Health coaching shown to improve inhaler use among low-income COPD patients

Over 14 million U.S. adults have chronic obstructive pulmonary disease, and many face barriers to using inhaled medications regularly and effectively. Although inhaled medications can improve daily life and long-term outcomes, only 25 to 43% of people with COPD use them regularly. In addition, inhalers can be complex to use—requiring users to master a series of six to eight steps that differ across devices. Physicians and health teams have not yet found a solution to bring COPD medication adherence to the level of other chronic diseases.

In a multi-site randomized controlled trial from the University of California, San Francisco, non-licensed, trained health coaches offered COPD patients one-on-one support in person and by phone, with contact at least every three weeks for nine months. Participants were primarily low-income, African American and Latino men in an urban area.

Those who received health coaching showed significant improvement in adherence to controller inhalers and improved inhaler technique, with 40% of health-coached patients versus 11% of a control group able to demonstrate effective use of their inhalers after the intervention. Researchers conclude that "improved inhaler technique and adherence are one of multiple factors contributing to long-term COPD outcomes, but their research has confirmed one technique—use of lay health coaches—that may help patients get optimal benefit from their COPD medications.