Sobia F Ali-Faisal1, Tracey J F Colella2, Naomi Medina-Jaudes3, Lisa Benz Scott4. 1. Program in Public Health, Stony Brook Medicine, Stony Brook University, Stony Brook, USA. Electronic address: sobia.f.ali@gmail.com. 2. Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada; University Health Network/Toronto Rehabilitation Cardiovascular Prevention & Rehabilitation Program, Toronto, Canada. Electronic address: Tracey.Colella@uhn.ca. 3. Program in Public Health, Stony Brook Medicine, Stony Brook University, Stony Brook, USA. Electronic address: nem2@williams.edu. 4. Program in Public Health, Stony Brook Medicine, Stony Brook University, Stony Brook, USA; The School of Health Technology & Management, Stony Brook University, Stony Brook, USA. Electronic address: lisa.benzscott@stonybrook.edu.
Abstract
OBJECTIVE: To determine the effects of patient navigation (PN) on healthcare utilization outcomes using meta-analysis and the quality of evidence. METHODS: Medical and social science databases were searched for randomized controlled trials published in English between 1989 and May 2015. The review process was guided by PRISMA. Included studies were assessed for quality using the Downs and Black tool. Data were extracted to assess the effect of navigation on: health screening rates, diagnostic resolution, cancer care follow-up treatment adherence, and attendance of care events. Random-effects models were used to compute risk ratios and I2 statistics determined the impact of heterogeneity. RESULTS: Of 3985 articles screened, 25 articles met inclusion criteria. Compared to usual care, patients who received PN were significantly more likely to access health screening (OR 2.48, 95% CI, 1.93-3.18, P<0.00001) and attend a recommended care event (OR 2.55, 95% CI, 1.27-5.10, P<0.01). PN was favoured to increase adherence to cancer care follow-up treatment and obtain diagnoses. Most studies involved trained lay navigators (n=12) compared to health professionals (n=9). CONCLUSION: PN is effective to increase screening rates and complete care events. PRACTICE IMPLICATIONS: PN is an effective intervention for use in healthcare.
OBJECTIVE: To determine the effects of patient navigation (PN) on healthcare utilization outcomes using meta-analysis and the quality of evidence. METHODS: Medical and social science databases were searched for randomized controlled trials published in English between 1989 and May 2015. The review process was guided by PRISMA. Included studies were assessed for quality using the Downs and Black tool. Data were extracted to assess the effect of navigation on: health screening rates, diagnostic resolution, cancer care follow-up treatment adherence, and attendance of care events. Random-effects models were used to compute risk ratios and I2 statistics determined the impact of heterogeneity. RESULTS: Of 3985 articles screened, 25 articles met inclusion criteria. Compared to usual care, patients who received PN were significantly more likely to access health screening (OR 2.48, 95% CI, 1.93-3.18, P<0.00001) and attend a recommended care event (OR 2.55, 95% CI, 1.27-5.10, P<0.01). PN was favoured to increase adherence to cancer care follow-up treatment and obtain diagnoses. Most studies involved trained lay navigators (n=12) compared to health professionals (n=9). CONCLUSION: PN is effective to increase screening rates and complete care events. PRACTICE IMPLICATIONS: PN is an effective intervention for use in healthcare.
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