Conducting clinical research studies often takes years, from recruiting participants to analyzing data. It can often take many more years for new evidence from research to inform health care and healthcare delivery and reach patients.
Promoting the uptake of research findings is part of PCORI’s congressional mandate to improve the quality and relevance of evidence available to help patients, caregivers, clinicians, and stakeholders from across the healthcare community make better-informed health decisions.
PCORI recently published new Evidence Updates, which capture the highlights and context for new research results and present them in an understandable and digestible format. Our newest Evidence Updates share the latest results from PCORI-funded research on treating depression among patients with kidney failure on dialysis, managing mild persistent asthma in children, and choosing between two types of weight loss surgery.
Treating Depression in Patients with Kidney Failure Receiving Dialysis
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In the United States, an estimated 37 million adults live with chronic kidney disease, a condition that can develop into kidney failure, according to the Centers for Disease Control and Prevention. Depression is common among patients with kidney failure and is associated with poor outcomes, including a higher risk of kidney function decline and hospitalization. Practice guidelines recommend either cognitive behavioral therapy (CBT) or drug treatment as first-line therapy for these patients.
A PCORI-funded study was the first randomized controlled trial to compare CBT and sertraline, an antidepressant drug, in patients with kidney failure who are undergoing maintenance hemodialysis.
The study found that patients taking sertraline had slightly more improvement in depression symptoms. But they also had side effects more often than patients using CBT.
These Evidence Updates—one for patients and one for clinicians—describe the findings from this research as well as common challenges patients experience when seeking treatment for depression. The Evidence Updates suggest topics that patients and their kidney care team can talk about to help patients choose the treatment that works best for them.
Choosing the Best Option for Managing Mild Persistent Asthma in Children
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Children with mild persistent asthma usually experience symptoms two or more days a week, but less often if their asthma is well controlled. A PCORI-funded study compared two approaches to treating mild persistent asthma in African-American children, who are more likely than other children to have asthma and worse health outcomes from it. The first approach was daily use, where children use a control inhaler, which usually contains corticosteroids, every day as directed by a doctor, regardless of symptoms. The second approach was as-needed symptom-based use, where children use a control inhaler only on days when they have symptoms.
The study found that the two groups did not differ significantly in asthma control, exacerbation, lung function, or quality of life. Also, children using the as-needed approach used a quarter of the amount of corticosteroid per month compared to children in the daily use group.
These findings add to the evidence base about the as-needed approach to using control inhalers, which was recently added to clinical guidelines as an alternative to the traditional daily use treatment practice. The Evidence Updates can help families and their clinicians think about and discuss which treatment approach will work best for them to manage their child or teen’s mild persistent asthma.
Helping Patients Choose between Weight Loss Surgery Options
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Bariatric surgery may be a viable treatment option for adults with obesity who are not able to lose weight with diet and exercise alone. However, outcomes vary across the procedures. A PCORI-funded study compared the benefits and harms of two common types of bariatric surgery: gastric bypass and sleeve gastrectomy.
The study found that people lost more weight with gastric bypass. However, gastric bypass had a higher rate of adverse outcomes, such as additional surgeries and rehospitalization. Among patients with type 2 diabetes, about the same number of people experienced remission with both surgeries, but more people who had sleeve gastrectomy saw their diabetes return.
The PCORI Evidence Updates share information for patients to consider before pursuing bariatric surgery and recommend topics clinicians can discuss with patients to provide comprehensive patient support.
About PCORI's Evidence Updates
PCORI’s Evidence Updates are created and disseminated in collaboration with patients, providers, and stakeholders and are one way PCORI puts evidence to work to improve health outcomes. Other PCORI Evidence Updates cover managing type 2 diabetes in patients who don’t need insulin, reducing stroke risk in patients with atrial fibrillation, treating urinary incontinence in women without surgery, and more.
What's Happening at PCORI?
The Patient-Centered Outcomes Research Institute sends weekly emails about opportunities to apply for funding, newly funded research studies and engagement projects, results of our funded research, webinars, and other new information posted on our site.
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