1. Pulmonary Specialist-Supported Health Coaching Delivered by Lay Personnel Improves Receipt of Quality Care for Chronic Obstructive Pulmonary Disease: A Randomized Controlled Trial
- Author
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Rachel Willard-Grace, Danielle Hessler, Beatrice Huang, Denise DeVore, Chris Chirinos, Jessica Wolf, Devon Low, Chris Garvey, DorAnne Donesky, Stephanie Tsao, David H. Thom, and George Su
- Subjects
health care quality ,evidence-based care ,guideline adherence ,chronic obstructive pulmonary disease ,copd ,health coaching ,inhalers ,pulmonology ,primary care ,Medicine - Abstract
Purpose: Half of people living with chronic obstructive pulmonary disease (COPD) do not receive high-quality, evidenced-based care as described in international guidelines. We conducted secondary data analysis of a previously published study to assess the ability of a model of lay health coaching to improve provision of guideline-based care in a primary care setting. Methods: As part of a randomized controlled trial, we recruited English- and Spanish-speaking patients with moderate to severe COPD from primary care clinics serving a low-income, predominantly African American population. Participants were randomized to receive usual care or 9 months of health coaching from primary care personnel informed by a pulmonary specialist practitioner. Outcome measures included prescription of appropriate inhaler therapy, participation in COPD-related education, engagement with specialty care, prescription of smoking cessation medications, and patient ratings of the quality of care. Results: Baseline quality measures did not differ between study arms. At 9 months, coached patients were more likely (increase of 9.3% over usual care; P = 0.014) to have received guideline-based inhalers compared to those in usual care. Coached patients were more likely to engage with pulmonary specialty care (increase of 8.3% over usual care with at least 1 visit; P = 0.04) and educational classes (increase of 5.3% over usual care; P = 0.03). Receipt of smoking cessation medications among patients smoking at baseline in the health coaching group increased 21.1 percentage points more than in usual care, a difference near statistical significance (P = 0.06). Conclusions: Health coaching may improve the provision of quality chronic illness care for conditions such as COPD.
- Published
- 2023
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