Health Coaches Can Help Prevent Short-Term Readmissions After COPD Exacerbations

Summary and Comment |
October 27, 2016

Health Coaches Can Help Prevent Short-Term Readmissions After COPD Exacerbations

  1. Patricia Kritek, MD

Patients with chronic obstructive pulmonary disease were less likely to be readmitted and had better quality of life when they received coaching.

  1. Patricia Kritek, MD

Avoiding hospital readmission after chronic obstructive pulmonary disease (COPD) exacerbations has not been studied intensively. Investigators at two institutions in Minnesota randomized 215 hospitalized patients with COPD exacerbations to receive either usual care or comprehensive health coaching by dedicated coaches (registered nurse or respiratory therapist) who met with patients during hospitalization and at least once after discharge. During the first visit, coaches employed motivational interviewing and created written action plans for each patient. Additional sessions were conducted by telephone, initially weekly and then monthly. All patients in the intervention arm also received exercise prescriptions.

Compared with usual-care patients, coached patients were less likely to be rehospitalized at 1, 3, and 6 months (numbers needed to coach to prevent 1 hospitalization: 13, 9, and 8, respectively), but this benefit did not persist at 1 year. Interestingly, the groups did not differ in use of medications (prednisone and antibiotics) included in the action plans. The coaching group scored higher in health-related quality of life.

Comment

Although this study is not definitive, it supports the concept of health coaching to prevent readmissions. As the intervention was multifaceted, we don't know what specifically was effective. Because medication use was similar, the action plans probably were not responsible for the difference; more likely, the engagement and support of the coaches were important. The authors state that the intervention is “inexpensive,” but a cost-analysis is essential before widespread adoption can be recommended.

Editor Disclosures at Time of Publication

  • Disclosures for Patricia Kritek, MD at time of publication Speaker’s Bureau American College of Chest Physicians (Critical Care Board Review Course)

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