Randomized Controlled Trial of Health Coaching for Vulnerable Patients with Chronic Obstructive Pulmonary Disease

Thom, David H.; Willard-Grace, Rachel; Tsao, Stephanie; Hessler, Danielle; Huang, Beatrice; DeVore, Denise; Chirinos, Chris; Wolf, Jessica; Donesky, DorAnne; Garvey, Chris; Su, George

doi:10.1513/annalsats.201806-365oc

Cited by 28 publications

(43 citation statements)

References 56 publications

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“… 20 One of the advantages of EBIP is its face-to-face nature and the consequent opportunity to address individual problems and integrate them to the process. 21 However, this program may have limited applicability in regions where the number of nurses is limited or where home visits are problematic due to security. The subsequently increased probability of noncompliance to the determined home visit and phone appointment schedule will impair the effectiveness of the study design.…”

Section: Discussionmentioning

confidence: 99%

The impact of an Education-Based Intervention Program (EBIP) on dyspnea and chronic self-care management among chronic obstructive pulmonary disease patients

Çevirme

GÖKÇAY

2020

SMJ

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To evaluate the impact of dyspnea and chronic self-care management outcomes of an Education-Based Intervention Program (EBIP) compared to routine care. Methods: The population of the study consisted of self-care management scale of 61 patients diagnosed with chronic obstructive pulmonary disease (COPD) stage 2 and within one month after discharge. A total of 51 conforming patients were divided into experimental and control groups for a single-blind randomized trial. Data were collected using an introductory information form, the baseline dyspnea index (BDI), pulmonary function test (PFT), the self-care management process in chronic illness Original Article (SCMP-G) scale and body mass index (BMI). There were no addition interventions to the control group. The intervention group underwent a 3-month EBIP intervention that included education, house visits and follow-ups through phone calls between March 2019 and June 2019. The data were analyzed using Kolmogorov-Smirnov and Shapiro-Wilk tests, χ 2 , Mann Whitney U and Wilcoxon signed-rank tests. p<0.05 was statistically significant. Results: The study was completed with a total of 40 COPD patients. The effect of the EBIP training program on BDI, PFT, and SCMP-G scores in the intervention group was statistically proven (p<0.05). However, the differences between the groups in the BDI sub-dimension of functional impairment and PFT were not statistically significant (p>0.05). Conclusion: Providing patients with illness-related education through EBIP provided a partial improvement in dyspnea and a significant improvement in chronic care management among COPD patients.

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Section: Discussionmentioning

confidence: 99%

The impact of an Education-Based Intervention Program (EBIP) on dyspnea and chronic self-care management among chronic obstructive pulmonary disease patients

Çevirme

GÖKÇAY

2020

SMJ

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“…14-12872) and registered with clinicaltrials.gov (NCT02234284). The study protocol 48 and primary outcomes 47 have been previously published.…”

Section: Methodsmentioning

confidence: 99%

“…The direction of change for the primary outcomes in the AIR study, such as disease-specific quality of life and exacerbations, were positive for the coached group, but differences did not reach statistical significance over usual care. 70 This result may suggest that improved inhaler technique and adherence are only one of the factors required to move outcomes.…”

Section: Key Findingsmentioning

confidence: 99%

“…As previously published, improvements in these primary outcomes did not reach statistical significance. 47 In this article, we report on secondary outcomes related to inhaler adherence and technique. We explored the efficacy of health coaching using trained, unlicensed personnel to improve adherence to and technique in using inhalers among a lowincome, predominantly African American population living with moderate to severe COPD.…”

Section: Introductionmentioning

confidence: 99%

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Lay Health Coaching to Increase Appropriate Inhaler Use in COPD: A Randomized Controlled Trial

et al. 2020

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PURPOSE Poor adherence to medications is more prevalent for chronic obstructive pulmonary disease (COPD) than for other chronic conditions and is associated with unfavorable health outcomes. Few interventions have successfully improved adherence for COPD medications; none of these use unlicensed health care personnel. We explored the efficacy of lay health coaches to improve inhaler adherence and technique.METHODS Within a randomized controlled trial, we recruited English-and Spanish-speaking patients with moderate to severe COPD from urban, public primary care clinics serving a low-income, predominantly African American population. Participants were randomized to receive 9 months of health coaching or usual care. Outcome measures included self-reported adherence to inhaled controller medications in the past 7 days and observed technique for all inhalers. We used generalized linear models, controlling for baseline values and clustering by site. RESULTSBaseline adherence and inhaler technique were uniformly poor and did not differ by study arm. At 9 months, health-coached patients reported a greater number of days of adherence compared with usual care patients (6.4 vs 5.5 days; adjusted P = .02) and were more likely to have used their controller inhalers as prescribed for 5 of the last 7 days (90% vs 69%; adjusted P = .008). They were more than 3 times as likely to demonstrate perfect technique for all inhaler devices (24% vs 7%; adjusted P = .01) and mastery of essential steps (40% vs 11%; adjusted P <.001).CONCLUSIONS Health coaching may provide a scalable model that can improve care for people living with COPD.

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“…There was no difference between the two groups in terms of first respiratory hospitalization or allcause death. A similar trial, the AIR study, randomized 192 participants with moderate to severe COPD to receive health coaching by college graduates without any medical training versus usual care and showed mild improvement in quality of life and depression symptoms but no difference in COPD hospitalizations (104,105).…”

Section: Disease Managementmentioning

confidence: 99%

Update in Chronic Obstructive Pulmonary Disease 2018

Labaki

Kimmig

Mutlu

et al. 2019

Am J Respir Crit Care Med

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Randomized Controlled Trial of Health Coaching for Vulnerable Patients with Chronic Obstructive Pulmonary Disease

Cited by 28 publications

References 56 publications

The impact of an Education-Based Intervention Program (EBIP) on dyspnea and chronic self-care management among chronic obstructive pulmonary disease patients

The impact of an Education-Based Intervention Program (EBIP) on dyspnea and chronic self-care management among chronic obstructive pulmonary disease patients

Lay Health Coaching to Increase Appropriate Inhaler Use in COPD: A Randomized Controlled Trial

Update in Chronic Obstructive Pulmonary Disease 2018

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