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  • Effects of telephone health mentoring in community-recruited chronic obstructive pulmonary disease on self-management capacity, quality of life and psychological morbidity: a randomised controlled trial

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Respiratory medicine
Research
Effects of telephone health mentoring in community-recruited chronic obstructive pulmonary disease on self-management capacity, quality of life and psychological morbidity: a randomised controlled trial
  1. Julia Walters1,
  2. Helen Cameron-Tucker1,
  3. Karen Wills2,
  4. Natalie Schüz1,
  5. Jenn Scott3,
  6. Andrew Robinson4,
  7. Mark Nelson5,
  8. Paul Turner6,
  9. Richard Wood-Baker1,
  10. E Haydn Walters1
  1. 1School of Medicine, University of Tasmania, Hobart, Tasmania, Australia
  2. 2Menzies Research Institute Tasmania, University of Tasmania, Hobart, Tasmania, Australia
  3. 3School of Psychology, University of Tasmania, Hobart, Tasmania, Australia
  4. 4School of Nursing and Midwifery, University of Tasmania, Hobart, Australia
  5. 5School of Medicine & Menzies Research Institute Tasmania, University of Tasmania, Hobart, Tasmania, Australia
  6. 6School of Computing and Information Systems, University of Tasmania, Hobart, Tasmania, Australia
  1. Correspondence to Dr Julia Walters; Julia.Walters{at}utas.edu.au

Abstract

Objectives To assess benefits of telephone-delivered health mentoring in community-based chronic obstructive pulmonary disease (COPD).

Design Cluster randomised controlled trial.

Setting Tasmanian general practices: capital city (11), large rural (3), medium rural (1) and small rural (16).

Participants Patients were invited (1207) from general practitioner (GP) databases with COPD diagnosis and/or tiotropium prescription, response rate 49% (586), refused (176) and excluded (criteria: smoking history or previous study, 68). Spirometry testing (342) confirmed moderate or severe COPD in 182 (53%) patients.

Randomisation By random numbers code, block stratified on location, allocation by sequentially numbered, opaque and sealed envelopes.

Intervention Health mentor (HM) group received regular calls to manage illness issues and health behaviours from trained community health nurses using negotiated goal setting: problem solving, decision-making and action planning. Control: usual care (UC) group received GP care plus non-interventional brief phone calls.

Outcomes Measured at 0, 6 and 12 months, the Short Form 36 (SF-36) and St George’s Respiratory Questionnaire (SGRQ, primary); Partners In Health (PIH) Scale for self-management capacity, Hospital Anxiety and Depression Scale (HADS), Center for Epidemiologic Studies-Depression (CES-D) questionnaire, Post-Traumatic Stress Disorder Checklist, Satisfaction with life and hospital admissions (secondary).

Results 182 participants with COPD (age 68±8 years, 62% moderate COPD and 53% men) were randomised (HM=90 and UC=92). Mixed model regression analysis accounting for clustering, adjusting for age, gender, smoking status and airflow limitation assessed efficacy (regression coefficient, β, reported per 6-month visit). There was no difference in quality of life between groups, but self-management capacity increased in the HM group (PIH overall 0.15, 95% CI 0.03 to 0.29; knowledge domain 0.25, 95% CI 0.00 to 0.50). Anxiety decreased in both groups (HADS A 0.35; 95% CI −0.65 to −0.04) and coping capacity improved (PIH coping 0.15; 95% CI 0.04 to 0.26).

Conclusions Health mentoring improved self-management capacity but not quality of life compared to regular phone contact, which itself had positive effects where decline is generally expected.

  • Preventive Medicine
  • Primary Care

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/3.0/

https://doi.org/10.1136/bmjopen-2013-003097

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