Phone support boost to COPD patients

Researchers from Australia have found that even brief phone contact from medical professionals can provide benefits to patients with chronic obstructive pulmonary disease (COPD).

But a structured telephone-delivered mentoring program over 12 months provided additional advantages with regard to self-management capacity and disease knowledge.

The team randomly assigned 31 general practices in Tasmania to intervention or control, with 74 and 80 COPD patients subsequently assigned to the respective groups completing the study.

Patients in the intervention group received a median of 9.5 30-minute telephone calls from community nurses trained as health mentors. They provided cognitive behavioral-based support, including psychoeducation, self-management skills, cognitive coping skills training, communication skills, and self-efficacy promotion.

Meanwhile patients in the control group received usual care as well as a median of nine phone calls, lasting on average 1 minute, from a research nurse.

Reporting in BMJ Open, the team found that patients in the mentored group experienced significantly greater improvements in chronic disease self-management scores, according to the Partners in Health (PIH) scale.

There was a significant increase in overall PIH score (6.8 vs 6.3; 12 months vs baseline) and in the knowledge domain (6.7 vs 5.9) over time in the mentored group, while scores in the coping domain increased significantly over time in both groups (6.3 vs 5.8 in mentored group; 6.2 vs 5.8 in control group).

Psychologic distress, particularly anxiety, was high at baseline, being reported by up to 40% of patients, and the researchers observed significant declines in anxiety over time in both groups; the mean score on the anxiety subscale of the Hospital Anxiety and Depression Scale fell from 6.7 at baseline to 6.2 at 12 months in the intervention group and from 7.0 to 6.2 in the control group.

However, there was no significant difference in quality of life between the groups as measured by either the Short Form-36 or the St George’s Respiratory Questionnaire, and the annual rate of hospitalization for COPD was comparable.

The researchers, led by Julia Walters (University of Tasmania, Hobart), say that the finding that a brief, regular phone call alone could benefit patients was unexpected but could be related to the social isolation COPD patients often experience.

“A likely explanation is that control calls were therapeutic, providing participants with regular empathetic support,” they write.

The authors conclude that their study demonstrates the efficacy of health mentoring for COPD, something that could likely be improved by optimizing the training and support available for community nurses.

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