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Randomized Controlled Trial
. 2012 Jun 10:12:147.
doi: 10.1186/1472-6963-12-147.

Health coaching by telephony to support self-care in chronic diseases: clinical outcomes from The TERVA randomized controlled trial

Kristiina Patja  1 , Pilvikki Absetz, Anssi Auvinen, Kari Tokola, Janne Kytö, Erja Oksman, Risto Kuronen, Timo Ovaska, Kari Harno, Mikko Nenonen, Tom Wiklund, Raimo Kettunen, Martti Talja
Affiliations
Randomized Controlled Trial

Health coaching by telephony to support self-care in chronic diseases: clinical outcomes from The TERVA randomized controlled trial

Kristiina Patja et al. BMC Health Serv Res. .

Abstract

Background: The aim was to evaluate the effect of a 12-month individualized health coaching intervention by telephony on clinical outcomes.

Methods: An open-label cluster-randomized parallel groups trial. Pre- and post-intervention anthropometric and blood pressure measurements by trained nurses, laboratory measures from electronic medical records (EMR). A total of 2594 patients filling inclusion criteria (age 45 years or older, with type 2 diabetes, coronary artery disease or congestive heart failure, and unmet treatment goals) were identified from EMRs, and 1535 patients (59%) gave consent and were randomized into intervention or control arm. Final analysis included 1221 (80%) participants with data on primary end-points both at entry and at end. Primary outcomes were systolic and diastolic blood pressure, serum total and LDL cholesterol concentration, waist circumference for all patients, glycated hemoglobin (HbA1c) for diabetics and NYHA class in patients with congestive heart failure. The target effect was defined as a 10-percentage point increase in the proportion of patients reaching the treatment goal in the intervention arm.

Results: The proportion of patients with diastolic blood pressure initially above the target level decreasing to 85 mmHg or lower was 48% in the intervention arm and 37% in the control arm (difference 10.8%, 95% confidence interval 1.5-19.7%). No significant differences emerged between the arms in the other primary end-points. However, the target levels of systolic blood pressure and waist circumference were reached non-significantly more frequently in the intervention arm.

Conclusions: Individualized health coaching by telephony, as implemented in the trial was unable to achieve majority of the disease management clinical measures. To provide substantial benefits, interventions may need to be more intensive, target specific sub-groups, and/or to be fully integrated into local health care.

Trial registration: ClinicalTrials.gov Identifier: NCT00552903.

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Figures

Figure 1
Figure 1
Flow Diagram. Distribution of study population from those filling inclusion criteria by the healthcare charts to those completed the intervention.
Figure 2
Figure 2
Pfizer Health Solutions has developed a tele-coaching intervention with 5 key functions and 8 recommendations to engage, inform, involve, and empower the patients in self-care.
See this image and copyright information in PMC

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