Back to Search
Start Over
Effectiveness of Telephone-Based Health Coaching for Patients with Chronic Conditions: A Randomised Controlled Trial
- Source :
- PLoS ONE, Vol 11, Iss 9, p e0161269 (2016), PLoS ONE
- Publication Year :
- 2016
- Publisher :
- Public Library of Science (PLoS), 2016.
-
Abstract
- Background Chronic diseases, like diabetes mellitus, heart disease and cancer are leading causes of death and disability. These conditions are at least partially preventable or modifiable, e.g. by enhancing patients’ self-management. We aimed to examine the effectiveness of telephone-based health coaching (TBHC) in chronically ill patients. Methods and Findings This prospective, pragmatic randomized controlled trial compares an intervention group (IG) of participants in TBHC to a control group (CG) without TBHC. Endpoints were assessed two years after enrolment. Three different groups of insurees with 1) multiple conditions (chronic campaign), 2) heart failure (heart failure campaign), or 3) chronic mental illness conditions (mental health campaign) were targeted. The telephone coaching included evidence-based information and was based on the concepts of motivational interviewing, shared decision-making, and collaborative goal setting. Patients received an average of 12.9 calls. Primary outcome was time from enrolment until hospital readmission within a two-year follow-up period. Secondary outcomes comprised the probability of hospital readmission, number of daily defined medication doses (DDD), frequency and duration of inability to work, and mortality within two years. All outcomes were collected from routine data provided by the statutory health insurance. As informed consent was obtained after randomization, propensity score matching (PSM) was used to minimize selection bias introduced by decliners. For the analysis of hospital readmission and mortality, we calculated Kaplan-Meier curves and estimated hazard ratios (HR). Probability of hospital readmission and probability of death were analysed by calculating odds ratios (OR). Quantity of health service use and inability to work were analysed by linear random effects regression models. PSM resulted in patient samples of 5,309 (IG: 2,713; CG: 2,596) in the chronic campaign, of 660 (IG: 338; CG: 322) in the heart failure campaign, and of 239 (IG: 101; KG: 138) in the mental health campaign. In none of the three campaigns, there were significant differences between IG and CG in time until hospital readmission. In the chronic campaign, the probability of hospital readmission was higher in the IG than in the CG (OR = 1.13; p = 0.045); no significant differences could be found for the other two campaigns. In the heart failure campaign, the IG showed a significantly reduced number of hospital admissions (-0.41; p = 0.012), although the corresponding reduction in the number of hospital days was not significant. In the chronic campaign, the IG showed significantly increased number of DDDs. Most striking, there were significant differences in mortality between IG and CG in the chronic campaign (OR = 0.64; p = 0.005) as well as in the heart failure campaign (OR = 0.44; p = 0.001). Conclusions While TBHC seems to reduce hospitalization only in specific patient groups, it may reduce mortality in patients with chronic somatic conditions. Further research should examine intervention effects in various subgroups of patients, for example for different diagnostic groups within the chronic campaign, or duration of coaching. Trial Registration German Clinical Trials Register DRKS00000584
- Subjects :
- Economics
Social Sciences
lcsh:Medicine
law.invention
0302 clinical medicine
Randomized controlled trial
law
Medicine and Health Sciences
030212 general & internal medicine
lcsh:Science
Multidisciplinary
030503 health policy & services
Mortality rate
Mental Disorders
Hazard ratio
Telephones
Telemedicine
Hospitals
Engineering and Technology
0305 other medical science
Research Article
medicine.medical_specialty
Randomization
Health coaching
Drug Research and Development
Patients
Death Rates
Cardiology
Equipment
Health Promotion
Research and Analysis Methods
Patient Readmission
03 medical and health sciences
Health Economics
Population Metrics
Internal medicine
Mental Health and Psychiatry
medicine
Diabetes Mellitus
Humans
Clinical Trials
Demography
Heart Failure
Communication Equipment
Pharmacology
Population Biology
business.industry
lcsh:R
Biology and Life Sciences
Odds ratio
Randomized Controlled Trials
Telephone
Clinical trial
Self Care
Health Care
Health Care Facilities
Propensity score matching
Chronic Disease
People and Places
Physical therapy
lcsh:Q
Clinical Medicine
business
Program Evaluation
Health Insurance
Subjects
Details
- Language :
- English
- ISSN :
- 19326203
- Volume :
- 11
- Issue :
- 9
- Database :
- OpenAIRE
- Journal :
- PLoS ONE
- Accession number :
- edsair.doi.dedup.....65e7b4a338fb5a021066a6ab45c89c54