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COMPAR-EU RCTs Web
The effect of real-time teleconsultations between hospital-based nurses and patients with severe COPD discharged after an exacerbation
See more Setting of implementation: Outpatient care (hospital) Professionals delivering the intervention: Nurses Targeted self-management behaviours: Physical activity /exercise, Smoking cessation or reduction
Components
Individual sessions
A single person receives the self-management support. Examples: self-guided actions (without the participation of any other person) during a clinical visit or within the context of a support or educational session
Face-to-face
Self-management support delivered in a face-to-face encounter between the providers and patients and/or caregivers.
See more Setting of implementation: Home-care, Virtual location Professionals delivering the intervention: Nurses Targeted self-management behaviours: Condition-specific behaviours, Medication use and adherence, Physical activity /exercise, Self-monitoring
Components
Education (E)
Education (E)
Sharing information. This form of support consists in sharing of information about self-management topics like coping with symptoms, diet, exercise, medication, information about what other people are doing, and information about the disease itself, or about any other relevant aspects that could lead to improved self-management, and ultimately better health. This information can be told or distributed in printed materials like a folder or workbook, or via website or DVD.
Examples: Educational session on healthy eating for people with obesity, provision of a printed leaflet on the importance of foot care in diabetes, or a link to a website with information on chronic obstructive pulmonary disease care.
Monitoring techniques (MT)
Monitoring techniques (MT)
Self-monitoring training and feedback. Training and encouraging people to recognize, monitor, and record behaviours, symptoms, or clinical data. This process may include regular feedback from a clinician, or a synopsis of information registered in a digital tool to encourage you to continue monitoring your illness and behaviours.
Example: Showing a patient how to record blood sugar levels, physical activity, or pain.
Action-based behavioural change techniques (AB)
Action-based behavioural change techniques (AB)
There are different action-based behavioural change techniques:
Enhancing problem-solving skills. This technique consists in teaching on how to analyse factors that influence your behaviour and provide you or help you to develop strategies to reduce or overcome barriers and/or support facilitators (e.g., not eating unhealthy foods when you feel depressed). Strategies include anticipation, self-treatment, resource utilization, and problem management. Ideally, there should be an initial plan, but this is not a requisite.
Example: Identification and attenuation of environmental barriers (e.g., no gym in the neighbourhood when one want to exercise) and facilitators (e.g., someone who keeps you company during exercise) to everyday physical activities.
Goal setting and action planning. This technique consists in encouraging you to set one or more achievable goals based on your needs and preferences. These goals may be behaviours (e.g., a consuming a healthy meal three times a day) or outcomes (e.g., less pain) and can be used as a starting point. The process usually involves the formulation of a detailed action plan, specifying what you would do and at least when and/or where you will do it. It could also include an assessment of your behaviours with your health care provider and a discussion of goals and the writing up of agreed-on action plans, including plans for emergency situations.
Examples of goals: achieving a daily walking distance of 2 km or a weight loss of some kilograms in x months with diet and exercise.
Individual sessions
A single person receives the self-management support. Examples: self-guided actions (without the participation of any other person) during a clinical visit or within the context of a support or educational session
Remote
When patients (and/or caregivers) are not in the same place as the health care providers. This interaction can take place through different communication means or tools (e.g., telephone, smartphone, Internet).
Outcomes measured in the study
| Outcome | Measure | Tool |
|---|---|---|
| Number of emergency room visits and admissions | All-cause hospital readmissions | N/A |
| Number of emergency room visits and admissions | COPD-related hospital readmissions | N/A |
| Number of emergency room visits and admissions | Hospital days (Lenght of stay) | N/A |
Patient characteristics
Number of co-morbidities: N/A
Tool: N/A
Risk of Bias of this study
| Outcome | Random sequence generation | Allocation concealment | Blinding performance | Blinding detection objective outcomes assessment | Attrition incomplete outcome | Incorrect statistical methods | Recruitment bias | Selective outcome reporting |
|---|---|---|---|---|---|---|---|---|
| Number of emergency room visits and admissions - All-cause hospital readmissions | ||||||||
| Number of emergency room visits and admissions - COPD-related hospital readmissions | ||||||||
| Number of emergency room visits and admissions - Hospital days (Lenght of stay) |
Learn more about the intervention: Monitoring and action-based behavioural techniques delivered remotely
Recommendations for this type of intervention | |
Summary of findings | |
Evidence to Decision frameworks | |
RCTs that also analysed this type of intervention | |
Related cost-effectiveness analysis |
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To learn more about the cost-effectiveness of self-management interventions check our section on the topic: Cost-effectiveness
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Related contextual analysis |
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To learn more about the contextual factors that can facilitate or hinder the implementation of a self-management intervention check our section on the topic: Contextual factors
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