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Improved health outcomes persist 1 year after health coaching

Improved health outcomes resulting from health coaching continued 1 year after completion, according to data published in the Annals of Family Medicine.

“Health coaching, provided by a member of a primary care team trained to support patient engagement in chronic disease self-management, is a promising intervention that helps offset the heavy workload placed on primary care providers for chronic disease management,” Anjana E. Sharma, MD, of the department of family and community medicine at the University of California, San Francisco, and colleagues wrote. “… Since health coaching applies principles of motivational interviewing and goal-setting to influence behavioral change and chronic disease self-management, it may have longer-lasting benefits than traditional interventions such as medications, which are only effective when taken.”

To determine if the improvements seen in patients following health coaching were sustained among those treated for diabetes, hypertension and hyperlipidemia, the researchers conducted a 12-month observational study of patients after their participation in the Health Coaching in Primary Care trial. The trial was a 1-year randomized controlled study comparing health coaching to usual primary care among patients with uncontrolled diabetes, hypertension or hyperlipidemia.

Researchers followed up with participants at 24 months after the randomized controlled trial baseline. The primary outcome was the proportion at goal for at least one measure — either HbA1c, systolic BP or LDL cholesterol — that had been above the participant’s goal at initial enrollment. The researchers used chi-square tests and paired t-tests to compare dichotomous and continuous measures. In all, 290 of the 441 patients participated at both 12 and 24 months.

According to the researchers, the proportion of patients in the trial’s health coaching group who achieved the primary outcome dropped slightly from 47.1% at 12 months to 45.9% at 24 months (P = .8). The proportion of participants who reached their goal for HbA1c dropped from 53.4% to 36.2% (P = .03).

“The original [randomized controlled trial] showed that health coaching is an effective intervention in low-resource settings,” Sharma and colleagues wrote. “The current study shows that most clinical effects are largely maintained up to a year after receiving coaching. Health coaching by medical assistants may provide a cost-effective way to provide self-management support with effects that are largely sustainable over time.” – by Jason Laday

Disclosure: The researchers report no relevant financial disclosures.