Telephone health coaching in primary care patients with MRC I/II COPD: randomised controlled trial

Background: Most COPD self-management trials have identified patients from secondary care populations. Aims: This trial assessed the effectiveness of telephone health coaching to encourage self-management in primary care patients with mild symptoms of COPD. Methods: Multi-centre randomised controlled trial of COPD patients with mild dyspnoea (MRC grade 1/2) recruited from primary care. Interventions: Nurse delivered telephone health coaching package with 4 components: accessing smoking cessation services, increasing physical activity, medication management and action planning. Outcomes: Primary: HRQoL at 1 year (SGRQ-C). Secondary: self-reported smoking and physical activity, anxiety, depression, MRC dyspnoea scale, self-efficacy, EQ-5D-5L, health care utilisation, accelerometry to measure physical activity. Results: 577 participants from 71 general practices were randomised to intervention (289) and usual care (288). 29% had MRC dyspnoea 1 and 71% MRC 2; total SGRQ-C mean score 28.7 (SD 14.6). Intervention delivery: 86% of scheduled calls were delivered, 75% of participants received all 4 calls. Follow-up: 89% at 12 months. There was no difference in SGRQ-C total score at 12 months (mean difference -1.3, 95%CI -3.6, 0.9; p=0.2). In the intervention group at 6 months self-reported physical activity was significantly higher, more participants had a care plan, rescue packs of antibiotics and had their inhaler technique checked within the past 6 months. Conclusions: A telephone health coaching intervention to promote behaviour change in patients with mild symptoms of dyspnoea in primary care led to changes in some self-management activities, but did not improve health related quality of life.