HOME VISITS FOR UNCONTROLLED ASTHMA AMONG LOW-INCOME ADULTS WITH PATIENT PORTAL ACCESS
| Autor: | Andrea J. Apter, John T. Howell, Alyssa N. Mullen, Heather Klusaritz, Luzmercy Perez, Tyra Bryant-Stephens, Marisa Rogers, Xiaoyan Han, Maryori Canales, Knashawn H Morales, A. Russell Localio |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Immunology Specialty Article 03 medical and health sciences Young Adult 0302 clinical medicine Quality of life (healthcare) Patient Portals Intervention (counseling) medicine Immunology and Allergy Humans 030212 general & internal medicine Health Education Poverty Asthma Aged Aged 80 and over Community Health Workers business.industry Patient portal Emergency department Middle Aged medicine.disease Health equity House Calls 030228 respiratory system Asthma Control Questionnaire Family medicine Quality of Life Female business |
| Zdroj: | J Allergy Clin Immunol |
| Popis: | BACKGROUND: Asthma disproportionately affects low-income and minority adults. In an era of electronic records and internet-based digital devices, it is unknown whether portals, for patient-provider communication, can improve asthma outcomes. OBJECTIVE: To estimate the effect on asthma outcomes of an intervention using home visits by community health workers plus training in patient portals compared to usual care and portal training only. METHODS: 301 predominantly African American and Hispanic/Latino adults with uncontrolled asthma, were recruited from primary care and asthma-specialty practices serving low income urban neighborhoods, directed to internet access, and given portal training. Half were randomized to home visits over six months by community health workers to facilitate competency in portal use and promote care coordination. RESULTS: 170 (56%) patients used the portal independently. Rates of portal activity did not differ between randomized groups. Asthma control and asthma-related quality of life improved in both groups over one year. Differences in improvements over time were greater for the home visit group for all outcomes, but reached conventional levels of statistical significance only for yearly hospitalization rate (−0.53, 95% CI= −1.08 to −0.024). Poor neighborhoods and living conditions plus limited internet access were barriers for patients to complete the protocol and for community health workers to make home visits. CONCLUSION: For low-income adults with uncontrolled asthma, portal access and community health workers produced small incremental benefits. Home visits with emphasis on self-management education might be necessary to facilitate patient-clinician communication and to improve outcomes for asthma. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|