Special Emphasis Notice: Research Priorities for the Agency for Healthcare Research and Quality

Notice Number: NOT-HS-06-032

Key Dates
Release Date: December 29, 2005

Issued by
Agency for Healthcare Research and Quality (AHRQ), (http://www.ahrq.gov)

The mission of the Agency for Healthcare Research and Quality (AHRQ) is to improve the quality, safety, efficiency, and effectiveness of healthcare for all Americans. AHRQ achieves this mission by supporting a broad program of health services research and by working with partners to promote improvements in clinical and health systems practices, including the prevention of diseases and other health conditions. AHRQ achieves this mission through programs designed to (1) improve clinical practice, (2) improve the health care system's ability to provide access to and deliver high quality, high-value health care, and (3) provide policymakers with the ability to assess the impact of system changes on outcomes, quality, access to, cost, and use of health care services.

In FY2006, AHRQ plans to emphasize research gaps regarding the care of individuals with multiple health conditions in its grants portfolio of large research (R01) grants, small research (R03) grants and career development (K02, K08) awards. While many studies have focused on the efficacy and effectiveness of disease-specific interventions, there has been limited work that addresses the unique needs of sicker patients – those with multiple co-morbid conditions and those in need of multiple risk-behavior interventions. From the perspective of the chronically ill, sicker patient and their care givers, the health system does not appear patient-centered or coordinated. In a recent Commonwealth Fund study of sicker adults in six countries, many of the problems related to care of these patients appeared universal, though there were some issues unique to the United States . While most of the sicker adults had seen multiple physicians and were taking multiple medications, 53 percent of patients reported taking 4 or more medications and 43 percent of patients reported 4 or more physicians. In addition, patients in the U.S. were least likely to have the same physician for five or more years. While achieving patient-centered care is an important goal for all patients, we request applications that specifically examine the gaps in patient-centered care for the complicated patient with multiple conditions and risk factors. These may include proposals which examine the value of a medical home, care coordination, medication therapy management, patient education and self-efficacy, and health professions education. Practice-based research and other research networks are encouraged to apply.

Researchers are encouraged to propose projects that emphasize patients with multiple chronic illnesses and need for multiple risk-behavior interventions, episodes of care that extend beyond hospitalization and across different care settings, longitudinal care, and priority populations (e.g., inner-city areas; rural areas, including frontier areas; low-income groups; minority groups; women; children; the elderly; and individuals with special health care needs. Examination of clinical and system approaches to reduce racial, ethnic and socioeconomic disparities in the care of sicker adults are encouraged.

AHRQ is specifically interested in patient-centered care research focusing on the redesign and evaluation of new care processes and interventions for sicker individuals that could lead to improvements in care through patient activation or empowerment, improved patient-provider interaction and communication, and improved navigation and coordination. Specific strategies could include, but are not limited to, electronic clinical communication, self-management programs, medication therapy management programs, web-based applications for patients and/or health care providers, shared decision-making programs; enhanced case-management, and multi-disciplinary team approaches. Development and evaluation of new approaches to promote patient-centered care as well as projects that expand and evaluate the use of programs previously found to be promising in select settings and circumstances are encouraged.

Specific research areas could include the following:

Due to limitations on available grant funds for fiscal year 2006 AHRQ will maintain a limitation on grant funds on large research grant applications to $300,000 total costs (direct and indirect) per year and $100,000 total costs per year for large conference grant applications http://grants.nih.gov/grants/guide/notice-files/NOT-HS-04-007.html. With this notice, AHRQ provides information about the highest research priorities for unsolicited applications for fiscal year 2006. AHRQ will continue to provide regular updates of research priorities as research budget information becomes available. Applications focused on priority areas identified in this Special Emphasis Notice may be submitted on regular research and training grant application receipt dates and will be reviewed by standing AHRQ study sections. Application mechanisms currently accepted by AHRQ include R01, R03, R13, R18, K02, K08, F31, F32, and R36 applications.

Funding announcements for these mechanisms, as well as information about the grant application process, can be found at http://www.ahrq.gov/fund/.

Applicants are encouraged to contact AHRQ staff early in the process of preparing applications in order to clarify questions and discuss potential research projects. A listing of AHRQ staff contacts can be found at: http://www.ahrq.gov/fund/staffcon.htm.


Weekly TOC for this Announcement
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