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Using Health Coaching to Improve Chronic Disease Management

Research shows that health coaching can have lasting effects on patients, making great strides in chronic disease management.

By Sara Heath

- New research supports claims that robust health coaching helps enhance chronic disease management for safety net populations.


In a recent article published in the May/June issue of the Annals of Family Medicine, lead researcher Anjana E. Sharma, MD, shows that health coaching can help chronically ill patients maintain their health over an extended period of time.

Sharma and colleagues conducted an experiment in which they provided health coaching to safety net patients with poorly controlled diabetes, hypertension, and/or hyperlipidemia. Patients received health coaching for one year, and then stopped receiving the coaching.

Twelve months after discontinuing the health coaching, the researchers looked at the following measures of health: hemoglobin A1c, systolic blood pressure, and LDL cholesterol. The research team wanted to see if the health coaching could help patients achieve a wellness goal in one of those three categories.

Over the course of their health coaching, patients made improvements in all of their wellness measures. One year following the completion of their health coaching, the researchers saw little decline in the wellness measures, except HBA1c measures, which did decline more sharply.

“While our initial study found that a 12-month health coaching intervention significantly improved achievement of clinical goals, we now know that up to 1 year after health coaching, patients in the health coaching intervention arm experienced only minimal declines in clinical goals, with the exception of HbA1c, implying overall maintenance of health coaching effects,” the researchers reported.

The researchers state that the sharp decline in HBA1c measures may show that diabetes health coaching requires more maintenance, perhaps through periodic coaching sessions, or “booster coaching.”

However, they note that the results are overall promising, showing that consistent health coaching for one year may have lasting effects.

“The finding in our study showing that most of the improvements seen at 12 months in the [randomized control trial] health-coaching arm were maintained at 24 months is encouraging,” the researchers explained.

“The current study shows that most clinical effects are largely maintained up to a year after receiving coaching. Health coaching by medical assistants may provide a cost-effective way to provide self-management support with effects that are largely sustainable over time.”

Health coaching by medical assistants is especially important due to the growing number of safety net patients suffering from cardiovascular diseases, like the ones included in the study.

“Cardiovascular disease and risk factors, including diabetes, hypertension, and hyperlipidemia, are increasing in prevalence in the United States and contribute to growing morbidity and mortality,” the researchers explained. “Underserved patients, including low-income and racial/ethnic minorities, disproportionately suffer from cardiovascular diseases.”

Sharma and colleagues noted that health coaching is important because it works as a motivator for patients rather than a simple reminder for them to take their medications or engage in their wellness efforts.

“Health coaching has been shown to improve outcomes in cardiovascular risk factors including diabetes and hypertension,” they stated. “Since health coaching applies principles of motivational interviewing and goal-setting to influence behavioral change and chronic disease self-management, it may have longer-lasting benefits than traditional interventions such as medications, which are only effective when taken.”

The healthcare industry has explored several other ways to improve chronic disease management. On the mHealth side, automated messages have proven effective in motivating patients with type II diabetes to stay active and maintain a healthy diet.

This sort of intervention helps build upon that described above because it inspires lifestyle changes, as well as provides reminders for patients, helping them to build habits that will foster long-term results.

“This type of intervention could address non-adherence to lifestyle recommendations by providing frequent reminders, motivational support and prompts to action, as well as timely access and feedback to relevant health information, while making patient-provider communication much easier,” the study authors wrote.

Going forward, healthcare professionals will have to continue to identify and test various ways to improve chronic disease management, particularly as safety net patient populations continue to be most widely affected by these conditions. Doing so will help keep healthcare spending down by preventing major episodes of care.

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