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Patient Navigation to Reduce Readmissions among Black Men with Heart Failure

患者导航可减少患有心力衰竭的黑人男性的再入院率

基本信息

批准号：
8754298
负责人：
Raegan Winston Durant
金额：
$ 1.74万
依托单位：
UNIVERSITY OF ALABAMA AT BIRMINGHAM
依托单位国家：
美国
项目类别：
财政年份：
2013
资助国家：
美国
起止时间：
2013-10-15 至 2018-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8754298
关键词：
Accident and Emergency department Accounting Address Adherence African African American Ambulatory Care Area Cancer Survivorship Cardiovascular Diseases Caring Chronic Disease Communities Complex Diagnostic Disease Disease Management Education Educational Intervention Emotional Environment Face Gender Health Health Professional Health Services Accessibility Health education Health system Healthcare Heart failure Hospitalization Hospitals Inpatients Instruction Intervention Intervention Studies Knowledge Lead Malignant Neoplasms Medicare Minority Modeling Nurses Outcome Outpatients Participant Patient Education Patients Pharmacists Population Provider Quality of Care Race Randomized Recommendation Recruitment Activity Resources Self Care Self Efficacy Self Management Severities Social support Solutions Subgroup Symptoms Training Transportation Treatment outcome Underserved Population Woman arm beneficiary cancer care care delivery comorbidity cost cost effectiveness education planning health disparity high risk hospital readmission improved male male health men patient population programs psychosocial screening social tool

项目摘要

PROJECT SUMMARY (See instructions): Multiple aspects of the Affordable Care Act of 2010 focus on reducing 30-day all-cause hospital readmission rates among heart failure patients, and African American men with heart failure may be among those at highest risk for rehospitalization following discharge. Chronic disease management programs are among the many tools used to improve heart failure self-care as well as reduce readmission rates. However, most chronic disease management programs are staffed by health care professionals limiting the generalizability of this model in some resource-poor communities. Therefore, laypersons, such as patient navigators, may be a viable alternative for the delivery of heart failure self-care education and the provision of emotional and instrumental support for heart failure self-care. In minority cancer populations, patient navigators have been effective in improving diagnostic and treatment outcomes by educating patients and assisting them with barriers to care. Patient navigators may be well-suited to perform comparable tasks, among African American men with heart failure, to address their unique barriers to self-care, including low heart failure symptom recognition and more frequent treatment-seeking delays. The use of laypersons trained as patient navigators may lead to health care solutions for high heart failure readmission rates, but the cost-effectiveness of such an approach is largely unknown. Therefore, in the Patient NAVIgation to Reduce Readmissions among Black Men with Heart Failure (NAVI-HF) study, we propose to recruit 416 African American men with heart failure receiving inpatient care at UAB Hospital and randomize them either to HF self-care education plus a patient navigator-delivered self-care plan (Patient Navigation + Education arm) after discharge or to HF self-care education alone (Educational Control arm). We will compare participant outcomes such as 30-day all-cause readmission rates, heart failure selfcare adherence as well as cost-effectiveness across the two intervention arms. Our Specific Aims are: 1) To assess the 30-day all-cause readmission rates among male African Amencan HF patients receiving HF self-care education plus a patient navigator-delivered self-care plan versus heart failure self-care education alone 2) To assess the heart failure self-efficacy and heart failure self-care adherence among male African American HF patients receiving heart failure self-care education plus a patient navigator-delivered self-care plan versus heart failure self-care education alone 3) To evaluate the cost-effectiveness of heart failure self-care education plus a patient navigator-delivered self-care plan versus heart failure self-care education alone

项目总结(见说明)： 2010年《平价医疗法案》的多个方面侧重于降低心力衰竭患者30天的全原因再住院率，患有心力衰竭的非裔美国男性可能是出院后再次住院风险最高的人群之一。慢性病管理计划是用于改善心力衰竭自我护理以及降低再住院率的众多工具之一。然而，大多数慢性病管理项目的工作人员都是卫生保健专业人员，这限制了这种模式在一些资源匮乏的社区的推广。因此，非专业人员，如患者导航员，可能是提供心力衰竭自我护理教育和为心力衰竭自我护理提供情感和工具支持的可行替代方案。在少数癌症人群中，患者导航员通过教育患者并帮助他们克服护理障碍，有效地改善了诊断和治疗结果。患者导航员可能非常适合在患有心力衰竭的非裔美国男性中执行类似的任务，以解决他们自我护理的独特障碍，包括较低的心力衰竭症状认知度和更频繁的寻求治疗延迟。使用受训为患者导航员的非专业人员可能会导致针对高心力衰竭再住院率的医疗保健解决方案，但这种方法的成本效益在很大程度上是未知的。因此，在患者导航减少黑人男性心力衰竭再入院(NAVI-HF)研究中，我们建议招募416名在UAB医院接受住院护理的非裔美国男性心力衰竭患者，并将他们随机分为两组，一组在出院后接受HF自我护理教育，另一组在出院后接受患者导航提供的自我护理计划(患者导航+教育臂)或单独接受HF自我护理教育(教育控制臂)。我们将比较参与者的结果，如30天全因再住院率、心力衰竭自我护理依从性以及两个干预分支的成本效益。我们的具体目标是： 1)评估接受心力衰竭自我护理教育和患者导航员提供的自我护理计划的非洲男性Amencan心衰患者30天的全原因再住院率与仅接受心力衰竭自我护理教育的对比 2)评估接受心力衰竭自我护理教育加患者导航员提供的自我护理计划与仅接受心力衰竭自我护理教育的非裔美国男性心力衰竭患者的心力衰竭自我效能和心力衰竭自我护理依从性。 3)评估心力衰竭自我护理教育加上患者导航员提供的自我护理计划与单独进行心力衰竭自我护理教育的成本效益