Health Disparities in Patients with Pulmonary Arterial Hypertension: A Blueprint for Action. An Official American Thoracic Society Statement

Health disparities have a major impact in the quality of life and clinical care received by minorities in the United States. Pulmonary arterial hypertension (PAH) is a rare cardiopulmonary disorder that affects children and adults and that, if untreated, results in premature death. The impact of hea...

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Published inAmerican journal of respiratory and critical care medicine Vol. 196; no. 8; pp. e32 - e47
Main Authors Talwar, Arunabh, Garcia, Joe G. N., Tsai, Halley, Moreno, Matthew, Lahm, Tim, Zamanian, Roham T., Machado, Roberto, Kawut, Steven M., Selej, Mona, Mathai, Stephen, D’Anna, Laura Hoyt, Sahni, Sonu, Rodriquez, Erik J., Channick, Richard, Fagan, Karen, Gray, Michael, Armstrong, Jessica, Rodriguez Lopez, Josanna, de Jesus Perez, Vinicio
Format Journal Article
LanguageEnglish
Published United States American Thoracic Society 15.10.2017
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ISSN1073-449X
1535-4970
1535-4970
DOI10.1164/rccm.201709-1821ST

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Abstract Health disparities have a major impact in the quality of life and clinical care received by minorities in the United States. Pulmonary arterial hypertension (PAH) is a rare cardiopulmonary disorder that affects children and adults and that, if untreated, results in premature death. The impact of health disparities in the diagnosis, treatment, and clinical outcome of patients with PAH has not been systematically investigated. The specific goals of this research statement were to conduct a critical review of the literature concerning health disparities in PAH, identify major research gaps and prioritize direction for future research. Literature searches from multiple reference databases were performed using medical subject headings and text words for pulmonary hypertension and health disparities. Members of the committee discussed the evidence and provided recommendations for future research. Few studies were found discussing the impact of health disparities in PAH. Using recent research statements focused on health disparities, the group identified six major study topics that would help address the contribution of health disparities to PAH. Representative studies in each topic were discussed and specific recommendations were made by the group concerning the most urgent questions to address in future research studies. At present, there are few studies that address health disparities in PAH. Given the potential adverse impact of health disparities, we recommend that research efforts be undertaken to address the topics discussed in the document. Awareness of health disparities will likely improve advocacy efforts, public health policy and the quality of care of vulnerable populations with PAH.
AbstractList [...]data supporting health disparities from PAH cohort studies and registries are sparse. [...]strategies should be developed to make insurance companies aware that advanced treatment methods, although expensive upfront, will pay off in the long term in the form of reduced admissions, emergency department visits, and overall healthcare use. The results demonstrated that patients in the intervention group were more likely than control subjects to receive counseling or use antidepressants (50.9 vs. 39.7%; P < 0.001) and less likely than control subjects to meet criteria for depression (39.9 vs. 49.9%; P = 0.001) (119). [...]health disparities education could improve provider-patient communication and help eliminate the pervasive racial disparities seen in medical care today (120). In a study by Morrison and colleagues, in a random selection of 30% of New York City pharmacies, only 25% of nonwhite neighborhood pharmacies supplied a sufficient amount of opioids to treat severe pain, compared with 72% of white neighborhood pharmacies (124). [...]the use of professional interpreters is associated with improved patient understanding of disease and appears to raise quality of clinical care for non-English-speaking patients toward the level of care for patients without language barriers (125, 126).
Health disparities have a major impact in the quality of life and clinical care received by minorities in the United States. Pulmonary arterial hypertension (PAH) is a rare cardiopulmonary disorder that affects children and adults and that, if untreated, results in premature death. The impact of health disparities in the diagnosis, treatment, and clinical outcome of patients with PAH has not been systematically investigated.BACKGROUNDHealth disparities have a major impact in the quality of life and clinical care received by minorities in the United States. Pulmonary arterial hypertension (PAH) is a rare cardiopulmonary disorder that affects children and adults and that, if untreated, results in premature death. The impact of health disparities in the diagnosis, treatment, and clinical outcome of patients with PAH has not been systematically investigated.The specific goals of this research statement were to conduct a critical review of the literature concerning health disparities in PAH, identify major research gaps and prioritize direction for future research.OBJECTIVESThe specific goals of this research statement were to conduct a critical review of the literature concerning health disparities in PAH, identify major research gaps and prioritize direction for future research.Literature searches from multiple reference databases were performed using medical subject headings and text words for pulmonary hypertension and health disparities. Members of the committee discussed the evidence and provided recommendations for future research.METHODSLiterature searches from multiple reference databases were performed using medical subject headings and text words for pulmonary hypertension and health disparities. Members of the committee discussed the evidence and provided recommendations for future research.Few studies were found discussing the impact of health disparities in PAH. Using recent research statements focused on health disparities, the group identified six major study topics that would help address the contribution of health disparities to PAH. Representative studies in each topic were discussed and specific recommendations were made by the group concerning the most urgent questions to address in future research studies.RESULTSFew studies were found discussing the impact of health disparities in PAH. Using recent research statements focused on health disparities, the group identified six major study topics that would help address the contribution of health disparities to PAH. Representative studies in each topic were discussed and specific recommendations were made by the group concerning the most urgent questions to address in future research studies.At present, there are few studies that address health disparities in PAH. Given the potential adverse impact of health disparities, we recommend that research efforts be undertaken to address the topics discussed in the document. Awareness of health disparities will likely improve advocacy efforts, public health policy and the quality of care of vulnerable populations with PAH.CONCLUSIONSAt present, there are few studies that address health disparities in PAH. Given the potential adverse impact of health disparities, we recommend that research efforts be undertaken to address the topics discussed in the document. Awareness of health disparities will likely improve advocacy efforts, public health policy and the quality of care of vulnerable populations with PAH.
Health disparities have a major impact in the quality of life and clinical care received by minorities in the United States. Pulmonary arterial hypertension (PAH) is a rare cardiopulmonary disorder that affects children and adults and that, if untreated, results in premature death. The impact of health disparities in the diagnosis, treatment, and clinical outcome of patients with PAH has not been systematically investigated. The specific goals of this research statement were to conduct a critical review of the literature concerning health disparities in PAH, identify major research gaps and prioritize direction for future research. Literature searches from multiple reference databases were performed using medical subject headings and text words for pulmonary hypertension and health disparities. Members of the committee discussed the evidence and provided recommendations for future research. Few studies were found discussing the impact of health disparities in PAH. Using recent research statements focused on health disparities, the group identified six major study topics that would help address the contribution of health disparities to PAH. Representative studies in each topic were discussed and specific recommendations were made by the group concerning the most urgent questions to address in future research studies. At present, there are few studies that address health disparities in PAH. Given the potential adverse impact of health disparities, we recommend that research efforts be undertaken to address the topics discussed in the document. Awareness of health disparities will likely improve advocacy efforts, public health policy and the quality of care of vulnerable populations with PAH.
Background: Health disparities have a major impact in the quality of life and clinical care received by minorities in the United States. Pulmonary arterial hypertension (PAH) is a rare cardiopulmonary disorder that affects children and adults and that, if untreated, results in premature death. The impact of health disparities in the diagnosis, treatment, and clinical outcome of patients with PAH has not been systematically investigated. Objectives: The specific goals of this research statement were to conduct a critical review of the literature concerning health disparities in PAH, identify major research gaps and prioritize direction for future research. Methods: Literature searches from multiple reference databases were performed using medical subject headings and text words for pulmonary hypertension and health disparities. Members of the committee discussed the evidence and provided recommendations for future research. Results: Few studies were found discussing the impact of health disparities in PAH. Using recent research statements focused on health disparities, the group identified six major study topics that would help address the contribution of health disparities to PAH. Representative studies in each topic were discussed and specific recommendations were made by the group concerning the most urgent questions to address in future research studies. Conclusions: At present, there are few studies that address health disparities in PAH. Given the potential adverse impact of health disparities, we recommend that research efforts be undertaken to address the topics discussed in the document. Awareness of health disparities will likely improve advocacy efforts, public health policy and the quality of care of vulnerable populations with PAH.
Author Moreno, Matthew
Machado, Roberto
Armstrong, Jessica
Channick, Richard
Tsai, Halley
Rodriquez, Erik J.
Talwar, Arunabh
Fagan, Karen
Lahm, Tim
Selej, Mona
Kawut, Steven M.
D’Anna, Laura Hoyt
Gray, Michael
Sahni, Sonu
de Jesus Perez, Vinicio
Zamanian, Roham T.
Mathai, Stephen
Garcia, Joe G. N.
Rodriguez Lopez, Josanna
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BackLink https://www.ncbi.nlm.nih.gov/pubmed/29028375$$D View this record in MEDLINE/PubMed
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PublicationTitle American journal of respiratory and critical care medicine
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SecondaryResourceType review_article
Snippet Health disparities have a major impact in the quality of life and clinical care received by minorities in the United States. Pulmonary arterial hypertension...
[...]data supporting health disparities from PAH cohort studies and registries are sparse. [...]strategies should be developed to make insurance companies...
Background: Health disparities have a major impact in the quality of life and clinical care received by minorities in the United States. Pulmonary arterial...
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StartPage e32
SubjectTerms Adolescent
Adult
Aged
Aged, 80 and over
American Thoracic Society Documents
Antihypertensive Agents - standards
Child
Child, Preschool
Committees
Cultural differences
Curricula
Disease
Education
Female
Health care policy
Health disparities
Health Policy
Healthcare Disparities
Humans
Hypertension, Pulmonary - diagnosis
Hypertension, Pulmonary - drug therapy
Infant
Infant, Newborn
Male
Middle Aged
Minority & ethnic groups
Patients
Physicians
Practice Guidelines as Topic
Pulmonary hypertension
Quality of life
Race
Societies, Medical
Socioeconomic factors
United States
Young Adult
Title Health Disparities in Patients with Pulmonary Arterial Hypertension: A Blueprint for Action. An Official American Thoracic Society Statement
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