Patient navigators for people with chronic disease: A systematic review
Open accessAbstract
BACKGROUND: People with chronic diseases experience barriers to managing their diseases and accessing available health services. Patient navigator programs are increasingly being used to help people with chronic diseases navigate and access health services. OBJECTIVE: The objective of this review was to summarize the evidence for patient navigator programs in people with a broad range of chronic diseases, compared to usual care. METHODS: We searched MEDLINE, EMBASE, CENTRAL, CINAHL, PsycINFO, and Social Work Abstracts from inception to August 23, 2017. We also searched the reference lists of included articles. We included original reports of randomized controlled trials of patient navigator programs compared to usual care for adult and pediatric patients with any one of a defined set of chronic diseases. RESULTS: From a total of 14,672 abstracts, 67 unique studies fit our inclusion criteria. Of these, 44 were in cancer, 8 in diabetes, 7 in HIV/AIDS, 4 in cardiovascular disease, 2 in chronic kidney disease, 1 in dementia and 1 in patients with more than one condition. Program characteristics varied considerably. Primary outcomes were most commonly process measures, and 45 of 67 studies reported a statistically significant improvement in the primary outcome. CONCLUSION: Our findings indicate that patient navigator programs improve processes of care, although few studies assessed patient experience, clinical outcomes or costs. The inability to definitively outline successful components remains a key uncertainty in the use of patient navigator programs across chronic diseases. Given the increasing popularity of patient navigators, future studies should use a consistent definition for patient navigation and determine which elements of this intervention are most likely to lead to improved outcomes. TRIAL REGISTRATION: PROSPERO #CRD42013005857.
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Qualifications, training and time dedicated to the care navigator role vary based on the care team structure and the health system.
“Qualifications, training and time dedicated to the care navigator role vary based on the care team structure and the health system.”
From 2024 Alzheimer's disease facts and figures (2024) · cites this paper as [987]
The Introduction and Results > Description of studies show that navigators have different professional backgrounds, while Results > Intervention characteristics reports wide variation in contact frequency and navigation duration. The paper does not establish that training or time dedicated to the role varies according to care-team structure or health system; navigation duration is not necessarily time dedicated to the role. The indexed passages provide no page numbers. (LLM, conf=0.83)
Experimental — accuracy not yet measuredCare navigators, including dementia care navigators, frequently share the racial, ethnic or cultural background of those they assist, enhancing the delivery of culturally competent care and building stronger patient-navigator relationships.
“Care navigators, including dementia care navigators, frequently share the racial, ethnic or cultural background of those they assist, enhancing the delivery of culturally competent care and building stronger patient‐navigator relationships. 983 , 987”
From 2024 Alzheimer's disease facts and figures (2024) · cites this paper as [987]
The Results (Intervention characteristics; page unavailable) report that 26 studies used culturally aligned navigation, which could mean a navigator shared patients’ ethnicity or other cultural factors, but could also mean tailored materials or communication. The review includes a dementia study (Results, Description of studies), but does not establish that its navigators shared patients’ backgrounds or that matching improved culturally competent care or patient–navigator relationships. (LLM, conf=0.86)
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2024 Alzheimer's disease facts and figures
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“Specific strategies used to address structural barriers included providing or assisting in obtaining transportation services, 6,28,29,35,36,40,42,57,59,60,63–67, 73,77, 80, 87 providing”
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Revising the logic model behind health care's social care investments
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- Authors
- McBrien, K. A., Ivers, N., Barnieh, L., Bailey, J. J., Lorenzetti, D. L., Nicholas, D., Tonelli, M., Hemmelgarn, B., Lewanczuk, R., Edwards, A., Braun, T., & Manns, B.
- Affiliations
- University of Calgary (CA)
- University of Toronto (CA)
- Alberta Health Services (CA)
- Corresponding author
- McBrien, Kerry A.
- ORCID
- Venue
- PLOS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2018-02-20
- Volume
- 13
- Issue
- 2
- Pages
- e0191980
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC5819768
- OpenAlex
- W2789835003
- Cited by
- 307
- References
- 104
- Citations by year
- 2026: 24 · 2025: 45 · 2024: 39 · 2023: 45 · 2022: 47 · 2021: 48 · 2020: 36 · 2019: 20 · 2018: 3
- FWCI
- 3.82
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- PLoS ONE (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Figshare (submittedVersion, cc-by)
- Funders
- Alberta Innovates - Health Solutions
- Canadian Diabetes Association (CA)
- Topics
- Health Sciences › Medicine › Epidemiology › Chronic Disease Management Strategies
- Health Sciences › Health Professions › General Health Professions › Nursing Roles and Practices
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Keywords
- patient navigators, chronic disease, health care access, barriers to care, cancer, diabetes mellitus, HIV/AIDS, cardiovascular disease, chronic kidney disease, dementia, process of care, usual care comparison, intervention components
- MeSH terms
- Chronic Disease, Humans, Patient Navigation
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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