Purpose: To systematically review the evidence for health coaching as an intervention to improve health related quality of life (HRQoL) and reduce hospital admissions in people with chronic obstructive pulmonary disease (COPD).
Methods: We systematically searched Medline, EMBASE, PsycINFO and CINAHL from database inception to August 2018 to identify all randomised controlled trials (RCTs) of health coaching for people with COPD. Eligible health coaching interventions had to include three components: goal setting, motivational interviewing, and COPD-related health education. Data were extracted on study characteristics and the effects of the intervention on HRQoL, hospital admissions, physical activity, self-care behaviour and mood. Study quality was appraised by two authors using the Cochrane tool for assessing the risk of bias in RCTs. Effect sizes (standardised mean differences [SMD] or odds ratios [OR]) with 95% confidence intervals (CIs) were calculated and pooled using random effects meta-analyses.
Results: Of 1578 articles, 10 RCTs were included. Meta-analysis showed that health coaching has a significant positive effect on HRQoL (SMD=-0.69, 95% CI -1.28, -0.09, p=0.02, from k=4) and leads to a significant reduction in COPD-related hospital admissions (OR=0.46, 95% CI 0.31, 0.69, p=0.0001, from k=5), but not in all-cause hospital admissions (OR=0.70, 95% CI 0.41-1.12, p=0.20, from k=3). Three of four studies reported significant improvements to self-care behaviours such as medication adherence and exercise compliance.
Conclusions: This is the first systematic review to show that health coaching may be a candidate intervention to improve HRQoL and reduce costly hospital admissions in people with COPD.