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Dating with copd

Patients were randomised to telephone health coaching (n=289) or usual care (n=288).Interventions Telephone health coaching intervention delivered by nurses, underpinned by Social Cognitive Theory.Nurses provided standard written prompts or information at weeks 16 and 24.The eight nurses attended two days of training and practiced telephone coaching sessions with the research team.Patient self management for chronic obstructive pulmonary disease (COPD) was a pragmatic multicentre phase III randomised controlled trial (RCT) of a telephone health coaching intervention to support self management compared with usual care for people with COPD with mild dyspnoea.Details of the study protocol have been published elsewhere.21 We followed the CONSORT guidelines for reporting RCTs of non-pharmacological treatments to report this study.22 After publication of the protocol in the ISRCTN clinical trial registry at the feasibility study phase, we changed the inclusion criterion for post-bronchodilator spirometry from below the lower limit of normal to forced expiratory volume in one second/forced vital capacity Participants were recruited from 71 general practices within England located in Birmingham and West Midlands South, Greater Manchester, West Midlands North, and Oxfordshire or Gloucestershire.Smoking is a major cause of COPD, and smoking cessation has been shown to be beneficial in maintaining better lung function and in slowing disease progression across all severity levels.1314 Reduced physical activity level is an independent risk factor for exacerbations, hospital stays, and mortality among those with COPD and occurs even in the early stages of disease.151617 Inhaler treatments have well established efficacy in reducing exacerbations and admissions among patients with moderate and severe COPD, and growing evidence of efficacy in improving clinical outcomes and reducing decline in lung function among patients with more mild impairment.1819 Any intervention that improves medication adherence and inhaler use technique, which is frequently poor,20 is thus likely to improve outcomes for patients.

The intervention consisted of telephone health coaching delivered by a nurse with supporting written documents, a pedometer, and a self monitoring diary.Patients aged over 18 were identified as eligible if they were on the practice COPD register, thus had respiratory symptoms consistent with COPD; reported mild dyspnoea (MRC grades 1 (only breathless on strenuous exercise) or 2 (only get short of breath when hurrying on level ground or up a slight hill)) at the baseline assessment; had a forced expiratory volume in one second/forced vital capacity Patients who expressed an interest in the study were telephoned by a researcher and invited to a recruitment assessment at their practice, undertaken by a research nurse or trained researcher.Patients who attended baseline assessments were given the opportunity to discuss the study.The coaching promoted accessing smoking cessation services, increasing physical activity, medication management, and action planning (4 sessions over 11 weeks; postal information at weeks 16 and 24). The usual care group received a leaflet about COPD.Results The intervention was delivered with good fidelity: 86% of scheduled calls were delivered; 75% of patients received all four calls.

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