Study Shows Benefits of Health Coaching Plus a Written Action Plan
Background: There is considerable attention focused on preventing hospital readmissions for COPD. One factor is that hospitals are penalized by lower reimbursement for services if there is a high readmission rate.
Study: Dr. Roberto Benzo and colleagues at the Mayo Clinic in Rochester, MN, studied a total of 215 patients hospitalized for a COPD flare-up (called an exacerbation). At discharge from the hospital, one-half were assigned to health coaching and a written action plan for any flare-up OR usual care.
The health coach met with each patient in the hospital for 2 hours and at least once in person after discharge. At the first visit, the patient was provided with prednisone and an antibiotic to be started if the individual experienced a flare-up. Also, during the visit self-management concepts, goal setting, action planning, and details of the telephone sessions to come were discussed. All subsequent sessions were conducted by telephone.
The study was published in the September 15, 2016, issue of the American Journal of Respiratory and Critical Care Medicine (volume 194; pages 671-680).
Results: There was a significant reduction in hospital readmissions at 6 months, but not at one year, in the group who received health coaching compared with usual care. The health coaching group also had better quality of life than the usual care group.
Conclusions: The authors concluded that their study was the first to show the benefits of “a feasible, innovative, and effective intervention designed to reduce short-term readmissions for those with COPD.”
My Comments: Health coaching is popular in managed care and accountable care organizations (ACOs) in an effort to improve care and to reduce costs. Health coaching is patient-centered, individualized, and aimed at improving health behaviors. For those with COPD, a health coach may assist the individual with quitting smoking, increasing physical activity, and starting early treatment for a flare-up. Whether health coaches will become an integral part of medical practices in the future is unknown.