Success in the Achieving CARdiovascular Excellence in Colorado (A CARE) Home Blood Pressure Monitoring Program: A Report from the Shared Networks of Colorado Ambulatory Practices and Partners (SNOCAP)

DeAlleaume, Lauren; Parnes, Bennett; Zittleman, Linda; Sutter, Christin; Chavez, Robert; Bernstein, Jackie; LeBlanc, William G.; Dickinson, Miriam; Westfall, John M.

doi:10.3122/jabfm.2015.05.150024

Cited by 19 publications

(18 citation statements)

References 16 publications

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“…The community advisory council worked in an iterative process to “translate” health care promotions into public service messages that would be understandable to the lay community [ 23 ]. In accompanying articles, this approach was found to have positive results in several distinct interventions and was associated with statistically significant increased self-reported intention to engage in colorectal cancer screening [ 24 ], increased use of asthma inhalers as well as asthma action plans [ 25 ], and improved blood pressure control rates [ 26 ].…”

Section: Resultsmentioning

confidence: 99%

The impact of patient advisors on healthcare outcomes: a systematic review

Sharma

Knox

Mleczko

et al. 2017

BMC Health Serv Res

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BackgroundPatient advisory councils are a way for healthcare organizations to promote patient engagement. Despite mandates to implement patient advisory councils through programs like the Patient-Centered Medical Home (PCMH), there is a paucity of data measuring the impact of patients functioning in advisory roles. Our objective is to investigate whether patient engagement in patient advisory councils is linked to improvements in clinical quality, patient safety or patient satisfaction.MethodsWe searched PubMed, SCOPUS, CINAHL and Google Scholar for English language publications between November 2002 to August 2015, using a combination of “patient advisor” and “care outcomes” search terms. Article selection utilized dual screening facilitated by DistillerSR software, with group discussion to resolve discordance. Observational studies, randomized controlled trials, and case studies were included that described patients serving in an advisory role where primary outcomes were mentioned. Reference lists of included studies and grey literature searches were conducted. Qualitative thematic analysis was performed to synthesize results.ResultsDatabase searching yielded 639 articles total after removing duplicates, with 129 articles meeting full text inclusion criteria. 32 articles were identified for final review, 16 of which were case studies. Advisory roles included patient advisory councils, ad-hoc patient committees, community advisory councils, experience-based co-design, and other. Four practice-based studies from one research group, involving community advisors in the design of public health interventions, found improved clinical outcomes. No prospective experimental studies assessed the impact of patient advisors on patient safety or patient satisfaction. One cluster-randomized RCT showed that patient advisors helped health care planning efforts identify priorities more aligned with the PCMH. Ten case studies reported anecdotal benefit to individual patient advisors.ConclusionFive included studies demonstrate promising methods for evaluating patient engagement in healthcare delivery and describe impacts on clinical outcomes and priority setting. Based on the case studies found, patient advisors tend to contribute to patient-facing services that may affect clinical care but are not easily evaluated. As clinics and hospitals implement patient advisory councils, rigorous evaluation of their programs is needed to support the expansion of system-level patient engagement.Trial registrationThis systematic review was registered in the PROSPERO database of the University of York Centre for Reviews and Dissemination (ID: 2015:CRD42015030020).Electronic supplementary materialThe online version of this article (10.1186/s12913-017-2630-4) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

The impact of patient advisors on healthcare outcomes: a systematic review

Sharma

Knox

Mleczko

et al. 2017

BMC Health Serv Res

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“…Some providers cited concerns over accuracy of data as a potential road block to using home BP monitors on a wider scale (n=4) [14,42-44]. Another barrier to provider adoption was the lack of evidence or proof that DHTs improved patient outcomes (n=3) [32,38,45].…”

Section: Resultsmentioning

confidence: 99%

Provider- and Patient-Related Barriers to and Facilitators of Digital Health Technology Adoption for Hypertension Management: Scoping Review

Palacholla¹,

Fischer²,

Coleman³

et al. 2019

JMIR Cardio

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BackgroundThe uptake of digital health technology (DHT) has been surprisingly low in clinical practice. Despite showing great promise to improve patient outcomes and disease management, there is limited information on the factors that contribute to the limited adoption of DHT, particularly for hypertension management.ObjectiveThis scoping review provides a comprehensive summary of barriers to and facilitators of DHT adoption for hypertension management reported in the published literature with a focus on provider- and patient-related barriers and facilitators.MethodsThis review followed the methodological framework developed by Arskey and O’Malley. Systematic literature searches were conducted on PubMed or Medical Literature Analysis and Retrieval System Online, Cumulative Index to Nursing and Allied Health Literature, and Excerpta Medica database. Articles that reported on barriers to and/or facilitators of digital health adoption for hypertension management published in English between 2008 and 2017 were eligible. Studies not reporting on barriers or facilitators to DHT adoption for management of hypertension were excluded. A total of 2299 articles were identified based on the above criteria after removing duplicates, and they were assessed for eligibility. Of these, 2165 references did not meet the inclusion criteria. After assessing 134 studies in full text, 98 studies were excluded (full texts were either unavailable or studies did not fulfill the inclusion criteria), resulting in a final set of 32 articles. In addition, 4 handpicked articles were also included in the review, making it a total of 36 studies.ResultsA total of 36 studies were selected for data extraction after abstract and full-text screening by 2 independent reviewers. All conflicts were resolved by a third reviewer. Thematic analysis was conducted to identify major themes pertaining to barriers and facilitators of DHT from both provider and patient perspectives. The key facilitators of DHT adoption by physicians that were identified include ease of integration with clinical workflow, improvement in patient outcomes, and technology usability and technical support. Technology usability and timely technical support improved self-management and patient experience, and positive impact on patient-provider communication were most frequently reported facilitators for patients. Barriers to use of DHTs reported by physicians include lack of integration with clinical workflow, lack of validation of technology, and lack of technology usability and technical support. Finally, lack of technology usability and technical support, interference with patient-provider relationship, and lack of validation of technology were the most commonly reported barriers by patients.ConclusionsFindings suggest the settings and context in which DHTs are implemented and individuals involved in implementation influence adoption. Finally, to fully realize the potential of digitally enabled hypertension management, there is a greater need to validate these technologies to provide...

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“…These control rates are similar to the 6-to-12-month hypertension control rates of 54% to 71% noted in 4 HBPM studies using telemonitoring with independent pharmacist comanagement 18,19,46,47 and the 53% 12-month control rate in a study without telemonitoring that used direct HBPM feedback to primary care clinicians. 48 Primary care clinicians have expressed several concerns about implementing AOBP and HBPM in a nonresearch setting: whether an AOBP/HBPM program can be efficiently incorporated into daily clinical practice; whether patients will follow through with HBPM despite its substantial time/ effort commitment; and whether patients will perform HBPM with sufficient accuracy. 14,49 With respect to the first concern about clinic efficiency, 68% of our clinic staff reported that the AOBP/ HBPM program positively affected hypertension management and did not require excessive time/ effort, an interpretation supported by the estimated time commitments noted in Table 3.…”

Section: Discussionmentioning

confidence: 99%

“…Prior HBPM studies note that up to 20% of patients decline to initiate HBPM 18 and report rates of submission of HBPM results of 70% to 91% with dedicated pharmacist support 46,47 but as low as 32% to 36% when such support was unavailable. 27,48 Studies are needed to determine which patients are more likely not to complete HBPM and whether directed intensive patient education and shared decision making can minimize this barrier.…”

Section: Discussionmentioning

confidence: 99%