12
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: not found

      Health Coaching and Chronic Obstructive Pulmonary Disease Rehospitalization. A Randomized Study

      research-article

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Rationale: Hospital readmission for chronic obstructive pulmonary disease (COPD) has attracted attention owing to the burden to patients and the health care system. There is a knowledge gap on approaches to reducing COPD readmissions.

          Objectives: To determine the effect of comprehensive health coaching on the rate of COPD readmissions.

          Methods: A total of 215 patients hospitalized for a COPD exacerbation were randomized at hospital discharge to receive either ( 1) motivational interviewing–based health coaching plus a written action plan for exacerbations (the use of antibiotics and oral steroids) and brief exercise advice or ( 2) usual care.

          Measurements and Main Results: We evaluated the rate of COPD-related hospitalizations during 1 year of follow-up. The absolute risk reductions of COPD-related rehospitalization in the health coaching group were 7.5% ( P = 0.01), 11.0% ( P = 0.02), 11.6% ( P = 0.03), 11.4% ( P = 0.05), and 5.4% ( P = 0.24) at 1, 3, 6, 9, and 12 months, respectively, compared with the control group. The odds ratios for COPD hospitalization in the intervention arm compared with the control arm were 0.09 (95% confidence interval [CI], 0.01–0.77) at 1 month postdischarge, 0.37 (95% CI, 0.15–0.91) at 3 months postdischarge, 0.43 (95% CI, 0.20–0.94) at 6 months postdischarge, and 0.60 (95% CI, 0.30–1.20) at 1 year postdischarge. The missing value rate for the primary outcome was 0.4% (one patient). Disease-specific quality of life improved significantly in the health coaching group compared with the control group at 6 and 12 months, based on the Chronic Respiratory Disease Questionnaire emotional score (emotion and mastery domains) and physical score (dyspnea and fatigue domains) ( P < 0.05). There were no differences between groups in measured physical activity at any time point.

          Conclusions: Health coaching may represent a feasible and possibly effective intervention designed to reduce COPD readmissions.

          Clinical trial registered with www.clinicaltrials.gov (NCT01058486).

          Related collections

          Author and article information

          Journal
          Am J Respir Crit Care Med
          Am. J. Respir. Crit. Care Med
          ajrccm
          American Journal of Respiratory and Critical Care Medicine
          American Thoracic Society
          1073-449X
          1535-4970
          15 September 2016
          15 September 2016
          15 September 2016
          : 194
          : 6
          : 672-680
          Affiliations
          [ 1 ]Mindful Breathing Laboratory, Division of Pulmonary and Critical Care Medicine
          [ 2 ]Department of Psychology, and
          [ 3 ]Department of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota
          [ 4 ]University of Iowa Hospitals & Clinics, Iowa City, Iowa
          [ 5 ]HealthPartners Institute for Education and Research, Bloomington, Minnesota
          [ 6 ]Academic Health Center, University of Minnesota, Minneapolis, Minnesota; and
          [ 7 ]Stanford Patient Education Research Center, Palo Alto, California
          Author notes
          Correspondence and requests for reprints should be addressed to Roberto Benzo, M.D., Mindful Breathing Laboratory, Division of Pulmonary and Critical Care Medicine, Mayo Clinic, 200 First Street S.W., Rochester, MN 55905. E-mail benzo.roberto@ 123456mayo.edu
          Article
          PMC5027231 PMC5027231 5027231 201512-2503OC
          10.1164/rccm.201512-2503OC
          5027231
          26953637
          da62240a-eecb-4263-8f47-977abb8e95d1
          Copyright © 2016 by the American Thoracic Society
          History
          : 29 December 2015
          : 07 March 2016
          Page count
          Figures: 1, Tables: 4, Pages: 9
          Categories
          Original Article
          Chronic Obstructive Pulmonary Disease

          quality of life,chronic obstructive pulmonary disease,health coaching,hospitalizations,communication skills

          Comments

          Comment on this article