Impacts of a health literacy-informed intervention in people with chronic obstructive pulmonary disease (COPD) on hospitalization, health literacy, self-management, quality of life, and health costs - A randomized controlled trial

Christine R Borge; Marie H Larsen; Richard H Osborne; Eline Aas; Ingrid Tryland Kolle; Rikke Reinertsen; Martha P Lein; Maria Thörn; Ragnhild Mørch Lind; Marie Groth; Oda Strand; Marit Helen Andersen; Torbjørn Moum; Eivind Engebretsen; Astrid K Wahl

doi:10.1016/j.pec.2024.108220

Impacts of a health literacy-informed intervention in people with chronic obstructive pulmonary disease (COPD) on hospitalization, health literacy, self-management, quality of life, and health costs - A randomized controlled trial

Patient Educ Couns. 2024 Jun:123:108220. doi: 10.1016/j.pec.2024.108220. Epub 2024 Feb 16.

Authors

Affiliations

¹ Department of Interdisciplinary Health Sciences, University of Oslo, Norway; Lovisenberg Diaconal Hospital, Oslo, Norway. Electronic address: christineraaheim.borge@lds.no.
² Department of Interdisciplinary Health Sciences, University of Oslo, Norway; Lovisenberg Diaconal University College, Oslo, Norway.
³ Centre of Global Health and Equity, School of Health Sciences, Swinburne University of Technology, Hawthorn, Australia.
⁴ Department of Health Management and Health Economics, University of Oslo, Norway; Division of Health Services, Norwegian Institute of Public Health, Oslo, Norway.
⁵ Lovisenberg Diaconal Hospital, Oslo, Norway.
⁶ Department of Interdisciplinary Health Sciences, University of Oslo, Norway; Department of Transplantation Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
⁷ Department of Behavioral Sciences in Medicine, University of Oslo, Norway.
⁸ Department of Interdisciplinary Health Sciences, University of Oslo, Norway.

PMID: 38458089
DOI: 10.1016/j.pec.2024.108220

Abstract

Objective: To compare the effect of motivational interviewing (MI) and tailored health literacy (HL) follow-up with usual care on hospitalization, costs, HL, self-management, Quality of life (QOL), and psychological stress in people with chronic obstructive pulmonary disease (COPD).

Methods: A RCT was undertaken in Norway between March 2018-December 2020 (n = 127). The control group (CG, n = 63) received usual care. The intervention group (IG, n = 64) received tailored HL follow-up from MI-trained COPD nurses with home visits for eight weeks and phone calls for four months after hospitalization. Primary outcomes were hospitalization at eight weeks, six months, and one year from baseline. The trial was registered with ClinicalTrials.gov (NCT03216603) and analysed per protocol.

Results: Compared with the IG, the CG had 2.8 higher odds (95% CI [1.3 to 5.8]) of hospitalization and higher hospital health costs (MD=€ -6230, 95% CI [-6510 to -5951]) and lower QALYs (MD=0.1, 95% CI [0.10 to 0.11]) that gives an ICER = - 62,300. The IG reported higher QOL, self-management, and HL (p = 0.02- to <0.01).

Conclusion: MI-trained COPD nurses using tailored HL follow-up is cost-effective, reduces hospitalization, and increases QOL, HL, and self-care in COPD.

Practice implication: Tailored HL follow-up is beneficial for individuals with COPD and the healthcare system.

Keywords: COPD; Chronic diseases; Community health care service; Health literacy; Health literacy intervention; Quality of life; Self-management; Tailored follow-up.

Publication types

Randomized Controlled Trial

MeSH terms

Health Care Costs
Health Literacy*
Hospitalization
Humans
Pulmonary Disease, Chronic Obstructive* / psychology
Pulmonary Disease, Chronic Obstructive* / therapy
Quality of Life
Self-Management*

Associated data

ClinicalTrials.gov/NCT03216603