Andrea J. Apter|A. Russell Localio|Knashawn H. Morales|Xiaoyan Han|Luzmercy Perez|Alyssa N. Mullen|Marisa Rogers|Heather Klusaritz|John T. Howell|Maryori Canales|Tyra Bryant-Stephens
Home visits for uncontrolled asthma among low-income adults with patient portal access
University of Pennsylvania Health System|University of Pennsylvania|University of Pennsylvania|University of Pennsylvania|University of Pennsylvania|University of Pennsylvania|Temple University Health System|University of Pennsylvania Health System|University of Pennsylvania|University of Pennsylvania Health System|University of Pennsylvania|University of Pennsylvania Health System|Children's Hospital of Philadelphia|Children's Hospital of Philadelphia
h3backgroundh3 asthma disproportionately affects lowincome minority adults era electronic records internetbased digital devices unknown whether portals patientprovider communication improve asthma outcomes h3objectiveh3 sought estimate effect asthma outcomes intervention using home visits hvs community health workers chws plus training patient portals compared usual care portal training h3methodsh3 three hundred one predominantly african american hispaniclatino adults uncontrolled asthma recruited primary care asthma specialty practices serving lowincome urban neighborhoods directed internet access given portal training half randomized hvs 6 months chws facilitate competency portal use promote care coordination h3resultsh3 one hundred seventy 56 patients used portal independently rates portal activity differ randomized groups asthma control asthmarelated quality life improved groups 1 year differences improvements time greater hv group outcomes reached conventional levels statistical significance yearly hospitalization rate 053 95 ci 108 0024 poor neighborhoods living conditions plus limited internet access barriers patients complete protocol chws make hvs h3conclusionh3 lowincome adults uncontrolled asthma portal access chws produced small incremental benefits hvs emphasis selfmanagement education might necessary facilitate patientclinician communication improve asthma outcomes