Table 1Barriers to Evidence-Based COPD Care Addressed by Health Coaching

BarrierHow health coaching addresses barrier
PCP barriers
 PCP lack of familiarity with and use of COPD guidelines14,15,24
  • Facilitates consultation with pulmonary specialist who can make guideline-based treatment recommendations
 PCP lack of time due to competing clinical demands23,44
  • Summarizes medical information for PCP
  • Identifies needed preventive services
 PCP lack of confidence in assessing patient response to therapy
  • Administers COPD Assessment Test and reports to clinician
Patient barriers
 Complexity of care25
  • Accompanies patient to medical visit
  • Helps patient set agenda for visit and participate in decision-making
  • Checks for and reinforces patient understanding of treatment plan after visit
  • Checks with patients between visits; provides social support for patient
 Poor medication adherence45,46
  • Conducts medication reconciliation and education
  • Assists patients in obtaining prescriptions and communicating with PCP about prescriptions
 Improper use of inhalers8,47-49
  • Observes and corrects inhaler use via a list of steps
 Challenge of making lifestyle changes50
  • Supports smoking cessation using motivational interviewing and stages of change
  • Encourages patient to exercise within guidelines set by PCP or pulmonary specialist
Structural barriers
 Limited access to specialist care
  • Presents patient's information to pulmonary nurse practitioner specialist who can make treatment recommendations usually without requiring the patient to travel to the specialty clinic
 Lack of integrated care or team support for managing patients with COPD23,44
  • Facilitates access to other professionals (eg, mental health, pharmacy, social work) who would be part of an integrated care team

Abbreviations: COPD, chronic obstructive pulmonary disease; PCP, primary care provider.

From: Does Working with a Health Coach Help Patients with COPD Improve Their Quality of Life and Breathe Easier?

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Does Working with a Health Coach Help Patients with COPD Improve Their Quality of Life and Breathe Easier? [Internet]
Thom DH, Su G, Hessler D, et al.
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