Clearing Clinical Barriers: Enhancing Social Support Using a Patient Navigator for Asthma Care

Adherence in Asthma and COPD: New Strategies for an Old Problem

“…70 Like coaching, navigators may be effective in addressing unintentional non-adherence, but because it is a costly and labor-intensive approach, most trials have focused on populations with suboptimal clinical outcomes due, in part, to intentional non-adherence. This model has more recently been applied to adults with asthma [71][72][73] and COPD, 70 but its effectiveness it unknown either because of methodological limitations 70 or because evaluation is ongoing. 73 Shared Decision-Making.…”

Electronic Health Record Portals adoption: Empirical model based on UTAUT2

“…Our study focuses on a specific type of e-health technology, the electronic health record (EHR) portals, which bring clear benefits for both patients and healthcare providers and has received great attention at the governmental level worldwide [1][2][3]. In the US the support given to EHRs, via meaningful use program, led the federal government to commit unprecedented resources to support adoption and use of EHRs through incentive payments totalling $27 billion over 10 years, or as much as $44,000 (through Medicare) and $63,750 (through Medicaid) per physician [4][5][6]. EHR portals are an important topic not only in the US, but also in Europe, where there is a new trans-European initiative, the European Patients Smart Open Services (epSOS), promoted by the EU Commission [3].…”

Patient Advocates for Low-Income Adults with Moderate to Severe Asthma: A Randomized Clinical Trial

“…PAs were recent college graduates interested in health care careers. 9,12,14 Focus groups of patients who had participated in pilot studies for this project recommended these individuals because they had liked working with them previously, felt comfortable, and noticed they were comfortable with clinic staff. 9 At least 2 of the PAs had lived in patients' Philadelphia neighborhoods; one had worked in other low-income communities, but the other had not worked with such patients previously.…”

“…In the figure we have labeled with numbers when the collection actually took place, indicating a spread of time when collection occurred. For example, the third data collection was to occur at month 6 but actually occurred between months 3 and 21 (for 1 outlier) for those assigned a PA. 19 (12) 59 (38) 25 (16) 156 * These data are reported at the patient level: "any cause" = asthma or nonasthma event.…”

“…10 Variations on this theme have had some partial success in different patient groups (eg, elderly, children, and adolescents) with different acute medical problems (eg, surgery, chronic kidney failure, diabetes, smoking cessation, hospice, cancer screening, and needing a procedure or chemotherapy). 11 With input from focus groups of our patients and providers 12 and piloting, 13 we developed a patient advocate (PA) who coached, modeled, and assisted with preparations for asthma-related medical visits, attended visits with permission of patient and clinician, and confirmed patient understanding of provider recommendations. We evaluated the effect of 6 months of PAI on the primary outcome (asthma control) and secondary outcomes (asthma-related quality of life, prednisone bursts, emergency department [ED] visits, hospitalizations, and urgent office visits) relative to baseline and compared with usual care (UC).…”