July 22, 2019
While interventions using community health workers appear to show promise in improving certain aspects of asthma-related disease burden in adults in the United States, more studies are needed to confirm their effectiveness in adults with respiratory disease, according to a systematic review published in BMC Pulmonary Medicine.
“With rising medical costs, stakeholders and healthcare professionals are exploring community-based solutions to relieve the burden of chronic diseases and reduce health care spending,” researchers wrote. “The community health worker (CHW) model is one example that has proven effective in improving patient outcomes globally.”
Community health workers are trusted members of the community who act as liaisons between the healthcare system and residents. The systematic review aimed to describe their effectiveness in populations of US adults with asthma and chronic obstructive pulmonary disease (COPD).
Researchers identified just four studies that met inclusion criteria. All focused on asthma, and two were randomized controlled trials, one was a nonrandomized trial, and one involved a CHW intervention with a pre/post comparison.
CHW interventions, according to the systematic review, led to gains in asthma-related quality of life, asthma control, home trigger scores, and asthma-symptom-free days.
“CHW interventions demonstrated improvements in some patient-reported outcomes… however had no effect on healthcare utilization,” researchers reported. “Due to the limited evidence for use of CHW in adult respiratory diseases, we conclude that additional studies are needed to confirm the effectiveness of CHW interventions in these populations.”
Specifically, researchers called for additional randomized controlled trials with disease-specific outcomes—especially trials involving adults with COPD.
Parekh TM, Copeland CR, Dransfield MT, Cherrington A. Application of the community health worker model in adult asthma and COPD in the US: a systematic review. BMC Pulmonary Medicine. 2019 June 26;19(1):116.