Newswise — Alex D. Federman, MD, Associate Professor in the Department of Medicine, General Internal Medicine at the Icahn School of Medicine at Mount Sinai, has been approved for funding by the Patient-Centered Outcomes Research Institute (PCORI) for his research, “Clinic-Based vs. Home-Based support to improve care and outcomes for older asthmatics.” Dr. Federman will lead 1 of 82 research projects approved for PCORI funding to help patients and those who care for them make better-informed healthcare decisions.
“Asthma is common and debilitating in older adults and members of African-American and Latino communities are more likely to suffer from and have poor outcomes from asthma than people in other racial and ethnic communities,” said Dr. Federman. “The management is complex and further complicated by other chronic illnesses that are frequently found in older adults. Improving outcomes for older adults with asthma requires addressing the various medical, social, psychological, environmental, and health system problems that prevent patients from achieving good control of their disease.”
PCORI funds research to help asthmatic patients and those who care for them make better informed healthcare decisions. The investigators will conduct a comparative effectiveness study of different approaches to supporting older adults with asthma.
The project will compare two approaches to improving health and healthcare for older adults with asthma. One approach involves the use of an “asthma care coach,” or ACC. The ACC is a lay health educator based in clinical practices who will identify older asthmatics at high risk of poor outcomes like emergency department visits or hospitalizations. The ACC will work with the patient to identify and address barriers to good control of their asthma, and will provide ongoing support to the patient to ensure that their asthma stays under control.
The other approach uses the ACC concept and places it in the home. Community health workers will visit high risk, older asthmatics in their homes and conduct a similar assessment as that performed by the ACC. Providing this support in the home may have several advantages over providing it in a clinic or office, including the ability of the community health worker to directly observe environmental factors that may trigger asthma attacks and the patient’s strategy for organizing their medications.
“Findings from this study will not only identify best practices for improving the health of older adults with asthma, but will illuminate effective strategies for older adults with complex chronic illnesses in general,” said Dr. Federman.
The research will be conducted with academic partners, the Health Literacy and Learning Program (HeLP) at Northwestern University in Chicago; the Institute for Family Health in New York and community-based partners, the Little Sisters of the Assumption, Settlement Health, and City Health Works. The Greater New York Hospital Association and the New York State Department of Health will also take part in the research.
About the Mount Sinai Health System The Mount Sinai Health System is an integrated health system committed to providing distinguished care, conducting transformative research, and advancing biomedical education. Structured around seven member hospital campuses and a single medical school, the Health System has an extensive ambulatory network and a range of inpatient and outpatient services—from community-based facilities to tertiary and quaternary care.
The System includes approximately 6,600 primary and specialty care physicians, 12-minority-owned free-standing ambulatory surgery centers, over 45 ambulatory practices throughout the five boroughs of New York City, Westchester, and Long Island, as well as 31 affiliated community health centers. Physicians are affiliated with the Icahn School of Medicine at Mount Sinai, which is ranked among the top 20 medical schools both in National Institutes of Health funding and by U.S. News & World Report.
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