Results Summary and Professional Abstract
|Article Highlight: For a range of reasons, older adults have more trouble managing asthma than younger patients. Researchers in this study developed and tested a program called Supporting Asthma Self-Management Behaviors in Aging Adults (SAMBA) that screened patients for barriers to receiving and managing their care, and then worked with patients to overcome those barriers. Among other outcomes, patients who used SAMBA were half as likely to end up in the emergency room as patients who didn’t use SAMBA, the research team reported in JAMA Internal Medicine.|
|This project's final research report is expected to be available by November 2019.|
Peer Review Summary
Peer review of PCORI-funded research helps make sure the report presents complete, balanced, and useful information about the research. It also assesses how the project addressed PCORI’s Methodology Standards. During peer review, experts read a draft report of the research and provide comments about the report. These experts may include a scientist focused on the research topic, a specialist in research methods, a patient or caregiver, and a healthcare professional. These reviewers cannot have conflicts of interest with the study.
The peer reviewers point out where the draft report may need revision. For example, they may suggest ways to improve descriptions of the conduct of the study or to clarify the connection between results and conclusions. Sometimes, awardees revise their draft reports twice or more to address all of the reviewers’ comments.
Peer reviewers commented, and the researchers made changes or provided responses. The comments and responses included the following:
- The reviewers asked for additional detail on how the organizations hired, employed, and supervised community health workers and care coaches in clinics. They also asked for additional detail on how community health workers and care coaches worked within the care system. The researchers explained that four separate organizations provided the coaching staff used in the study and that each organization had its own processes for hiring, supervision, and documenting procedures. The researchers said they did observe commonalities among the type of people employed in these roles and expanded the description of staff in the report.
- Reviewers observed that the study designated many primary outcomes but was best powered for the asthma control test (ACT) and asthma quality of life questionnaire (AQLQ), suggesting that in hindsight those measures should have been considered primary and the other outcomes secondary. The researchers agreed that it would have been appropriate to designate only the ACT and AQLQ measures as primary outcomes. However, for consistency with other reports, they requested keeping the existing primary and secondary outcome designations.
- Reviewers wondered if staff who work with patients with a variety of chronic illnesses could administer the intervention as part of a menu of potential interventions. This should be possible. The researchers explained that they originally hoped to develop a platform to support people with any chronic disease, given that people with chronic illnesses face common challenges and often have multiple illnesses. The researchers added some text about this in the discussion section.
- Reviewers also noted that in the comparison of clinic- versus home-based intervention delivery, there were no significant differences. The researchers similarly added a comment to the discussion suggesting that health systems could choose between either format for delivering the intervention. The researchers did add the caveat, however, that this comparison was not powered to test for noninferiority.
Conflict of Interest Disclosures
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