Does health coaching improve health‐related quality of life and reduce hospital admissions in people with chronic obstructive pulmonary disease? A systematic review and meta‐analysis

Abstract

Purpose To systematically review the evidence for health coaching as an intervention to improve health‐related quality of life (HRQoL) and reduce hospital admissions in people with chronic obstructive pulmonary disease (COPD). Methods We systematically searched MEDLINE, EMBASE, PsycINFO, and CINAHL from database inception to August 2018 to identify all randomized controlled trials (RCTs) of health coaching for people with COPD. Eligible health coaching interventions had to include three components: goal setting, motivational interviewing, and COPD‐related health education. Data were extracted on study characteristics and the effects of the intervention on HRQoL, hospital admissions, physical activity, self‐care behaviour, and mood. Study quality was appraised by two authors using the Cochrane tool for assessing the risk of bias in RCTs. Effect sizes (standardized mean differences [SMD] or odds ratios [OR]) with 95% confidence intervals (CIs) were calculated and pooled using random effects meta‐analyses. Results Of 1578 articles, 10 RCTs were included. Meta‐analysis showed that health coaching has a significant positive effect on HRQoL (SMD = −0.69, 95% CI: −1.28, −0.09, p = .02, from k = 4) and leads to a significant reduction in COPD‐related hospital admissions (OR = 0.46, 95% CI: 0.31, 0.69, p = .0001, from k = 5), but not in all‐cause hospital admissions (OR = 0.70, 95% CI: 0.41–1.12, p = .20, from k = 3). Three of four studies reported significant improvements to self‐care behaviours such as medication adherence and exercise compliance. Conclusions This is the first systematic review to show that health coaching may be a candidate intervention to improve HRQoL and reduce costly hospital admissions in people with COPD. What is already known on this subject? COPD is a leading cause of death worldwide and considerably reduces HRQoL. In turn, HRQoL is associated with a range of adverse health outcomes in COPD. Health coaching is a self‐management intervention for people with long‐term conditions such as COPD. Studies have examined whether health coaching improves HRQOL and other health outcomes in people with COPD, but no systematic review has been conducted. What does this study add? The first systematic review and meta‐analysis of RCTs of health coaching for people with COPD. Health coaching may be a candidate intervention for improving HRQoL and reducing COPD‐related hospital admissions in people with COPD. The need to establish the most effective health coaching components, delivery modality, and economic impact.

Patient perspectives on how to optimise benefits from a breathlessness service for people with COPD

“…Much attention has been paid in the literature to promoting a transition for patients who are initially less willing to take an active role in their healthcare, variously described in terms of self-efficacy 25 , activation 26 and empowerment 27 . Strategies aimed at boosting these requisites have been collectively subsumed under the umbrella term of 'coaching' and have been found effective for improving not only self-management but also reducing hospital admissions and even improving health-related quality of life 28 . However, few intervention studies have considered betweenpatient variability in the need for coaching.…”

Understanding face mask use to prevent coronavirus and other illnesses: Development of a multidimensional face mask perceptions scale

“…but many researchers point out that preventative measures also reduce the spread of illness (Chen et al, 2020;Long et al, 2019;Wang et al, 2020). Among these preventative measures are hand washing, social distancing, andthe focus of the current articleface mask wearing.…”

Experiences of Pulmonary Rehabilitation in People Living with Chronic Obstructive Pulmonary Disease and Frailty. A Qualitative Interview Study

“…Helpful approaches might include empathetic communication suggesting problem-focused strategies to support engagement (e.g., offering walking aids, focusing on falls within rehabilitation), but also importantly addressing the emotional aspects of their experience (e.g., building confidence, working through fears and misconceptions, emphasizing the social and safe environment, linking rehabilitation to their priorities). This could include learning from the success of motivational interviewing-based health coaching ( 60 ). If pulmonary rehabilitation is truly no longer the best fit for their goals, these conversations might also provide opportunities to discuss other suitable interventions.…”