Competencies and training of health professionals engaged in health coaching: A systematic review

OBJECTIVE

A systematic review was undertaken in order to evaluate the competencies of primary healthcare professionals who are engaged with health coaching patients with chronic health conditions.

METHODS

The databases CINHAL, EMBASE, PubMed, PsychINFO and SCOPUS were searched to identify peer reviewed papers referring to competencies of health professionals engaged in health coaching.

RESULTS

Nine key competencies that health professionals met and which resulted in successful patient outcomes from health coaching were identified. Comparisons of the core health coaching competencies to the competencies for coaches established by the International Coaching Federation and European Mentoring and Coaching Council showed considerable overlap. However, the comparison also reiterated the need for competencies specific to health coaches to be made explicit.

DISCUSSION

Health coaching has been shown to improve the health outcomes in patients with chronic health conditions. As such, there is a need to build an evidenced-based competency framework specific to health coaches. At present, the lack of a competency framework on which to base health coach training could significantly impact the outcomes of patients receiving health coaching. Practical implications include improving regulation and quality of health coaching, and more importantly, the health outcomes of patients receiving the service.

Does the Modality Used in Health Coaching Matter? A Systematic Review of Health Coaching Outcomes

OBJECTIVE

The purpose of this review was to evaluate the modalities (e.g., face-to-face, telephone or electronic) of pharmacist health coaching providing the greatest improvement in patient outcomes, to enable a more comprehensive evaluation to be done and quality decision-making around health coaching modalities to be undertaken by pharmacists.

METHODS

This systematic review followed the PRISMA guidelines. CINHAL, EMBASE, PubMed, PsychINFO and SCOPUS were searched (2000-2019). Included articles were reviewed for the modality used to health coach, the training provided, and the outcomes.

RESULTS

Twelve papers met the eligibility criteria. A majority of studies included involved a combination of modalities of pharmacist health coaching. Four papers referred to face-to-face sessions, and one study used telephone coaching. In each paper, coaching led to an improvement in clinical and non-clinical health outcomes.

CONCLUSION

The training provided to health coaches varied and in some cases was not reported. Inconsistencies in reports led to difficulties when comparing study outcomes. Therefore, conclusions about the modality providing the greatest improvement in patient outcomes and the most pragmatic health coaching modality are not possible. Studies that document the training, the modality, the outcomes and the cost benefits of coaching by pharmacists are warranted to enable a more comprehensive evaluation to be done and quality decision-making around health coaching modalities to be undertaken by pharmacists.

Pharmacist health coaching in Australian community pharmacies: What do pharmacy professionals think?

Health coaching is a service provided to patients by healthcare professionals for the purposes of disease management and health risk prevention. Internationally, pharmacist health coaching services provided to patients with chronic health conditions have produced beneficial health outcomes. Despite this, the service is not currently provided within Australian community pharmacies. This study evaluates the knowledge, opinions and attitudes of leaders within the pharmacy profession about the concept of health coaching as a service in community pharmacy. Semi-structured interviews with leaders in the pharmacy profession were carried out. Pharmacy leaders were interviewed until data saturation was reached; 10 pharmacists were interviewed. The interviews were transcribed verbatim and analysed thematically; extracts from the transcripts were compared and categorised to establish themes and subcategories. Analysis of the transcripts indicated the emergence of two main themes and 10 subcategories. The main themes were as follows: 'positive view of health coaching in Australian community pharmacy' and 'barriers to integrating health coaching into Australian community pharmacy'. There was an overall perception that health coaching within community pharmacies would be valued by the Australian community. Interviewees held differing perceptions of pharmacists' capability to effectively coach pharmacy clients and suggested that the main impediments to its introduction related to remuneration for the service. The findings indicated that there is a potential for pharmacists to provide a health coaching service in community pharmacies, but that remuneration is a fundamental barrier. The research also indicated the need to clearly identify the knowledge, skills and attitudes needed to health coach and to identify whether potential gaps in the competencies of Australian community pharmacists exist.

Treatment of Anxiety in Patients With Coronary Heart Disease: A Systematic Review

BACKGROUND

Anxiety is common in patients with coronary heart disease (CHD) and is associated with an increased risk for adverse outcomes. There has been a relative paucity of studies concerning treatment of anxiety in patients with CHD.

OBJECTIVE

We conducted a systematic review to organize and assess research into the treatment of anxiety in patients with CHD.

METHODS

We searched CCTR/CENTRAL, MEDLINE, EMBASE, PsycINFO, and CINAHL for randomized clinical trials conducted before October 2016 that measured anxiety before and after an intervention for patients with CHD.

RESULTS

A total of 475 articles were subjected to full text review, yielding 112 publications that met inclusion criteria plus an additional 7 studies from reference lists and published reviews, yielding 119 studies. Sample size, country of origin, study quality, and demographics varied widely among studies. Most studies were conducted with nonanxious patients. The Hospital Anxiety and Depression Scale and State-Trait Anxiety Inventory were the most frequently used instruments to assess anxiety. Interventions included pharmacological, counseling, relaxation-based, educational, or "alternative" therapies. Forty (33% of total) studies reported that the interventions reduced anxiety; treatment efficacy varied by study and type of intervention. Elevated anxiety was an inclusion criterion in only 4 studies, with inconsistent results.

CONCLUSION

Although there have been a number of randomized clinical trials of patients with CHD that assessed anxiety, in most cases anxiety was a secondary outcome, and only one-third found that symptoms of anxiety were reduced with treatment. Future studies need to target anxious patients and evaluate the effects of treatment on anxiety and relevant clinical endpoints.

Qualitative analysis of peer coaches' experiences with counseling African Americans about reducing heart disease risk

BACKGROUND

Despite mounting evidence that peer coaches can make significant contributions to patient health, little is known about factors that must be addressed to engage and retain them in their role.

OBJECTIVE

To identify motivators and barriers to serving as a peer coach.

DESIGN

Open ended semi-structured interviews.

PARTICIPANTS AND SETTING

In a randomized trial of peer support, patients with well controlled hypertension and good interpersonal skills were recruited and trained to serve as peer coaches for African-American patients from the same practices who had poorly controlled hypertension. Peer coaches spoke by telephone at least three times with their same sex patient-clients on alternate months during the 6-month intervention and counseled about medication adherence as well as other healthy lifestyles.

KEY RESULTS

Of 15 trained peer coaches, ten were contacted and agreed to participate in the qualitative interview. Peer coaches had a mean age of 66 years, 50% were women, and 80% were African-American. Themes regarding favorable aspects of the peer coach experience included: meaning and satisfaction derived from contributing to community health and the personal emotional and physical benefits derived from serving as a peer coach. Negative aspects centered on: challenges in establishing the initial telephone contact and wanting more information about their patient-clients' personal health conditions and status. Peer coaches endorsed gender matching but were less clear about race-matching.

CONCLUSIONS

Programs that utilize peer support to enhance positive health behaviors should recognize that a spirit of volunteerism motivates many successful peer coaches. Program planners should acknowledge the special characteristics required of successful peer coaches when selecting, motivating and training individuals for this role.

A review of telephone coaching services for people with long-term conditions

In one-to-one telephone coaching, the patient receives regular telephone calls from a health professional. We have reviewed the evidence for one-to-one telephone coaching. Following a literature search we retrieved 41 articles which reported on the development and the efficacy of 34 separate telephone coaching interventions for LTC management. Telephone coaching for LTC management has only occurred in the last ten years, is becoming increasingly prevalent, and is dominated by interventions in North America and Europe. Twenty-seven (79%) of the studies reported on randomised designs involving at least one control or comparison group/condition. Of the 34 interventions reviewed, 17 (50%) were aimed at diabetes management and 17 (50%) were designed to manage chronic cardiovascular conditions. Most studies (32 or 94%) reported outcomes in favour of the telephone coaching intervention, although few (15%) employed any form of cost-benefit analysis (CBA). In order to obtain a better impression of overall service efficacy, more clearly defined service outcomes are required in future.

Seeking the views of health professionals on translating chronic disease self-management models into practice

Few studies have investigated the views of health professionals with respect to their use of chronic disease self-management (CDSM) in the workplace.

OBJECTIVE

This qualitative study, conducted in an Australian health care setting, examined health professional's formal self-management (SM) training and their views and experiences on the use of SM techniques when working with people living with a chronic illness.

METHODS

Purposive sample of 31 health care professionals from a range of service types participated in semi-structured interviews.

RESULTS

The majority of participants (65%) had received no formal training in SM techniques. Participants reported a preference for an eclectic approach to SM, relying primarily on five elements: collaborative care, self-responsibility, client's individual situation, structured support and linking with community agencies. Problems with CDSM centred on medication management, complex measuring devices and limited efficacy with some patient groups.

CONCLUSION

This study provides valuable information with respect to the use of CDSM within the workplace from the unique perspective of a range of healthcare providers within an Australian health care setting.

PRACTICE IMPLICATIONS

Training implications, with respect to CDSM and patient care, are discussed, together with how these findings contribute to the debate concerning how SM principles are translated into healthcare settings.