Patient navigators for people with chronic disease: protocol for a systematic review and meta-analysis

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• 作者：Elizabeth Kelly (1)
  Noah Ivers (2)
  Rami Zawi (2)
  Lianne Barnieh (3)
  Braden Manns (3) (4)
  Diane L Lorenzetti (4)
  David Nicholas (5)
  Marcello Tonelli (3)
  Brenda Hemmelgarn (3) (4)
  Richard Lewanczuk (6) (7)
  Alun Edwards (3) (7)
  Ted Braun (8)
  Kerry A McBrien (1) (4)
  
  1. Department of Family Medicine ; University of Calgary ; G012 ; Health Sciences Centre ; 3330 Hospital Drive NW ; Calgary ; AB ; T2N 4聽N1 ; Canada
  2. Department of Family and Community Medicine ; Women鈥檚 College Hospital ; University of Toronto ; 77 Grenville Street 4th Floor ; Toronto ; Ontario ; M5S 1B3 ; Canada
  3. Department of Medicine ; University of Calgary ; 1403 29th Street NW ; Calgary ; AB ; T2N 2聽T9 ; Canada
  4. Department of Community Health Sciences ; University of Calgary ; TRW Building ; 3280 Hospital Drive NW ; Calgary ; AB ; T2N 4Z6 ; Canada
  5. Faculty of Social Work ; University of Calgary ; 2800 University Way NW ; Calgary ; AB ; T2N 1聽N4 ; Canada
  6. Department of Medicine ; University of Alberta ; 362 HMRC ; Edmonton ; AB ; T6G 2S2 ; Canada
  7. Alberta Health Services ; 10030-107 Street NW ; Edmonton ; AB ; T5J 3E4 ; Canada
  8. Department of Family Medicine ; Alberta Health Services ; Sheldon M. Chumir Health Centre ; 8th Floor ; 1213 鈥?4th Street SW ; Calgary ; AB ; T2R 0X7 ; Canada
  
• 关键词：Patient navigator ; Chronic disease ; Systematic review
• 刊名：Systematic Reviews
• 出版年：2015
• 出版时间：December 2015
• 年：2015
• 卷：4
• 期：1
• 全文大小：360 KB
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  3. Manns, BJ, Tonelli, M, Zhang, J, Campbell, DJ, Sargious, P, Ayyalasomayajula, B (2012) Enrolment in primary care networks: impact on outcomes and processes of care for patients with diabetes. CMAJ 184: pp. E144-52 CrossRef
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  15. Goff, SL, Pekow, PS, White, KO, Lagu, T, Mazor, KM, Lindenauer, PK (2013) IDEAS for a healthy baby鈥搑educing disparities in use of publicly reported quality data: study protocol for a randomized controlled trial. Trials 14: pp. 244 CrossRef
  16. Scott, LB, Gravely, S, Sexton, TR, Brzostek, S, Brown, DL (2013) Examining the effect of a patient navigation intervention on outpatient cardiac rehabilitation awareness and enrollment. J Cardiopulm Rehabil Prev 33: pp. 281-91 CrossRef
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• 刊物主题：Medicine/Public Health, general; Biomedicine general; Statistics for Life Sciences, Medicine, Health Sciences;
• 出版者：BioMed Central
• ISSN：2046-4053

文摘

Background Individuals with chronic diseases may have difficulty optimizing their health and getting the care they need due to a combination of patient, provider, and health system level barriers. Patient navigator programs, in which trained personnel assess and assist patients in overcoming barriers to care, may improve care and outcomes for patients with chronic disease by providing an alternative approach to conventional information and support resources. Methods This systematic review will evaluate the evidence for patient navigator programs, compared to usual care, in patients with chronic disease. We will include RCTs, cluster RCTs, and quasi-randomized RCTs that study the effects of patient navigator programs on clinical outcomes, patient experience, and markers of adherence to care. Studies will be identified by searching MEDLINE, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL, PsycINFO, Social Work Abstracts, and the references of included studies. Two authors will screen titles and abstracts independently. Full texts will be reviewed for relevance and data extraction will be done independently by two authors. Studies will be included if they assess patients of any age with one or more chronic diseases. Outcomes will be categorized into groups characterized by their proximity to mechanism of action of the intervention: patient-level outcomes, intermediate outcomes, and process outcomes. Descriptive data about the elements of the patient navigator intervention will also be collected for potential subgroup analyses. Risk of bias will be assessed using the Effective Practice and Organisation of Care Group (EPOC) risk of bias tool. Data will be analyzed using random effects meta-analysis (relative risk for dichotomous data and mean difference for continuous data), if appropriate. Discussion A comprehensive review of patient navigator programs, including a summary of the elements of programs that are associated with a successful intervention, does not yet exist. This systematic review will synthesize the evidence of the effect of patient navigator interventions on clinical and patient-oriented outcomes in populations across a comprehensive set of chronic diseases. Systematic Review Registration PROSPERO CRD42013005857.