Evidence mapPaperPMID 31181221Full record

Trial reportThe Journal of allergy and clinical immunology2019

Home visits for uncontrolled asthma among low-income adults with patient portal access.

Andrea J Apter, A Russell Localio, Knashawn H Morales, Xiaoyan Han, Luzmercy Perez, Alyssa N Mullen, Marisa Rogers, Heather Klusaritz, John T Howell, Maryori N Canales and 1 more

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in The Journal of allergy and clinical immunology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed, 6 pooled it
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

21 citing papers in PubMed, 6 syntheses or guidelines pooled it.

  1. Pooled it
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  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Adult patient access to electronic health records.The Cochrane database of systematic reviews · 2021
    Pooled it
  7. Trial
  8. Patient Portal Usage and Outcomes Among Adult Patients with Uncontrolled Asthma.The journal of allergy and clinical immunology. In practice · 2020
    Trial
  9. Chatbot To Help Patients Understand Their Health.Proceedings of the Conference on Empirical Methods in Natural Language Processing. Conference on Empirical Methods in Natural Language Processing · 2025
    Article
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  11. Article
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  15. Barriers and facilitators of electronic patient portal uptake for asthma management.The Journal of asthma : official journal of the Association for the Care of Asthma · 2023
    Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Andrea J ApterDivision of Pulmonary, Allergy, & Critical Care Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa; Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa; University of Pennsylvania Health System, Philadelphia, Pa. Electronic address: andrea.apter@uphs.upenn.edu.
A Russell LocalioDepartment of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa.
Knashawn H MoralesDepartment of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa.
Xiaoyan HanDepartment of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa.
Luzmercy PerezDivision of Pulmonary, Allergy, & Critical Care Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa.
Alyssa N MullenTemple Physicians, Temple University Health System, Philadelphia, Pa.
Marisa RogersDepartment of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa; University of Pennsylvania Health System, Philadelphia, Pa.
Heather KlusaritzUniversity of Pennsylvania Health System, Philadelphia, Pa; Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa.
John T HowellUniversity of Pennsylvania Health System, Philadelphia, Pa.
Maryori N CanalesChildren's Hospital of Philadelphia, Philadelphia, Pa.
Tyra Bryant-StephensChildren's Hospital of Philadelphia, Philadelphia, Pa.

Funding

Translational Research Support CoreP30ES013508 · UNIVERSITY OF PENNSYLVANIA · 2025 to 2025
$1.6M
Individualized Interventions to Improve Asthma AdherenceR01HL073932 · UNIVERSITY OF PENNSYLVANIA · 2005 to 2005
$782k
INHALED STEROID ADHERENCE IN MODERATE &SEVERE ASTHMAK23HL004337 · UNIVERSITY OF PENNSYLVANIA · 2000 to 2004
$651k
NHLBI NIH HHS K02 HL088469NHLBI NIH HHS K23 HL004337NHLBI NIH HHS R01 HL073932NHLBI NIH HHS R01 HL143364NHLBI NIH HHS R18 HL116285NHLBI NIH HHS U01 HL138687NIAMS NIH HHS K08 AR065577NICHD NIH HHS K23 HD048915NIEHS NIH HHS P30 ES013508
6 · The paper itself

Abstract

backgroundAsthma disproportionately affects low-income and minority adults. In an era of electronic records and Internet-based digital devices, it is unknown whether portals for patient-provider communication can improve asthma outcomes.

objectiveWe sought to estimate the effect on asthma outcomes of an intervention using home visits (HVs) by community health workers (CHWs) plus training in patient portals compared with usual care and portal training only.

methodsThree hundred one predominantly African American and Hispanic/Latino adults with uncontrolled asthma were recruited from primary care and asthma specialty practices serving low-income urban neighborhoods, directed to Internet access, and given portal training. Half were randomized to HVs over 6 months by CHWs to facilitate competency in portal use and promote care coordination.

resultsOne hundred seventy (56%) patients used the portal independently. Rates of portal activity did not differ between randomized groups. Asthma control and asthma-related quality of life improved in both groups over 1 year. Differences in improvements over time were greater for the HV group for all outcomes but reached conventional levels of statistical significance only for the yearly hospitalization rate (-0.53; 95% CI, -1.08 to -0.024). Poor neighborhoods and living conditions plus limited Internet access were barriers for patients to complete the protocol and for CHWs to make HVs.

conclusionFor low-income adults with uncontrolled asthma, portal access and CHWs produced small incremental benefits. HVs with emphasis on self-management education might be necessary to facilitate patient-clinician communication and to improve asthma outcomes.

Indexed as

House CallsPatient PortalsAdolescentAdultAgedAged, 80 and overAsthmaCommunity Health WorkersFemaleHealth EducationHumansMaleMiddle AgedPovertyQuality of LifeYoung AdultAsthmacommunity health workerelectronic health recordhealth disparitiesinformation technologypatient portal

Identifiers

PMID31181221
PMCPMC6742549

What Socratic holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.