Better Respiratory Education and Treatment Help Empower (BREATHE) study: Methodology and baseline characteristics of a randomized controlled trial testing a transitional care program to improve patient-centered care delivery among chronic obstructive pulmonary disease patients.

Autor:	Aboumatar H; Armstrong Institute for Patient Safety and Quality, The Johns Hopkins School of Medicine, United States; Division of General Internal Medicine, Dept. of Medicine, Johns Hopkins University School of Medicine, United States; Department of Health, Behavior, and Society, Bloomberg School of Public Health, Johns Hopkins University, United States; Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, United States. Electronic address: habouma1@jhmi.edu., Naqibuddin M; Armstrong Institute for Patient Safety and Quality, The Johns Hopkins School of Medicine, United States., Chung S; Armstrong Institute for Patient Safety and Quality, The Johns Hopkins School of Medicine, United States., Adebowale H; Johns Hopkins Bayview Medical Center, United States., Bone L; Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, United States; Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, United States., Brown T; Armstrong Institute for Patient Safety and Quality, The Johns Hopkins School of Medicine, United States., Cooper LA; Division of General Internal Medicine, Dept. of Medicine, Johns Hopkins University School of Medicine, United States; Department of Health, Behavior, and Society, Bloomberg School of Public Health, Johns Hopkins University, United States; Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, United States., Gurses AP; Armstrong Institute for Patient Safety and Quality, The Johns Hopkins School of Medicine, United States; Anesthesiology and Critical Care, The Johns Hopkins School of Medicine, United States; Division of Health Sciences Informatics, The Johns Hopkins School of Medicine, United States; Malone Center for Engineering in Healthcare, Whiting School of Engineering, Johns Hopkins University, United States., Knowlton A; Department of Health, Behavior, and Society, Bloomberg School of Public Health, Johns Hopkins University, United States., Kurtz D; Johns Hopkins Bayview Medical Center, United States., Piet L; Johns Hopkins Bayview Medical Center, United States., Putcha N; Pulmonary and Critical Care Medicine, The Johns Hopkins School of Medicine, United States., Rand C; Pulmonary and Critical Care Medicine, The Johns Hopkins School of Medicine, United States., Roter D; Department of Health, Behavior, and Society, Bloomberg School of Public Health, Johns Hopkins University, United States; Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, United States., Shattuck E; Patient Advocate/Co-investigator, BREATHE Project, United States., Sylvester C; Johns Hopkins Bayview Medical Center, United States., Urteaga-Fuentes A; Armstrong Institute for Patient Safety and Quality, The Johns Hopkins School of Medicine, United States., Wise R; Pulmonary and Critical Care Medicine, The Johns Hopkins School of Medicine, United States., Wolff JL; Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, United States., Yang T; Armstrong Institute for Patient Safety and Quality, The Johns Hopkins School of Medicine, United States., Hibbard J; Health Policy Research Group, University of Oregon., Howell E; Armstrong Institute for Patient Safety and Quality, The Johns Hopkins School of Medicine, United States; Johns Hopkins Bayview Medical Center, United States., Myers M; Johns Hopkins Home Care Group, United States., Shea K; Johns Hopkins Bayview Medical Center, United States., Sullivan J; COPD Foundation, United States., Syron L; Johns Hopkins Home Care Group, United States., Wang NY; Division of General Internal Medicine, Dept. of Medicine, Johns Hopkins University School of Medicine, United States; Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, United States., Pronovost P; Armstrong Institute for Patient Safety and Quality, The Johns Hopkins School of Medicine, United States; Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, United States; Anesthesiology and Critical Care, The Johns Hopkins School of Medicine, United States.
Jazyk:	angličtina
Zdroj:	Contemporary clinical trials [Contemp Clin Trials] 2017 Nov; Vol. 62, pp. 159-167. Date of Electronic Publication: 2017 Sep 05.
DOI:	10.1016/j.cct.2017.08.018
Abstrakt:	Background: Chronic Obstructive Pulmonary Disease (COPD) is a leading cause of hospitalizations. Interventional studies focusing on the hospital-to-home transition for COPD patients are few. In the BREATHE (Better Respiratory Education and Treatment Help Empower) study, we developed and tested a patient and family-centered transitional care program that helps prepare hospitalized COPD patients and their family caregivers to manage COPD at home. Methods: In the study's initial phase, we co-developed the BREATHE transitional care program with COPD patients, family-caregivers, and stakeholders. The program offers tailored services to address individual patients' needs and priorities at the hospital and for 3months post discharge. We tested the program in a single-blinded RCT with 240 COPD patients who were randomized to receive the program or 'usual care'. Program participants were offered the opportunity to invite a family caregiver, if available, to enroll with them into the study. The primary outcomes were the combined number of COPD-related hospitalizations and Emergency Department (ED) visits per participant at 6months post discharge, and the change in health-related quality of life over the 6months study period. Other measures include 'all cause' hospitalizations and ED visits; patient activation; self-efficacy; and, self-care behaviors. Discussion: Unlike 1month transitional care programs that focus on patients' post-acute care needs, the BREATHE program helps hospitalized COPD patients manage the post discharge period as well as prepare them for long term self-management of COPD. If proven effective, this program may offer a timely solution for hospitals in their attempts to reduce COPD rehospitalizations. (Copyright © 2017 Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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