• Contemp Clin Trials · Nov 2017

    Randomized Controlled Trial

    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.

    • H Aboumatar, M Naqibuddin, S Chung, H Adebowale, L Bone, T Brown, L A Cooper, A P Gurses, A Knowlton, D Kurtz, L Piet, N Putcha, C Rand, D Roter, E Shattuck, C Sylvester, A Urteaga-Fuentes, R Wise, J L Wolff, T Yang, J Hibbard, E Howell, M Myers, K Shea, J Sullivan, L Syron, Nae-Yuh Wang, P Pronovost, and BREATHE Study Patient Family Partners Group.
    • 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.
    • Contemp Clin Trials. 2017 Nov 1; 62: 159-167.

    BackgroundChronic 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.MethodsIn 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.DiscussionUnlike 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.

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