Telephone-based health coaching for chronically ill patients: study protocol for a randomized controlled trial

Abstract

BackgroundThe rising prevalence of chronic conditions constitutes a major burden for patients and healthcare systems and is predicted to increase in the upcoming decades. Improving the self-management skills of patients is a strategy to steer against this burden. This could lead to better outcomes and lower healthcare costs. Health coaching is one method for enhancing the self-management of patients and can be delivered by phone. The effects of telephone-based health coaching are promising, but still inconclusive. Economic evaluations and studies examining the transferability of effects to different healthcare systems are still rare. Aim of this study is to evaluate telephone-based health coaching for chronically ill patients in Germany.Methods/DesignThe study is a prospective randomized controlled trial comparing the effects of telephone-based health coaching with usual care during a 4-year time period. Data are collected at baseline and after 12, 24 and 36 months. Patients are selected based on one of the following chronic conditions: diabetes, coronary artery disease, asthma, hypertension, heart failure, COPD, chronic depression or schizophrenia. The health coaching intervention is carried out by trained nurses employed by a German statutory health insurance. The frequency and the topics of the health coaching are manual-based but tailored to the patients’ needs and medical condition, following the concepts of motivational interviewing, shared decision-making and evidence-based-medicine. Approximately 12,000 insurants will be enrolled and randomized into intervention and control groups. Primary outcome is the time until hospital readmission within two years after enrolling in the health coaching, assessed by routine data. Secondary outcomes are patient-reported outcomes like changes in quality of life, depression and anxiety and clinical values assessed with questionnaires. Additional secondary outcomes are further economic evaluations like health service use as well as costs and hospital readmission rates. The statistical analyses includes intention-to-treat and as-treated principles. The recruitment will be completed in September 2014.DiscussionThis study will provide evidence regarding economic and clinical effects of telephone-delivered health coaching. Additionally, this study will show whether health coaching is an adequate option for the German healthcare system to address the growing burden of chronic diseases.Trial registrationGerman Clinical Trials Register (Deutsches Register Klinischer Studien; DRKS) DRKS00000584.

Translation and validation of a multidimensional instrument to assess health literacy

“…The validation of the FCCHL is embedded in a 4‐year randomized controlled trail (RCT) evaluating a telephone‐based health coaching (TBHC) for chronically ill patients being registered in the German Clinical Trials Register (Deutsches Register Klinischer Studien; DRKS) under DRKS00000584. To be included in the RCT, participants should be at least 18 years old and members of the Kaufmännische Krankenkasse Hannover (KKH), a statutory health insurance.…”

Impacto do monitoramento telefônico em pacientes com insuficiência cardíaca: ensaio clínico randomizado

“…The studies do not usually provide detail about how the telephonic-based approach occurs, considering all recommendations for improving knowledge and self-care. (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15) The disclosure of the way in which the telephone-based approach has occurred can contribute to the ability of HF clinics to monitor their patients in an standardized manner, and the scientific community must have access to these previously tested instruments, for future validation.…”

“…(3) Health education is a widely used practice in the outpatient and in the hospital settings, whose strategies show beneficial effects on health promotion for the treatment of diseases, especially chronic diseases. (4) Health education is an influential factor, directly related to the outcomes of positive patient care, aiming to teach people how to live life as healthily as possible to reach their maximum health potential. (5) Dialogic education encourages autonomy in health care practice, and the participation of the individual in the control and supervision of the health service.…”

Telefoncoaching bei Depression

“…Zum Nachweis des klinischen Nutzens bei Depression bedarf es weiterer Forschung [8][9][10][11]. In der vorliegenden Arbeit sollte daher untersucht werden, ob das TC depressiv Kranker, die wegen einer hohen Wahrscheinlichkeit künftiger Hospitalisierungen ausgewählt wurden, als ergän-zende Maßnahme zur Regelversorgung zu geringeren direkten Krankheitskosten führt.…”

“…Somit können neben den von Dennis et al [7] in ihrem Review berücksichtigten somatischen chronischen Krankheiten auch depressiv Kranke von einem Telefoncoaching profitieren [12]. Weitere Studien sind unterwegs [9][10][11]. Neu in unserem Ansatz ist die Fokussierung der Intervention auf die Subgruppe mit dem höchsten zu erwartenden Ressourcenverbrauch (Kostenprognosemodell; [20][21][22] …”