By the same authors

From the same journal

From the same journal

Self management of patients with mild COPD in primary care: randomised controlled trial

Research output: Contribution to journalArticle

Author(s)

  • Kate Jolly
  • Manbinder S Sidhu
  • Catherine A Hewitt
  • Peter Coventry
  • Amanda Daley
  • Rachel Jordan
  • Carl Heneghan
  • Sally Singh
  • Natalie Ives
  • Peymane Adab
  • Susan Jowett
  • Jinu Varghese
  • David Nunan
  • Khaled Ahmed
  • Lee Dowson
  • David Fitzmaurice

Department/unit(s)

Publication details

JournalBMJ
DateAccepted/In press - 17 Apr 2018
DatePublished (current) - 13 Jun 2018
Volume361
Number of pages14
Original languageEnglish

Abstract

Objective: To evaluate the effectiveness of nurse-led telephone health coaching to encourage self-management in a primary care population with mild symptoms of COPD.
Design: Pragmatic, multi-centre randomised controlled trial.
Setting: 71 general practices in four areas of England.
Participants: 577 people, with MRC dyspnoea grade 1 or 2, recruited from primary care COPD registers with spirometry confirmed diagnosis, were randomised to the intervention (n=289) or usual care (n=288).
Interventions: Nurse-delivered telephone health coaching intervention, underpinned by Social Cognitive Theory, promoting: accessing smoking cessation services, increasing physical activity, medication management and action planning (4 sessions over 11 weeks; postal information at weeks 16 and 24). Nurses received two days of training. The usual care group received a leaflet about COPD.
Main outcome measures: The primary outcome was health related quality of life at 12 months using the short version of the St Georges Respiratory Questionnaire (SGRQ-C).
Results: The intervention was delivered with good fidelity: 86% of scheduled calls were delivered; 75% of participants received all four calls. 92% participants were followed-up at six months and 89% at 12 months. There was no difference in SGRQ-C total score at 12 months (mean difference -1.3, 95%CI -3.6 to 0.9; p=0.2). Compared to usual care participants, at six months follow-up, the intervention group reported significantly greater physical activity, more had received a care plan (44% v 30%), rescue packs of antibiotics (37% v 29%) and inhaler technique check (68% v 55%). There were no differences in other secondary outcomes (dyspnoea, smoking cessation, anxiety, depression, self-efficacy, objectively measured physical activity).
Conclusions
A novel telephone health coaching intervention to promote behaviour change in primary care patients with mild symptoms of dyspnoea did lead to changes in self-management activities, but did not improve health related quality of life.



Discover related content

Find related publications, people, projects, datasets and more using interactive charts.

View graph of relations