由非专业人员提供的肺病专家支持的健康指导提高了慢性阻塞性肺疾病高质量护理的接受:一项随机对照试验。

IF 1.6 Q3 HEALTH CARE SCIENCES & SERVICES
Journal of Patient-Centered Research and Reviews Pub Date : 2023-11-27 eCollection Date: 2023-01-01 DOI:10.17294/2330-0698.2024
Rachel Willard-Grace, Danielle Hessler, Beatrice Huang, Denise DeVore, Chris Chirinos, Jessica Wolf, Devon Low, Chris Garvey, DorAnne Donesky, Stephanie Tsao, David H Thom, George Su
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引用次数: 0

摘要

目的:半数慢性阻塞性肺疾病(COPD)患者没有得到国际指南中所描述的高质量、循证治疗。我们对先前发表的一项研究进行了二次数据分析,以评估非专业健康指导模型在初级保健环境中改善基于指南的护理的能力。方法:作为一项随机对照试验的一部分,我们从初级保健诊所招募了英语和西班牙语的中度至重度COPD患者,这些患者主要服务于低收入的非裔美国人人群。参与者被随机分为两组,一组接受常规护理,另一组接受由肺病专科医生告知的初级保健人员9个月的健康指导。结果测量包括适当吸入器治疗的处方、copd相关教育的参与、专科护理的参与、戒烟药物的处方以及患者对护理质量的评分。结果:基线质量测量在研究组之间没有差异。在9个月时,接受训练的患者更有可能(比常规护理增加9.3%;P=0.014),与接受常规护理的患者相比,接受基于指南的吸入器的患者比例更高。接受训练的患者更有可能接受肺部专科护理(比常规护理增加8.3%,至少一次就诊;P=0.04)和教育课程(比常规护理增加5.3%;P = 0.03)。在健康指导组中,基线吸烟患者接受戒烟药物治疗的比例比常规治疗组高出21.1个百分点,差异接近统计学意义(P=0.06)。结论:健康指导可以改善慢性阻塞性肺病等疾病的优质慢性疾病护理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Pulmonary Specialist-Supported Health Coaching Delivered by Lay Personnel Improves Receipt of Quality Care for Chronic Obstructive Pulmonary Disease: A Randomized Controlled Trial.

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.

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来源期刊
Journal of Patient-Centered Research and Reviews
Journal of Patient-Centered Research and Reviews HEALTH CARE SCIENCES & SERVICES-
自引率
5.90%
发文量
35
审稿时长
20 weeks
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