Motivational Health Coaching Reduces COPD Hospital Readmissions

Chronic obstructive pulmonary disease (COPD) hospital readmissions may be reduced using motivational interviewing — a type of goal-oriented, client-centered counseling method – according to clinical trial results presented at the American Thoracic Society 2016 International Conference. An accompanying press release stated that this is the first available randomized study to demonstrate these findings.

Researchers from the Mayo Clinic in Rochester, Minnesota enrolled 215 patients who either received health coaching or typical treatment for one year. The health coaching involved one hospital session and one session after hospital discharge, and then weekly phone sessions for three months. Then the phone sessions were monthly until a year went by.

“We tested an intervention that primarily aimed to promote patient activation and mindful communication, two critical and perhaps underrated aspects of care that we firmly believe are at the heart of practicing the art of medicine,” lead author Roberto Benzo, MD, MS, explained in the press release. “This coaching style emphasizes autonomy and choice in what the patient wanted to work on. It is a process that happens with a patient; it is not something the coach does to a patient.”

The COPD-related hospital readmissions were significantly reduced among patients who participated in health coaching: during the first month, readmissions rates were reduced by 7.5 percent, followed by 11 percent at three and six months post discharged — the time when reduction rates peaked. The researchers acknowledged they were unable to record data for the precise reason for the drop-off after six months, but Benzo said there might be some advantage to additional sessions of health coaching in order to stoke a patient’s motivation and reinforce the importance of self-management.

The study subjects also saw increased participation in pulmonary rehabilitation, no matter which group they were in. The researchers said this could possibly be attributed to the level of attention each patient received throughout the course of the study.

“Only individuals in the intervention group showed decreased hospitalization suggesting that the mindful attention — not any attention – like that received in health coaching may matter; health coaching may motivate people to behaviors like attending pulmonary rehab that translate into the improvement of ‘hard’ outcomes like hospitalizations,” Benzo continued.

Even though health coaching needs to be tested among larger cohorts to determine its true benefit for COPD patients, this preliminary study “addresses the knowledge gap on interventions that decrease short term re-hospitalizations and is translatable to other chronic diseases,” Benzo concluded.