Effect of Health Coaching Delivered by a Respiratory Therapist or Nurse on Self-Management Abilities in Severe COPD: Analysis of a Large Randomized Study

Roberto P Benzo, Charlene McEvoy

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

BACKGROUND: Self-management of patients with COPD has received increasing attention in recent years given its association with improved outcomes. There is a scarcity of feasible interventions that can improve self-management abilities. We recently reported the positive effect of health coaching, started at the time of hospital discharge, on re-hospitalizations and emergency department visits for patients with COPD admitted for an exacerbation. In this substudy, we aimed to investigate the effects of health coaching delivered by a respiratory therapist or a nurse compared with guideline-based usual care on self-management abilities in COPD. METHODS: Self-management was measured by using the Chronic Respiratory Disease Questionnaire mastery domain and was assessed at baseline, at 6 months, and at 12 months after hospitalization. RESULTS: Two hundred and fifteen subjects hospitalized for a COPD exacerbation were randomized to the intervention or the control. The mean change in the Chronic Respiratory Disease Questionnaire mastery score from baseline to month 6 was Δ0.58 32 ± 1.29 on the intervention arm and Δ0.17 32 ± 1.14 on the control arm (P = .02). Of the intervention subjects, 55% had at least a 0.5-point increase in Chronic Respiratory Disease Questionnaire mastery (minimum clinically important difference) compared with 38% in the control group. Health coaching was an independent predictor of the minimum clinically important difference or greater change in the Chronic Respiratory Disease Questionnaire mastery score at 6 months after initiation of the intervention (odds ratio 1.95, 95% CI 1.01-3.79). The changes in the Chronic Respiratory Disease Questionnaire mastery score at 12 months showed a trend but did not attain statistical significance. CONCLUSIONS: Health coaching delivered by a respiratory therapist or a nurse improved self-management abilities when applied to subjects with COPD after hospital discharge for an exacerbation. (ClinicalTrials.gov Identifier: NCT01058486, Mayo IRB 09-004341).

Original languageEnglish (US)
Pages (from-to)1065-1072
Number of pages8
JournalRespiratory care
Volume64
Issue number9
DOIs
StatePublished - Sep 1 2019

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Self Care
Chronic Obstructive Pulmonary Disease
Chronic Disease
Nurses
Health
Hospitalization
Research Ethics Committees
Hospital Emergency Service
Odds Ratio
Mentoring
Surveys and Questionnaires
Guidelines
Control Groups

Keywords

  • Chronic Respiratory Questionnaire mastery domain
  • COPD
  • health coaching
  • intervention
  • self-management

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine

Cite this

@article{ed96f859a8ba4a18a637aa1f0f99b62b,
title = "Effect of Health Coaching Delivered by a Respiratory Therapist or Nurse on Self-Management Abilities in Severe COPD: Analysis of a Large Randomized Study",
abstract = "BACKGROUND: Self-management of patients with COPD has received increasing attention in recent years given its association with improved outcomes. There is a scarcity of feasible interventions that can improve self-management abilities. We recently reported the positive effect of health coaching, started at the time of hospital discharge, on re-hospitalizations and emergency department visits for patients with COPD admitted for an exacerbation. In this substudy, we aimed to investigate the effects of health coaching delivered by a respiratory therapist or a nurse compared with guideline-based usual care on self-management abilities in COPD. METHODS: Self-management was measured by using the Chronic Respiratory Disease Questionnaire mastery domain and was assessed at baseline, at 6 months, and at 12 months after hospitalization. RESULTS: Two hundred and fifteen subjects hospitalized for a COPD exacerbation were randomized to the intervention or the control. The mean change in the Chronic Respiratory Disease Questionnaire mastery score from baseline to month 6 was Δ0.58 32 ± 1.29 on the intervention arm and Δ0.17 32 ± 1.14 on the control arm (P = .02). Of the intervention subjects, 55{\%} had at least a 0.5-point increase in Chronic Respiratory Disease Questionnaire mastery (minimum clinically important difference) compared with 38{\%} in the control group. Health coaching was an independent predictor of the minimum clinically important difference or greater change in the Chronic Respiratory Disease Questionnaire mastery score at 6 months after initiation of the intervention (odds ratio 1.95, 95{\%} CI 1.01-3.79). The changes in the Chronic Respiratory Disease Questionnaire mastery score at 12 months showed a trend but did not attain statistical significance. CONCLUSIONS: Health coaching delivered by a respiratory therapist or a nurse improved self-management abilities when applied to subjects with COPD after hospital discharge for an exacerbation. (ClinicalTrials.gov Identifier: NCT01058486, Mayo IRB 09-004341).",
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T1 - Effect of Health Coaching Delivered by a Respiratory Therapist or Nurse on Self-Management Abilities in Severe COPD

T2 - Analysis of a Large Randomized Study

AU - Benzo, Roberto P

AU - McEvoy, Charlene

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N2 - BACKGROUND: Self-management of patients with COPD has received increasing attention in recent years given its association with improved outcomes. There is a scarcity of feasible interventions that can improve self-management abilities. We recently reported the positive effect of health coaching, started at the time of hospital discharge, on re-hospitalizations and emergency department visits for patients with COPD admitted for an exacerbation. In this substudy, we aimed to investigate the effects of health coaching delivered by a respiratory therapist or a nurse compared with guideline-based usual care on self-management abilities in COPD. METHODS: Self-management was measured by using the Chronic Respiratory Disease Questionnaire mastery domain and was assessed at baseline, at 6 months, and at 12 months after hospitalization. RESULTS: Two hundred and fifteen subjects hospitalized for a COPD exacerbation were randomized to the intervention or the control. The mean change in the Chronic Respiratory Disease Questionnaire mastery score from baseline to month 6 was Δ0.58 32 ± 1.29 on the intervention arm and Δ0.17 32 ± 1.14 on the control arm (P = .02). Of the intervention subjects, 55% had at least a 0.5-point increase in Chronic Respiratory Disease Questionnaire mastery (minimum clinically important difference) compared with 38% in the control group. Health coaching was an independent predictor of the minimum clinically important difference or greater change in the Chronic Respiratory Disease Questionnaire mastery score at 6 months after initiation of the intervention (odds ratio 1.95, 95% CI 1.01-3.79). The changes in the Chronic Respiratory Disease Questionnaire mastery score at 12 months showed a trend but did not attain statistical significance. CONCLUSIONS: Health coaching delivered by a respiratory therapist or a nurse improved self-management abilities when applied to subjects with COPD after hospital discharge for an exacerbation. (ClinicalTrials.gov Identifier: NCT01058486, Mayo IRB 09-004341).

AB - BACKGROUND: Self-management of patients with COPD has received increasing attention in recent years given its association with improved outcomes. There is a scarcity of feasible interventions that can improve self-management abilities. We recently reported the positive effect of health coaching, started at the time of hospital discharge, on re-hospitalizations and emergency department visits for patients with COPD admitted for an exacerbation. In this substudy, we aimed to investigate the effects of health coaching delivered by a respiratory therapist or a nurse compared with guideline-based usual care on self-management abilities in COPD. METHODS: Self-management was measured by using the Chronic Respiratory Disease Questionnaire mastery domain and was assessed at baseline, at 6 months, and at 12 months after hospitalization. RESULTS: Two hundred and fifteen subjects hospitalized for a COPD exacerbation were randomized to the intervention or the control. The mean change in the Chronic Respiratory Disease Questionnaire mastery score from baseline to month 6 was Δ0.58 32 ± 1.29 on the intervention arm and Δ0.17 32 ± 1.14 on the control arm (P = .02). Of the intervention subjects, 55% had at least a 0.5-point increase in Chronic Respiratory Disease Questionnaire mastery (minimum clinically important difference) compared with 38% in the control group. Health coaching was an independent predictor of the minimum clinically important difference or greater change in the Chronic Respiratory Disease Questionnaire mastery score at 6 months after initiation of the intervention (odds ratio 1.95, 95% CI 1.01-3.79). The changes in the Chronic Respiratory Disease Questionnaire mastery score at 12 months showed a trend but did not attain statistical significance. CONCLUSIONS: Health coaching delivered by a respiratory therapist or a nurse improved self-management abilities when applied to subjects with COPD after hospital discharge for an exacerbation. (ClinicalTrials.gov Identifier: NCT01058486, Mayo IRB 09-004341).

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