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Lay Health Coaching to Increase Appropriate Inhaler Use in COPD: A Randomized Controlled Trial
- Source :
- Annals of family medicine, vol 18, iss 1, Ann Fam Med
- Publication Year :
- 2020
- Publisher :
- eScholarship, University of California, 2020.
-
Abstract
- PURPOSE: Poor adherence to medications is more prevalent for chronic obstructive pulmonary disease (COPD) than for other chronic conditions and is associated with unfavorable health outcomes. Few interventions have successfully improved adherence for COPD medications; none of these use unlicensed health care personnel. We explored the efficacy of lay health coaches to improve inhaler adherence and technique. METHODS: Within a randomized controlled trial, we recruited English- and Spanish-speaking patients with moderate to severe COPD from urban, public primary care clinics serving a low-income, predominantly African American population. Participants were randomized to receive 9 months of health coaching or usual care. Outcome measures included self-reported adherence to inhaled controller medications in the past 7 days and observed technique for all inhalers. We used generalized linear models, controlling for baseline values and clustering by site. RESULTS: Baseline adherence and inhaler technique were uniformly poor and did not differ by study arm. At 9 months, health-coached patients reported a greater number of days of adherence compared with usual care patients (6.4 vs 5.5 days; adjusted P = .02) and were more likely to have used their controller inhalers as prescribed for 5 of the last 7 days (90% vs 69%; adjusted P = .008). They were more than 3 times as likely to demonstrate perfect technique for all inhaler devices (24% vs 7%; adjusted P = .01) and mastery of essential steps (40% vs 11%; adjusted P
- Subjects :
- Male
self-management
Psychological intervention
Medical and Health Sciences
patient education
law.invention
0302 clinical medicine
Randomized controlled trial
7.1 Individual care needs
law
Health care
030212 general & internal medicine
Lung
Original Research
practice-based research
COPD
Self-management
Middle Aged
Health Services
Inhalation
inhaler technique
Studies in Human Society
Administration
Respiratory
Female
Family Practice
chronic illness
medicine.medical_specialty
Chronic Obstructive
Health coaching
Chronic Obstructive Pulmonary Disease
shared decision making
Clinical Trials and Supportive Activities
Medication Adherence
Pulmonary Disease
7.3 Management and decision making
03 medical and health sciences
primary care
Clinical Research
General & Internal Medicine
medicine
Humans
inhalers
Aged
health coaching
business.industry
Inhaler
Nebulizers and Vaporizers
Mentoring
medicine.disease
Good Health and Well Being
Physical therapy
Management of diseases and conditions
business
Patient education
Subjects
Details
- Database :
- OpenAIRE
- Journal :
- Annals of family medicine, vol 18, iss 1, Ann Fam Med
- Accession number :
- edsair.doi.dedup.....89f0af37549b0628d3dcaf7778e4398c