title: Care guides: employing nonclinical laypersons to help primary care teams manage chronic disease.
abstract: Lay persons ("care guides") without previous clinical experience were hired by a primary care clinic, trained for 2 weeks, and assigned to help 332 patients and their providers manage their diabetes, hypertension, and congestive heart failure. One year later, failure by these patients to meet nationally recommended guidelines was reduced by 28%, P < .001. Improvement was seen in tobacco usage, blood pressure control, pneumonia vaccination, low-density lipoprotein cholesterol levels, annual eye examinations, aspirin use, and microalbuminuria testing. Care guides served an average of 111 patients at an annual per patient cost of $392. Further testing of this model is warranted.
authors.affiliation: Allina Hospitals and Clinics, Minneapolis, MN, USA. adair001@umn.edu
authors.forename: Richard
authors.initials: R
authors.lastname: Adair
authors.forename: Jon
authors.initials: J
authors.lastname: Christianson
authors.forename: Douglas R
authors.initials: DR
authors.lastname: Wholey
authors.forename: Katie
authors.initials: K
authors.lastname: White
authors.forename: Robert
authors.initials: R
authors.lastname: Town
authors.forename: Suhna
authors.initials: S
authors.lastname: Lee
authors.forename: Heather
authors.initials: H
authors.lastname: Britt
authors.forename: Peter
authors.initials: P
authors.lastname: Lund
authors.forename: Anya
authors.initials: A
authors.lastname: Lukasewycz
authors.forename: Deborah
authors.initials: D
authors.lastname: Elumba
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease / Q000628:therapy*; D003150:Community Health Workers; D003299:Cooperative Behavior; D003365:Costs and Cost Analysis; D019468:Disease Management; D005260:Female; D006801:Humans; D033183:Interdisciplinary Communication; D008297:Male; D008875:Middle Aged; D008910:Minnesota; D010348:Patient Care Team; D010865:Pilot Projects; D011320:Primary Health Care; D024382:Professional Role