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Health coaching to reduce disparities for patients with chronic obstructive pulmonary disease (COPD)
Investigator (PI): Thom, David
Performing Organization (PO): (Current): University of California, San Francisco, School of Medicine, Department of Family and Community Medicine / (415) 476-1482
Supporting Agency (SA): Patient-Centered Outcomes Research Institute (PCORI)
Initial Year: 2014
Final Year: 2018
Record Source/Award ID: PCORI/AD-1306-03900
Funding: Total Award Amount: $2,095,882
Award Type: Contract
Award Information: PCORI: More information and project results (when completed)
Number of Subjects: 250
Abstract: Chronic obstructive pulmonary disease (COPD) is the third leading cause of death in the US; it affects over 12 million US adults. COPD is more common and more severe for adults living near or below the poverty level. Managing COPD is complex and programs designed to improve management can have substantial effects on a patient's health and well-being. The most comprehensive disease self-management programs, i.e. pulmonary rehabilitation, are generally not available to patients who are seen at community clinics. While self-management educational programs are more generally available, they are not often accessed by patients and do not provide personalized, sustained support. Health coaching by trained medical assistants or health workers has emerged as an effective model to provide individualized, patient-centered information, decision and self-management support, and coordination of care to improve outcomes for patients with chronic conditions. Health coaching provides patient support and reinforcement for self-management skills and activities, strategic approaches to effect behavior change, and a platform to improve comprehensiveness and quality of care. For the management of COPD, health coaches, for example, could assist patients with getting vaccinations, prescriptions, engaging in a graded exercise program, responding to exacerbations of their COPD, learning correct inhaler technique, and coordinating care between the patient's primary and specialty providers. This proposed study will examine whether health coaches can improve the management of COPD in a population of vulnerable patients cared for in "safety-net" clinics. The study is designed as a randomized controlled trial for patients with moderate to severe COPD. Patients will be randomized into a health coaching group and a usual care group. Those in the health coaching group will receive 9 months of active health coaching followed by 6 months of follow-up to see if improvements can be maintained. The study will determine whether patients who receive health coaching have a better quality of life, fewer exacerbations, and better exercise capacity than patients who receive usual care. The results of this study will provide important information for providers, administrators and payers to use in deciding whether to support health coaching for patients for COPD, and for patients with COPD to use in deciding whether or not to work with a health coach.
MeSH Terms:
  • Follow-Up Studies
  • Health Communication
  • * Healthcare Disparities
  • Humans
  • Outcome Assessment, Health Care
  • Patient Education as Topic
  • Patient-Centered Care
  • Pulmonary Disease, Chronic Obstructive /*therapy
  • Quality of Health Care
  • Quality of Life
  • Randomized Controlled Trials as Topic
  • Self Care
  • United States
  • Vulnerable Populations
Country: United States
State: California
Zip Code: 94143
UI: 20143408
CTgovId: NCT02234284
Project Status: Completed