Home visits for uncontrolled asthma among low-income adults with patient portal access

Apter, Andrea J.; Localio, A. Russell; Morales, Knashawn H.; Han, Xiaoyan; Perez, Luzmercy; Mullen, Alyssa N.; Rogers, Marisa; Klusaritz, Heather; Howell, John T.; Canales, Maryori

doi:10.1016/j.jaci.2019.05.030

Cited by 34 publications

(9 citation statements)

References 45 publications

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“…The benefits range from re-assurance, reduced anxiety, positive impact on consultations, better doctor-patient relationship, and increased awareness and adherence to medications. Patient access to their EHRs was found to improve patient outcomes in various study populations, [17][18][19][20] including medication adherence, 21,22 achieving control of blood pressure and sugar levels, 17,[23][24][25] improving functional status, and reduced high-cost healthcare utilization in patients with chronic conditions, 26 enhance timely patient-centered care. 27,28 In addition, patient portals were found to improve self-reported levels of engagement, knowledge or activation related to self-management, [29][30][31] improve engagement in care and caregiver-provider communication, 32 improve recovery scores, and reduce hospital admissions.…”

Section: Resultsmentioning

confidence: 99%

“…33 However, some studies did not find statistical effect of patient portals on health outcomes. 19,[34][35][36][37] Several research papers emphasized the importance of sharing clinical notes with patients via the patient portal. 24,28,38,39 In qualitative interviews, patients reported improved access to information, better insight into their conditions, decreased anxiety, increased appreciation for clinicians, improvements in health behaviors, and more engagement in care.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Impact of patient access to their electronic health record: systematic review

Tapuria

Porat

Kalra

et al. 2021

Informatics for Health and Social Care

113

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Patient access to their own electronic health records (EHRs) is likely to become an integral part of healthcare systems worldwide. It has the potential to decrease the healthcare provision costs, improve access to healthcare data, self-care, quality of care, and health and patient-centered outcomes. This systematic literature review is aimed at identifying the impact in terms of benefits and issues that have so far been demonstrated by providing patients access to their own EHRs, via providers' secure patient portals from primary healthcare centers and hospitals. Searches were conducted in PubMed, MEDLINE, CINHAL, and Google scholar. Over 2000 papers were screened and were filtered based on duplicates, then by reading the titles and finally based on their abstracts or full text. In total, 74 papers were retained, analyzed, and summarized. Papers were included if providing patient access to their own EHRs was the primary intervention used in the study and its impact or outcome was evaluated. The search technique used to identify relevant literature for this paper involved input from five experts. While findings from 54 of the 74 papers showed positive outcome or benefits of patient access to their EHRs via patient portals, 10 papers have highlighted concerns, 8 papers have highlighted both and 2 have highlighted absence of negative outcomes. The benefits range from re-assurance, reduced anxiety, positive impact on consultations, better doctor-patient relationship, increased awareness and adherence to medication, and improved patient outcomes (e.g., improving blood pressure and glycemic control in a range of study populations). In addition, patient access to their health information was found to improve self-reported levels of engagement or activation related to self-management, enhanced knowledge, and improve recovery scores, and organizational efficiencies in a tertiary level mental health care facility. However, three studies did not find any statistically significant effect of patient portals on health outcomes. The main concerns have been around security, privacy and confidentiality of the health records, and the anxiety it may cause amongst patients. This literature review identified some benefits, concerns, and attitudes demonstrated by providing patients' access to their own EHRs. This access is often part of government strategies when developing patient-centric self-management elements of a sustainable healthcare system. The findings of this review will give healthcare providers a framework to analyze the benefits offered by promoting patient access to EHRs and decide on the best approach for their own specialties and clinical setup. A robust cost-benefit evaluation of such initiatives along with its impact on major stakeholders within the healthcare system would be essential in KEYWORDS Electronic healthcare record; literature review; patient access; benefits; access to EHRs; patient portals CONTACT Archana Tapuria

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Impact of patient access to their electronic health record: systematic review

Tapuria

Porat

Kalra

et al. 2021

Informatics for Health and Social Care

113

View full text Add to dashboard Cite

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“…The Asthma Research for the Community (ARC) study [4] was a pragmatic randomized trial of 301 low-income participants with uncontrolled asthma. Participants randomized to the control group received usual care plus access to and training in a web-based portal designed to improve communication between participants and their healthcare providers.…”

Section: The Asthma Research For the Community Trialmentioning

confidence: 99%

“…The paper is organized as follows. In Section 2, we define notation, review existing methods, and introduce the Asthma Research for the Community (ARC) trial [4]. We 2 specify our models and sensitivity analysis framework in Section 3.…”

Section: Introductionmentioning

confidence: 99%

Semi-Parametric Sensitivity Analysis for Trials with Irregular and Informative Assessment Times

Smith¹,

Yang²,

Apter³

et al. 2022

Preprint

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Many trials are designed to collect outcomes at pre-specified times after randomization. However, in practice, there is often substantial variability in the times at which participants are actually assessed, which poses a challenge to learning about the treatment effects at the targeted assessment times. Any method for analyzing a trial with such irregular assessment times relies on untestable assumptions. Therefore, conducting a sensitivity analysis is an important step that can strengthen conclusions from such trials. However, no sensitivity analysis methodology has been developed. We develop a methodology that accounts for possibly informative assessment times, where assessment at time t may be related to the outcome at that time, even after accounting for observed past history. We implement our methodology using a new augmented inverse-intensity-weighted estimator, and we apply it to a trial of lowincome participants with uncontrolled asthma. We also evaluate the performance of our estimation procedure in a realistic simulation study.

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“…Other interventions in racial and ethnic minority groups that are effective include telemedicine or web-based self-care, 50 multidisciplinary team education in the community and hospital settings, 51 and home health care visits using community health workers. 52 These interventions may decrease utilization of health care resources because patients are empowered to participate in their own asthma management.…”

Section: What Has Been Done?mentioning

confidence: 99%