Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2018 Aug 31;13(8):e0203031.
doi: 10.1371/journal.pone.0203031. eCollection 2018.

Effects of a person-centred telephone-support in patients with chronic obstructive pulmonary disease and/or chronic heart failure - A randomized controlled trial

Andreas Fors  1   2   3 , Elin Blanck  1   2 , Lilas Ali  1   2 , Ann Ekberg-Jansson  4   5 , Michael Fu  6 , Irma Lindström Kjellberg  1   2 , Åsa Mäkitalo  7 , Karl Swedberg  2   6   8 , Charles Taft  1   2 , Inger Ekman  1   2
Affiliations
Randomized Controlled Trial

Effects of a person-centred telephone-support in patients with chronic obstructive pulmonary disease and/or chronic heart failure - A randomized controlled trial

Andreas Fors et al. PLoS One. .

Abstract

Purpose: To evaluate the effects of person-centred support via telephone in two chronically ill patient groups, chronic obstructive pulmonary disease (COPD) and/or chronic heart failure (CHF).

Method: 221 patients ≥ 50 years with COPD and/or CHF were randomized to usual care vs. usual care plus a person-centred telephone-support intervention and followed for six months. Patients in the intervention group were telephoned by a registered nurse initially to co-create a person-centred health plan with the patient and subsequently to discuss and evaluate the plan. The primary outcome measure was a composite score comprising General Self-Efficacy (GSE), re-hospitalization and death. Patients were classified as deteriorated if GSE had decreased by ≥ 5 points, or if they had been re-admitted to hospital for unscheduled reasons related to COPD and/or CHF or if they had died.

Results: At six-month follow-up no difference in the composite score was found between the two study groups (57.6%, n = 68 vs. 46.6%, n = 48; OR = 1.6, 95% CI: 0.9-2.7; P = 0.102) in the intention-to-treat analysis (n = 221); however, significantly more patients in the control group showed a clinically important decrease in GSE (≥ 5 units) (22.9%, n = 27 vs. 9.7%, n = 10; OR = 2.8, 95% CI: 1.3-6.0; P = 0.011). There were 49 clinical events (14 deaths, 35 re-admissions) in the control group and 41 in the intervention group (9 deaths, 32 re-admissions). Per-protocol analysis (n = 202) of the composite score showed that more patients deteriorated in the control group than in the intervention group (57.6%, n = 68 vs. 42.9%, n = 36; OR = 1.8, 95% CI 1.0-3.2; P = 0.039).

Conclusion: Person-centred support via telephone mitigates worsening self-efficacy without increasing the risk of clinical events in chronically ill patients with CHF and/or COPD. This indicates that a patient-healthcare professional partnership may be established without the need for face-to-face consultations, even in vulnerable patient groups.

Trial registration: ISRCTN.com ISRCTN55562827.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Trial profile.
See this image and copyright information in PMC

References

    1. Ekman I, Swedberg K, Taft C, Lindseth A, Norberg A, Brink E, et al. Person-centered care—ready for prime time. Eur J Cardiovasc Nurs. 2011;10(4):248–51. Epub 2011/07/19. 10.1016/j.ejcnurse.2011.06.008 . - DOI - PubMed
    1. Ahmad N, Ellins J, Krelle H, Lawrie M. Person-centred care: from ideas to action The Health Foundation; 2014.
    1. Lau-Walker M, Thompson DR. Self-management in long-term health conditions—a complex concept poorly understood and applied? Patient education and counseling. 2009;75(2):290–2. Epub 2009/03/11. 10.1016/j.pec.2009.02.001 . - DOI - PubMed
    1. Bandura A. Self-efficacy: toward a unifying theory of behavioral change. Psychol Rev. 1977;84(2):191–215. Epub 1977/03/01. . - PubMed
    1. Ekman I, Wolf A, Olsson LE, Taft C, Dudas K, Schaufelberger M, et al. Effects of person-centred care in patients with chronic heart failure: the PCC-HF study. Eur Heart J. 2012;33(9):1112–9. Epub 2011/09/20. 10.1093/eurheartj/ehr306 . - DOI - PMC - PubMed

Publication types