Results Summary

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What was the research about?

Chronic obstructive pulmonary disease (COPD) affects 24 million adults in the United States. COPD may make it hard to breathe. Patients with severe COPD may have lower levels of oxygen in the blood. Doctors often suggest that these patients use oxygen all the time when at home. But not all patients use oxygen as their doctors recommend.

Trained peer health coaches may help patients with COPD use oxygen as recommended by their doctors. Peer health coaches are people with COPD or caregivers of people with COPD. They understand home oxygen use and can give others advice about it. In this study, the research team compared patients with COPD who received phone calls from peer health coaches, patients with COPD who called peer health coaches only if needed, and patients with COPD who didn’t talk to peer health coaches. The team looked at how many hours per day patients used oxygen at home. They also looked at patients’ health and use of health care.

What were the results?

Use of oxygen. Calls from peer health coaches didn’t increase oxygen use. Patients who received five calls from peer health coaches used oxygen for fewer hours each day than patients who didn’t receive calls.

Patient health. Patients who received calls from peer health coaches had fewer symptoms of depression and sleep problems than patients who didn’t receive calls from peer health coaches. But calls from peer health coaches didn’t help patients feel less tired or anxious. The calls also didn’t improve patients’ abilities to take part in social or physical activities.

Use of health care. Calls from peer health coaches didn’t decrease the number of times patients visited the emergency room.

Who was in the study?

This study included 444 adults with COPD. Patients spoke English and had oxygen prescriptions for use at home 24 hours per day, 7 days per week.

What did the research team do?

The research team assigned patients to one of three groups by chance. Two groups didn’t receive phone calls from health coaches. In the first group, patients received written information about home oxygen use and the phone number of a peer health coach. In the second group, patients received all of this information and encouragement to contact peer health coaches for help. Patients in the third group received the written information as well as five phone calls from peer health coaches over a 60-day period to discuss any problems they had with home oxygen use. Before the study, peer health coaches received training about talking to patients about COPD and oxygen use.

The research team collected information from patients at the start of the study and again after 60 days. The team asked the patients about their oxygen use and their health. Patients reported on their depression, anxiety, sleep, tiredness, social activities, and physical activities. The team also asked patients about their emergency room visits. The team compared the results from the three groups.

What were the limits of the study?

The research team couldn’t collect completed records about oxygen use from 27 percent of patients at the end of the study. Results may have been different if the team had been able to collect information from all patients in the study. Also, patients reported the amount of oxygen they used at home. Although the research team tried to confirm the oxygen use numbers for some patients, these numbers may not be exact for all patients.

The research team couldn’t confirm the patients’ oxygen prescription from the company supplying the oxygen to patients. Patients who used less oxygen may have asked their doctors to reassess their need for home oxygen.

Future research could look at why phone calls from peer health coaches resulted in lower oxygen use in this study.

How can people use the results?

The study found that calls from peer health coaches didn’t help patients with COPD use oxygen at home as recommended. Doctors could consider using calls from peer health coaches to help patients with COPD who have feelings of depression and sleep problems.

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Peer-Review Summary

Peer review of PCORI-funded research helps make sure the report presents complete, balanced, and useful information about the research. It also confirms that the research has followed PCORI’s Methodology Standards. During peer review, experts who were not members of the research team read a draft report of the research. These experts may include a scientist focused on the research topic, a specialist in research methods, a patient or caregiver, and a healthcare professional. Reviewers do not have conflicts of interest with the study.

The peer reviewers point out where the draft report may need revision. For example, they may suggest ways to improve how the research team analyzed its results or reported its conclusions. Learn more about PCORI’s peer-review process here.

In response to peer review, the PI made changes including

  • Describing the concealment process of study-group assignment for participants, under which staff who collected data did not know the group to which participants had been assigned
  • Including a summary of the methods used for the qualitative study conducted in aim 1
  • Adding information to the Methods and Results sections about measuring the use of oxygen taken from the participants’ devices, rather than relying only on self-report of oxygen use
  • Revising the Discussion section to reduce the length of the first section and move details from the Conclusion section to the Discussion
  • Adding a note to the Study Limitations section regarding the lack of information about the types of oxygen-delivery devices participants used, because the user-friendliness of a device can play a role in how likely it is to be used

Conflict of Interest Disclosures

View the COI disclosure form.

Project Information

Jerry A. Krishnan, MD, PhD
University of Illinois at Chicago
$2,057,234
10.25302/11.2018.CE.13046490

Key Dates

45 months
September 2013
March 2018
2013
2018

Study Registration Information

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Last updated: October 20, 2021