Hanan Aboumatar1, Mohammad Naqibuddin2, Joseph Neiman3, Jamia Saunders2, Samuel Kim2, Hina Chaudhry2, Emmanuel Garcia-Morales4, Nancy Robinson5, Marjorie McBurney5, Leah Jager6, Tokunbo Ajayi7, Lee Bone8, Suna Chung9, Bernard Farrell7, Hui Joo Jin10, John Linnell11, Marlene Pirfo5, Cynthia Rand12, Peggy Riley11, Carmen Salvaterra13, Kai Shea5, Jorawar Singh7, Robert Wise12. 1. Armstrong Institute for Patient Safety and Quality, The Johns Hopkins School of Medicine, 750 East Pratt Street, 15th floor, Baltimore, MD 21202, USA; Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21218, USA; Department of Health, Behavior, and Society, Bloomberg School of Public Health, Johns Hopkins University, 601 North Caroline Street, Suite 2080, Baltimore, MD 21205, USA; Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, 2024 East Monument Street, Baltimore, MD 21287, USA. Electronic address: habouma1@jhmi.edu. 2. Armstrong Institute for Patient Safety and Quality, The Johns Hopkins School of Medicine, 750 East Pratt Street, 15th floor, Baltimore, MD 21202, USA. 3. Armstrong Institute for Patient Safety and Quality, The Johns Hopkins School of Medicine, 750 East Pratt Street, 15th floor, Baltimore, MD 21202, USA; Department of Internal Medicine, Hackensack University Medical Center, 30 Prospect Avenue, Hackensack, NJ 07601, USA. 4. Armstrong Institute for Patient Safety and Quality, The Johns Hopkins School of Medicine, 750 East Pratt Street, 15th floor, Baltimore, MD 21202, USA; Johns Hopkins University Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD 21205, USA. 5. Johns Hopkins Bayview Medical Center, 4940 Eastern Ave, Baltimore, MD 21224, USA. 6. Johns Hopkins University Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD 21205, USA. 7. Howard County General Hospital, 5755 Cedar Lane, Columbia, MD 21044, USA. 8. Department of Health, Behavior, and Society, Bloomberg School of Public Health, Johns Hopkins University, 601 North Caroline Street, Suite 2080, Baltimore, MD 21205, USA. 9. Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, 2024 East Monument Street, Baltimore, MD 21287, USA. 10. Department of Psychiatry, Johns Hopkins School of Medicine, 600 North Wolfe Street, Baltimore, MD 21287, USA. 11. BREATHE2 Study, 750 East Pratt Street, 15th floor, Baltimore, MD 21202, USA. 12. Pulmonary and Critical Care Medicine, The Johns Hopkins School of Medicine, 5501 Hopkins Bayview Circle, Baltimore, MD 21224, USA. 13. Pulmonary Disease & Critical Care Medicine, Johns Hopkins Community Physicians, 11085 Little Patuxent Parkway, Columbia, MD 21044, USA.
Abstract
BACKGROUND:Self-management support (SMS) for patients with COPD can improve health-related quality of life (HRQOL). However, it remains unclear what SMS strategies are most effective. Using peer support to advance self-management is promising, as peer supporters possess credibility and can serve as role models. METHODS: We conducted a single-blinded RCT comparing the effectiveness of two strategies to support patients with COPD. The strategies were 'Health Care Professional (HCP)' and 'HCP Plus Peer' support. Peer support was provided by patients with COPD who have stopped smoking, completed an acute pulmonary rehabilitation program, and met the requirements for becoming a peer supporter. We enrolled patients receiving treatment at inpatient and outpatient settings. Patients were encouraged to invite one family-caregiver to enroll with them. The primary outcome measure was the change in HRQOL at 6 months post enrollment. Secondary outcomes included COPD-related and all-cause hospitalizations and ED visits. Caregiver outcomes included preparedness for caregiving, caregiver stress, and coping. RESULTS: A total of 292 patients as well as 50 family-caregivers were enrolled. The average patient age was 67.3 yrs. (SD 9.4), 61% were female and 26% were African-Americans. The majority of caregivers were females (68%) and were a spouse/partner (58%). DISCUSSION: This study tested a dual strategy for providing support to patients with COPD that incorporates peer and health care professional support. The study had minimal exclusion criteria. If shown effective, the study offers a program of peer support that can be readily implemented in health care settings.
RCT Entities:
BACKGROUND: Self-management support (SMS) for patients with COPD can improve health-related quality of life (HRQOL). However, it remains unclear what SMS strategies are most effective. Using peer support to advance self-management is promising, as peer supporters possess credibility and can serve as role models. METHODS: We conducted a single-blinded RCT comparing the effectiveness of two strategies to support patients with COPD. The strategies were 'Health Care Professional (HCP)' and 'HCP Plus Peer' support. Peer support was provided by patients with COPD who have stopped smoking, completed an acute pulmonary rehabilitation program, and met the requirements for becoming a peer supporter. We enrolled patients receiving treatment at inpatient and outpatient settings. Patients were encouraged to invite one family-caregiver to enroll with them. The primary outcome measure was the change in HRQOL at 6 months post enrollment. Secondary outcomes included COPD-related and all-cause hospitalizations and ED visits. Caregiver outcomes included preparedness for caregiving, caregiver stress, and coping. RESULTS: A total of 292 patients as well as 50 family-caregivers were enrolled. The average patient age was 67.3 yrs. (SD 9.4), 61% were female and 26% were African-Americans. The majority of caregivers were females (68%) and were a spouse/partner (58%). DISCUSSION: This study tested a dual strategy for providing support to patients with COPD that incorporates peer and health care professional support. The study had minimal exclusion criteria. If shown effective, the study offers a program of peer support that can be readily implemented in health care settings.