Patient navigators are trained personnel who help patients overcome modifiable barriers to care and achieve their care goals by providing a tailored approach to addressing individual needs. System level barriers include the inherent complexity of the health care system and suboptimal access to primary or specialty care. At the provider level, barriers may include lack of clinical decision support systems to implement recommended care, lack of time and knowledge. Patient level barriers may include lack of awareness of publicly funded programs (including community-based resources), financial constraints, competing priorities (e.g., family and work), personal circumstances, language and culture (i.e., race/ethnicity) such barriers could make it challenging to follow even seemingly simple lifestyle recommendations. This difficulty in implementing evidence-based care may be due to a combination of patient, provider and system level barriers. Despite widespread dissemination of practice guidelines, many people with chronic diseases do not receive or adhere to recommended care. For example, clinical trials show that in patients with diabetes, tight control of blood pressure, use of statins and achieving good glycemic control improves outcomes and lowers costs. Adherence to evidence-based recommendations for clinical care is associated with better outcomes and lower resource use for patients with chronic diseases. People with chronic diseases have increased morbidity and consume substantially more health care resources than those without. There were an estimated 12.7 million new cases of cancer worldwide in 2008 and diabetes prevalence was estimated to be 6.4%, affecting 285 million adults worldwide in 2010. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.Ĭompeting interests: The authors have declared that no competing interests exist.Ĭhronic diseases, including physical and mental illnesses, are a significant burden to both patients and the health care system. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.ĭata Availability: All relevant data are within the paper and its Supporting Information files.įunding: This research was funded by an Alberta Innovates – Health Solutions (AI-HS) team grant to the Interdisciplinary Chronic Disease Collaboration (ICDC), project ID #10007987 ( ) to Brenda Hemmelgarn and the Canadian Diabetes Association (CA) to Kerry A McBrien. Received: JAccepted: JanuPublished: February 20, 2018Ĭopyright: © 2018 McBrien et al. (2018) Patient navigators for people with chronic disease: A systematic review. Citation: McBrien KA, Ivers N, Barnieh L, Bailey JJ, Lorenzetti DL, Nicholas D, et al.
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