Eight-year post-trial follow-up of morbidity and mortality of telephone health coaching

Abstract Background Health coaching is a patient-centred approach to supporting self-management for the chronic conditions. However, long-term evidence of effectiveness of health coaching remains scarce. The object of this study was to evaluate the long-term effect of telephone health coaching (THC)...

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Autores principales:	Erja Mustonen, Iiris Hörhammer, Kristiina Patja, Pilvikki Absetz, Johanna Lammintakanen, Martti Talja, Risto Kuronen, Miika Linna
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Health coaching Type 2 diabetes Coronary artery disease Morbidity Mortality Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/05bd55ce5b694b04a5dfeee941d76de6
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spelling	oai:doaj.org-article:05bd55ce5b694b04a5dfeee941d76de62021-11-21T12:06:17ZEight-year post-trial follow-up of morbidity and mortality of telephone health coaching10.1186/s12913-021-07263-w1472-6963https://doaj.org/article/05bd55ce5b694b04a5dfeee941d76de62021-11-01T00:00:00Zhttps://doi.org/10.1186/s12913-021-07263-whttps://doaj.org/toc/1472-6963Abstract Background Health coaching is a patient-centred approach to supporting self-management for the chronic conditions. However, long-term evidence of effectiveness of health coaching remains scarce. The object of this study was to evaluate the long-term effect of telephone health coaching (THC) on mortality and morbidity among people with type 2 diabetes (T2D), coronary artery disease (CAD) and congestive heart failure (CHF).. Methods 1535 T2D, CAD and CHF patients with unmet treatment targets were randomly allocated into an intervention group (n = 1034) and control group (n = 501). Intervention group received monthly individual strength-based, autonomy supportive THC sessions (average 30 min) for behavior change with a specially trained nurse for 12 months additional to usual health care. Control group received usual health care services. The primary outcome was a composite of death from cardiovascular causes or non-fatal stroke or non-fatal myocardial infarction (AMI) or unstable angina pectoris (UAP) during a follow-up of 8 years Three other composite endpoints with distinct combinations of fatal and non-fatal cardiovascular events and death from any cause were used as secondary outcomes. Other outcomes followed were the most relevant components of the composite endpoints. Randomized controlled trial (RCT) data was linked to Finnish national health and social care registries and electronic health records (EHR). Post-trial eight-year evaluation was conducted using intention-to-treat (ITT) and per-protocol (PP) analysis. Results The composite primary outcome event rate per 100 person years was lower in the intervention group (3.45) than in control group (3.88) in ITT -analysis, but the difference was not statistically significant (hazard ratio in the intervention group 0.87; 95% CI, 0.71 to 1.07; P = 0.19). In the subgroup (T2D, CAD/CHF) analysis, there were no statistically significant effects. The secondary PP-analysis showed statistically significant benefits for those who participated in the study. Conclusions No statistically significant effect of health coaching on mortality and morbidity was found in intention to treat analysis. The per protocol results suggest, however, that the intervention may be effective among patients who are willing and able to participate in health coaching. More research is needed to identify patients most likely to benefit from low-intensity health coaching. Trial registration NCT00552903 (registration date: the 1st of November 2007, updated the 3rd of February 2009).Erja MustonenIiris HörhammerKristiina PatjaPilvikki AbsetzJohanna LammintakanenMartti TaljaRisto KuronenMiika LinnaBMCarticleHealth coachingType 2 diabetesCoronary artery diseaseMorbidityMortalityPublic aspects of medicineRA1-1270ENBMC Health Services Research, Vol 21, Iss 1, Pp 1-7 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Health coaching Type 2 diabetes Coronary artery disease Morbidity Mortality Public aspects of medicine RA1-1270
spellingShingle	Health coaching Type 2 diabetes Coronary artery disease Morbidity Mortality Public aspects of medicine RA1-1270 Erja Mustonen Iiris Hörhammer Kristiina Patja Pilvikki Absetz Johanna Lammintakanen Martti Talja Risto Kuronen Miika Linna Eight-year post-trial follow-up of morbidity and mortality of telephone health coaching
description	Abstract Background Health coaching is a patient-centred approach to supporting self-management for the chronic conditions. However, long-term evidence of effectiveness of health coaching remains scarce. The object of this study was to evaluate the long-term effect of telephone health coaching (THC) on mortality and morbidity among people with type 2 diabetes (T2D), coronary artery disease (CAD) and congestive heart failure (CHF).. Methods 1535 T2D, CAD and CHF patients with unmet treatment targets were randomly allocated into an intervention group (n = 1034) and control group (n = 501). Intervention group received monthly individual strength-based, autonomy supportive THC sessions (average 30 min) for behavior change with a specially trained nurse for 12 months additional to usual health care. Control group received usual health care services. The primary outcome was a composite of death from cardiovascular causes or non-fatal stroke or non-fatal myocardial infarction (AMI) or unstable angina pectoris (UAP) during a follow-up of 8 years Three other composite endpoints with distinct combinations of fatal and non-fatal cardiovascular events and death from any cause were used as secondary outcomes. Other outcomes followed were the most relevant components of the composite endpoints. Randomized controlled trial (RCT) data was linked to Finnish national health and social care registries and electronic health records (EHR). Post-trial eight-year evaluation was conducted using intention-to-treat (ITT) and per-protocol (PP) analysis. Results The composite primary outcome event rate per 100 person years was lower in the intervention group (3.45) than in control group (3.88) in ITT -analysis, but the difference was not statistically significant (hazard ratio in the intervention group 0.87; 95% CI, 0.71 to 1.07; P = 0.19). In the subgroup (T2D, CAD/CHF) analysis, there were no statistically significant effects. The secondary PP-analysis showed statistically significant benefits for those who participated in the study. Conclusions No statistically significant effect of health coaching on mortality and morbidity was found in intention to treat analysis. The per protocol results suggest, however, that the intervention may be effective among patients who are willing and able to participate in health coaching. More research is needed to identify patients most likely to benefit from low-intensity health coaching. Trial registration NCT00552903 (registration date: the 1st of November 2007, updated the 3rd of February 2009).
format	article
author	Erja Mustonen Iiris Hörhammer Kristiina Patja Pilvikki Absetz Johanna Lammintakanen Martti Talja Risto Kuronen Miika Linna
author_facet	Erja Mustonen Iiris Hörhammer Kristiina Patja Pilvikki Absetz Johanna Lammintakanen Martti Talja Risto Kuronen Miika Linna
author_sort	Erja Mustonen
title	Eight-year post-trial follow-up of morbidity and mortality of telephone health coaching
title_short	Eight-year post-trial follow-up of morbidity and mortality of telephone health coaching
title_full	Eight-year post-trial follow-up of morbidity and mortality of telephone health coaching
title_fullStr	Eight-year post-trial follow-up of morbidity and mortality of telephone health coaching
title_full_unstemmed	Eight-year post-trial follow-up of morbidity and mortality of telephone health coaching
title_sort	eight-year post-trial follow-up of morbidity and mortality of telephone health coaching
publisher	BMC
publishDate	2021
url	https://doaj.org/article/05bd55ce5b694b04a5dfeee941d76de6
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Eight-year post-trial follow-up of morbidity and mortality of telephone health coaching

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