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What's the evidence that health coaching works?

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An increasing evidence-base for health coaching is evolving, with several studies demonstrating the effectiveness of health coaching.

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Researchers have found promising clinical benefits from health coaching in diabetes and asthma management, while phone coaching improved attendance at colonoscopy clinics and better adherence to lipid-lowering drugs than usual care. 

 

Clinics in the USA have also reported productivity gains in delegating the work of health coaching away from primary care clinicians, with reports of physicians being able to see two to three more patients a day, and improvements in visit volumes and collections by 60%.

 

One US study on type 2 diabetes found that after 6 months, people who were coached showed improvement in medication adherence, as well as a positive effect on their knowledge, skill, self-efficacy and behaviour change, while a non-coached control group did not show any improvement. Also, coached participants with a haemoglobin A1C over 7% showed significant improvement in A1C. (6)

 

A US study on coronary heart disease found that patients in a coaching programme achieved a significantly greater change in total cholesterol of 14 mg/dl than the non-coached patients, with a considerable reduction in LDL-C. They also showed improvements in secondary outcomes such as weight loss, increased exercise, improved quality of life and less anxiety, as well as improvement in overall health and mood. (7)

 

Another US study found telephone coaching to be effective in assisting people with weight loss. The average body mass index of participants significantly decreased during the study, from an average baseline of 32.1% to 31.4% at 3 months, 31% at 6 months and 30.6% at 12 months. (8)

 

In a US study on tobacco cessation over 12 months, the coached participants had a 32% quit rate compared to 18% for nonparticipants. (9)

 

And a study in six Minnesota primary care clinics found that adult patients with hypertension, diabetes or heart failure who were allocated ‘care guides’ (health coaches) achieved more goals, had a greater reduction in their unmet needs and improved more than the usual care patients in meeting several individual goals, including not using tobacco. (10)

 

References

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  1. Main J, Anstis O, O’Brien J. Transform patient outcomes through patient journey mapping Ko Awatea. 2016 August; 492. 

  2. Bodenheimer T, Lorig K, Holman H, Grumbach K. Patient self-management of chronic disease in primary care JAMA, 2002;288(19):2469–2475. 

  3. Bennett HD, Coleman EA, Parry C, Bodenheimer T, Chen EH. Health coaching for patients with chronic illness Family Practice Management. 2010 Sept/Oct:24–29. 

  4. The Care Transitions Program 

  5. Anderson P, Hally MD. A new approach to making your doctor-nurse team more productive Family Practice Management. July/Aug 2008:35–40. 

  6. Wolever RQ, Dreusicke M, Fikkan J, Hawkins TV, Yeung S, Wakefield J, Duda L, Flowers P, Cook C, Skinner E. Integrative health coaching for patients with type 2 diabetes: A randomized clinical trial The Diabetes Educator. 2010 June 9;36(4):629–639.

  7. Vale MJ, JeLinek MV, Best JD. Coaching patients on achieving cardiovascular health (COACH): A multicenter randomized trial in patients with coronary heart disease Archives of Internal Medicine. 2003 Dec 8;163(22):2775–2783. 

  8. Merrill RM, Aldana SG, Bowden DE. Employee weight management through health coaching. Eating and Weight Disorders: Studies on Anorexia, Bulimia and Obesity 2010 Mar-June;15(1-2):52–59. 

  9. Terry PE, Seaverson, ELD, Staufacker, MJ, Tanaka A. (June 2011). "The effectiveness of a telephone-based tobacco cessation program offered as part of a worksite health promotion program" Population Health Management. 2001 June;14(3):117–125. 

  10. Adair R, Wholey DR, Christianson J, White KM, Britt H, Lee S. Improving chronic disease care by adding laypersons to the primary care team: A parallel randomized trial Ann Intern Med. 2013 Aug 6;159(3):176–84. 

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