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Pre-transplant health coaching to improve patient-reported outcomes in lung transplant candidates

移植前健康指导可改善肺移植候选人的患者报告结果

基本信息

批准号：
10449543
负责人：
Cassie Colleen Kennedy
金额：
$ 48.42万
依托单位：
MAYO CLINIC ROCHESTER
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-05-15 至 2023-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10449543
关键词：
Address Adherence Adult Behavior Chronic Chronic Obstructive Pulmonary Disease Clinic Clinical Data Deterioration Disease Dissemination and Implementation Distress Dyspnea Emotional Emotions Enrollment Ensure Equation Face Florida Foundations Future Goals Health Intervention Interview Knowledge Logistics Lung Transplantation Lung diseases Measures Medical Medicine Minnesota Mission Modeling Multicenter Trials Obesity Outcome Outcome Measure Participant Patient Outcomes Assessments Patient Recruitments Patient-Focused Outcomes Patients Perception Personal Satisfaction Pharmaceutical Preparations Physical activity Population Preparation Psychometrics Pulmonary Emphysema Quality of life Questionnaires Readiness Research Research Personnel Risk Factors Role Self Management Stress Structure Telephone Testing Therapeutic Translating Transplant Recipients Transplantation Transplantation Surgery United States National Institutes of Health Waiting Lists Washington Work actigraphy base catalyst chronic respiratory disease clinical care cost dissemination trial effective intervention emotional functioning experience frailty health management implementation study implementation trial improved improved functioning improved outcome instrument negative affect novel physical conditioning pilot trial post-transplant prevent primary outcome randomized trial remote delivery resilience respiratory secondary outcome telephone session theories treatment as usual trial design

项目摘要

PROJECT SUMMARY/ABSTRACT Self-management abilities reflect patients’ capacity to manage emotions, social roles, and chronic medical conditions. In fact, self-management abilities are strongly associated with lung transplant candidates’ emotional health. Both self-management abilities and emotional health while waiting for lung transplant predict post- transplant quality of life. Additionally, a candidate’s self-management abilities and emotional health pre- transplant are associated with post-transplant adherence to immunosuppressive medications. Given the important role of these pre-transplant factors, the objective of this study is to optimize pre-transplant self- management abilities and emotional health with the long-term objective of improving post-transplant quality of life and transplant outcomes. Health coaching is an effective strategy to improve emotional health and self- management abilities in other populations and in non-transplant candidates with chronic obstructive pulmonary disease. We used semi-structured, qualitative interviews of lung transplant stakeholders to develop a relevant health coaching intervention for adult lung transplant candidates on the waiting list. In our small, single-center pilot trial we showed telephonic health coaching demonstrated improved pre-transplant self-management abilities, emotional health, and quality of life in comparison to usual care. In this application, we propose a randomized trial of a 30-minute telephonic health-coaching intervention once weekly for 12 weeks (compared to usual care) in 230 lung transplant candidates on the waiting list at the Mayo Clinic in Florida or Minnesota or at UW Medicine in Washington state. Patient-reported outcome instruments measuring emotional health, self- management, and quality of life will be measured at baseline, 12-16 weeks following enrollment, and post- transplant. Our primary outcomes will be differences between groups in Chronic Respiratory Questionnaire (CRQ) domains of Mastery (a measure of self-management) and Emotional function adjusted for baseline values. Secondary outcomes will compare the differences between groups of other psychometric questionnaire scores, adjusted for baseline, as well as short-term post-transplant outcomes. The long-term goal of this application is to optimize post-transplant outcomes through effective pre-transplant interventions. Our central hypothesis is that health coaching will improve lung transplant patients’ self-management abilities, emotional health, and quality of life pre-transplant. We further hypothesize that future studies will demonstrate that these pre-transplant improvements in self-management abilities and emotional health will translate into improved post- transplant quality of life. The results of this study will be used to refine the intervention and plan for a larger, multi-center trial designed to optimize dissemination and implementation in diverse settings. This proposal supports the NIH mission by striving to improve outcomes in lung disease patients while supporting a new investigator in her to transition to research independence.

项目总结/文摘