaluating Different Types of Cancer Survivorship Care,” no one type of care performed uniformly better than the others. However, cancer centers can use the results when considering the advantages of different cancer survivorship care alternatives.You can find all the additional projects PCORI has related to multiple chronic conditions in one place.

PCORI has curated all of their resources related to older adults’ health to support patients, communities, and clinicians to make informed healthcare choices. You can find many materials such as:

1. Study results that support better informed decisions such as “Comparing How Two Types of Anesthesia Affect Recovery From Hip Fracture Surgery – The REGAIN Trial”
   Every year, many of the 250,000 people who have surgery for hip fracture in the United States receive general anesthesia, but the use of regional anesthesia injected into the spine is rapidly increasing. A PCORI-funded randomized clinical trial, “Comparing How Two Types of Anesthesia Affect Recovery From Hip Fracture Surgery – The REGAIN Trial” led by researchers at the University of Pennsylvania found that the two approaches are equally safe and effective. Published in the New England Journal of Medicine, the study of 1,600 patients 50 and older at 46 hospitals across the United States and Canada found rates of survival, ability to walk, and post-operative delirium were similar for patients who had either anesthesia. The results could facilitate decision making about which option best fits a patient’s preferences.
2. Find study spotlights such as “PREVENTABLE, New NIH Study Targeting Older Adults, Will Leverage PCORnet Data Resource”
   “Pragmatic Evaluation of Events And Benefits of Lipid-Lowering in Older Adults (PREVENTABLE)” is the largest study to date to utilize PCORnet. The National Institute on Aging (NIA) has funded a major study to examine the overall benefits and risks of cholesterol-lowering drugs known as statins in adults aged 75 or older without cardiovascular disease. The trial will help determine whether a statin can help prevent dementia and disability in this age group, as well as heart attacks and other cardiovascular-related deaths, while not increasing risks of adverse health outcomes. PREVENTABLE will now recruit study participants from approximately 40 healthcare systems in seven of the CRNs and from 60 hospitals in the Veterans Affairs Health Network, which is also a study partner.
3. Find all of the additional projects related to older adults’ health such as “Testing a Way to Help Patients With Dementia and Their Caregivers Set Goals for Care”
   In “Testing a Way to Help Patients With Dementia and Their Caregivers Set Goals for Care,” researchers found that patients with dementia and their caregivers could set goals that they could operationalize, work toward, and achieve. Clinicians, patients, and caregivers can use GAS to set achievable care goals that are important to patients and caregivers.You can find all the additional projects PCORI has related to shared decision-making in one place.

PCORI has curated all of their resources related to shared decision-making to support patients, communities, and clinicians to make informed healthcare choices. You can find many materials such as:

1. Study results that supports better informed decisions such as “Patients With Complex Chronic Conditions: Health Care Use and Clinical Events Associated With Access to a Patient Portal”
   The PCORI-funded “Patients With Complex Chronic Conditions: Health Care Use and Clinical Events Associated With Access to a Patient Portal” study found that using antibiotics to treat appendicitis worked as well as surgical removal of the appendix for most patients in the three months post-treatment, as reported in the New England Journal of Medicine. Health outcomes were similar for each treatment group. More than 70% of patients on antibiotics avoided having surgery and missed less time away from work or school, but nearly 30% ultimately needed to have their appendix removed.
2. Find study spotlights such as “Comparing Two Ways to Help Parents of Children With Sickle Cell Disease Decide on Treatment With Their Doctors”
   In “Comparing Two Ways to Help Parents of Children With Sickle Cell Disease Decide on Treatment With Their Doctors,” the research team compared two ways to help doctors and parents of children with sickle cell disease (SCD) discuss treatment options. At one group of sites, parents receive a set of four decision aids that help doctors and parents talk about SCD treatment options. Decision aids help people choose between two or more healthcare options based on what is most important to them. The research team is training doctors on how to use them when talking with parents. The decision aids include:
   • A brochure for parents to review before their appointment
   • A treatment card for parents and doctors to use during their discussion about treatment
   • An after-visit booklet for parents to take home
   • Videos that show parents talking about how they decided about SCD treatment for their child

   At the other sites, doctors offer care as usual. They also use the American Society of Hematology pocket guide as a reference when discussing treatment options with parents of children with SCD.

   At the study start and again four to six months later, the research team asks parents how involved they were in the treatment decision and how conflicted they felt about the decision they made. In addition, the team is reviewing electronic medical records to see how many doctors offer patients hydroxyurea. The team is comparing results between sites that got the pocket guide and those that got the decision aids. Results are currently under peer-review.

3. Find all of the additional projects related to shared decision-making such as “Using Numbers in a Decision Aid to Describe Risks and Benefits of Colorectal Cancer Screening Options”
   In “Using Numbers in a Decision Aid to Describe Risks and Benefits of Colorectal Cancer Screening Options,” including numerical information in a decision aid did not affect the proportion of patients getting CRC screening, compared with a decision aid without numerical information. Patients showed improvement in most other outcomes after viewing either decision aid.You can find all the additional projects PCORI has related to shared decision-making in one place.