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HHS Issues New Strategic Framework on Multiple Chronic Conditions

Electronic Newsletter, Issue 302

December 17, 2010

AHRQ News and Numbers

U.S. workers took an average of 14 sick days in 2007 due to their own illness or injury, or to care for a sick child or other family member. On average, employees took 10 days off because they were sick or injured and an additional 4 to care for family members. [Source: Agency for Healthcare Research and Quality (AHRQ), MEPS Statistical Brief #300: Restricted-Activity Days, 2007: Estimates for the U.S. Civilian Noninstitutionalized Population, Ages 16-64 (PDF File, Plugin Software Help.]

Today's Headlines

  1. HHS issues new strategic framework on multiple chronic conditions
  2. NIST Partners with ONC and AHRQ to Deliver Guidance on EHR Usability
  3. Computer-based Clinical Decision Support Tool to Assess Patients' Risk for Deleterious BRCA Mutations Report Is Available
  4. AHRQ Updates 2001 Evidence Report on Treating Acute Otitis Media
  5. Highlights from Our Most
  6. AHRQ in the professional literature

1. HHS Issues New Strategic Framework on Multiple Chronic Conditions

The Department of Health & Human Services (HHS) issued its new Strategic Framework on Multiple Chronic Conditions—an innovative private-public sector collaboration to coordinate responses to a growing challenge. More than a quarter of all Americans—and two out of three older Americans—have multiple chronic conditions, and treatment for these individuals accounts for 66 percent of the country's health care budget. These numbers are expected to rise as the number of older Americans increases. The health care system is largely designed to treat one disease or condition at a time, but many Americans have more than one—and often several—chronic conditions. For example, just 9.3 percent of adults with diabetes have only diabetes, according to AHRQ's Medical Expenditure Panel Survey (MEPS). And as the number of chronic conditions one has increases, so, too, do the risks of complications, including adverse drug events, unnecessary hospitalizations and confusion caused by conflicting medical advice. The new HHS strategic framework expects to reduce the risks of complications and improve the overall health status of individuals with multiple chronic conditions by fostering change within the system; providing more information and better tools to help health professionals—as well as patients—learn how to better coordinate and manage care; and by facilitating research to improve oversight and care. The Affordable Care Act, with its emphasis on prevention, provides HHS with exciting new opportunities to keep chronic conditions from occurring in the first place and to improve the quality of life for patients who have them. Select to read the HHS press release.

2. NIST Partners with ONC and AHRQ to Deliver Guidance on EHR Usability

Two new publications from the National Institute of Standards and Technology intended to help developers of software and computer systems improve the ease of use of electronic health records (EHRs) are now available as part of a federal effort led by HHS's Office of The National Coordinator for Health Information Technology. Health care providers are encouraged to adopt and use EHRs that can bring about broad quality improvements and cost savings in the health care system. Efforts to improve the usabilityof EHRs are widely recognized as key to achieving widespread adoption and meaningful use of these systems. Select to access each report:

3. Computer-based Clinical Decision Support Tool to Assess Patients' Risk for Deleterious BRCA Mutations Report Is Available

AHRQ's Effective Health Care Program released a new technical report, A Primary Care-Focused, Computer-based Clinical Decision Support Tool to Assess Patients' Risk for Deleterious BRCA MutationsThe report, conducted by the RTI International DEcIDE (Developing Evidence to Inform Decisions about Effectiveness) Center, describes development of a clinical decision support tool that could be used to screen for risk of BRCA mutations in primary care settings and assist in the implementation of the U.S. Preventive Services Task Force recommendations regarding referrals for genetic counseling and evaluation for BRCA1 and BRCA2 genes. The first version of the BRCA clinical decision support tool is not considered ready for clinical use but is available to researchers, upon request, for further evaluation and modification. Select to access the report. People who wish to obtain a CD of the tool for research and evaluation should send an E-mail to

4. AHRQ Updates 2001 Evidence Report on Treating Acute Otitis Media

AHRQ released a new evidence report on treating children immediately for uncomplicated otitis media with amoxicillin produces a modest benefit compared to placebo or a delay in using antibiotics. The authors, led by Paul G. Shekelle, M.D., Ph.D., of AHRQ's Southern California Evidence-Based Practice Center in Santa Monica, also found that doing so may increase the likelihood of diarrhea and rash. The review found no evidence that any other antibiotic is superior to amoxicillin for success in treating uncomplicated acute otitis media; that symptoms such as a red, immobile, or bulging eardrum are critical to diagnosis, but the lack of a gold standard for diagnosing acute otitis media currently makes drawing firm conclusions about the precision of diagnostic methods difficult; and that the heptavalent Pneumococcal Conjugate Vaccine (PCV7) has had an impact on microbial epidemiology. The review also found that long-term use of antibiotics in children prone to the disease decreases episodes by about half, but drawbacks, such as diarrhea, allergic reactions, and the emergence of bacterial resistance should be weighed against the risk of the ear infection's recurrence. AHRQ's report was requested by the American Academy of Pediatrics. Select to access the report, Management of Acute Otitis Media: Update.

5. Highlights from Our Most Recent Monthly Newsletter

The December issue of Research Activities is available online. Key articles include:

  • For hypertensive patients with diabetes, blood pressure drops quicker with more frequent interactions with clinicians.

    High blood pressure is one of the major risk factors for microvascular and macrovascular complications in patients with diabetes, which lead to kidney, eye, and other problems. It is recommended that patients with elevated blood pressure see the doctor every month to keep blood pressure under control. However, a new study found that patients with hypertension and diabetes who had provider encounters (face-to-face or otherwise) less than 2 weeks apart had the fastest decrease in blood pressure. Select to read this article.

Other articles include:

  • Nationwide survey shows free clinics provide care to nearly 2 million patients.
  • Fever over 100°F following multiple infant vaccinations is rare.
  • Risk factors for cognitive decline still murky.
  • Telephone counseling helps Korean Americans who speak little English improve hypertension management.

Select to read these articles and others.

6. AHRQ in the Professional Literature

We are providing the following hyperlinks to journal abstracts through PubMed® for your convenience. Unfortunately, some of you may not be able to access the abstracts because of firewalls or specific settings on your individual computer systems. If you are having problems, you should ask your technical support staff for possible remedies.

Persell SD, Zei C, Cameron KA, et al. Potential use of 10-year and lifetime coronary risk information for preventive cardiology prescribing decisions: a primary care physician survey. Arch Intern Med 2010 Mar 8; 170(5):470-7. Select to access the abstract on PubMed®.

Torke AM, Moloney R, Siegler M, Abalos A, Alexander GC. Physicians' views on the importance of patient preferences in surrogate decision-making. J Am Geriatr Soc 2010 Mar; 58(3):533-8. Select to access the abstract on PubMed®.

Crespi CM, Smith SK, Petersen L, et al. Measuring the impact of cancer: a comparison of non-Hodgkin lymphoma and breast cancer survivors. J Cancer Surviv 2010 Mar; 4(1):45-58. Select to access the abstract on PubMed®.

Manber R, Schnyer RN, Lyell D, et al. Acupuncture for depression during pregnancy: a randomized controlled trial. Obstet Gynecol 2010 Mar; 115(3):511-20. Select to access the abstract on PubMed®.

Palsbo SE, Diao G. The business case for adult disability care coordination. Arch Phys Med Rehabil 2010 Feb; 91(2):178-83. Select to access the abstract on PubMed®.

Westrick SC, Mount JK. Impact of perceived innovation characteristics on adoption of pharmacy-based in-house immunization services. Int J Pharm Pract 2010 Feb; 17(1):39-46. Select to access the abstract on PubMed®.

Kinsman H, Roter D, Berkenblit G, et al. "We'll do this together": the role of the first person plural in fostering partnership in patient-physician relationships. J Gen Intern Med 2010 Mar; 25(3):186-93. Select to access the abstract on PubMed®.

Contact Information

Please address comments and questions regarding the AHRQ Electronic Newsletter to Nancy Comfort at or (301) 427-1866.

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Page last reviewed December 2010
Internet Citation: HHS Issues New Strategic Framework on Multiple Chronic Conditions. December 2010. Agency for Healthcare Research and Quality, Rockville, MD.


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