Long term health conditions, including chronic heart failure (CHF) and chronic obstructive pulmonary disease (COPD), are one of the major challenges facing healthcare systems worldwide; and telehealth has been suggested as a safe option to promote self-management. The effectiveness of person-centred care as a tool to improve health care has been demonstrated in several conditions and contexts but there are few existing telehealth interventions that fully address person-centred care.
To evaluate the effects of person-centred support at distance via telephone for patients with CHF and/or COPD.
221 patients = 50 years with CHF and/or COPD were randomized to usual care or a person-centred telephone-support intervention in addition to usual care and followed during six months. In the intervention group patients where phone called by a registered nurse and a person-centred health plan reflecting both perspectives was co-created, which was further discussed and evaluated during additional follow-ups by telephone. A composite score of changes that included changes in general self-efficacy = 5 units, re-hospitalization and death was used as primary outcome measure.
Results At the 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). Significantly more patients in the control group decreased = 5 units in general self-efficacy (22.9%, n=27 vs. 9.7%, n=10; OR = 2.8, 95% CI: 1.3 – 6.0; P = 0.011). There were no differences between groups on re-hospitalization or death. In the per-protocol analysis of the composite score more patients in the control group deteriorated compared with the intervention group (57.6%, n = 68 vs. 42.9%, n = 36; OR = 1.8, 95% CI 1.0 – 3.2; P = 0.039).
A person-centred support at distance via telephone mitigates worsened self-efficacy without increasing the risk of clinical events in patients with CHF and/or COPD. This highlights the possibility to establish a patient-health care professional partnership, which is not dependent on face-to-face consultations, not the least in vulnerable patient groups.