The Value of Health Coaching for Patients with Chronic Disease

Chronic diseases—the leading cause of death and disability in the United States—are among the most common, costly, and preventable of all health problems. A staggering 133 million Americans—more than 40 percent of the population—are affected by chronic disease, with that number expected to grow to an estimated 157 million by 2020.

Notoriously difficult to manage, half of chronically ill patients leave primary care visits not understanding what their doctor told them. Adherence rates for prescribed medications are approximately 50 percent and lifestyle changes fall below 10 percent. Given the substantial number of individuals living with a chronic illness, these statistics are troublesome.

Health providers are looking for more effective ways to work collaboratively with patients to ensure that they not only understand their disease, key to learning how to self-manage, but are active participants in the management of their chronic condition.

It’s difficult to imagine a professional athlete preparing for the big game without a coach. The same can be said for an individual receiving a chronic disease diagnosis. Having a health strategy in place and an advocate to teach you how to maintain one, can be a game changer.

Changing Patient Behavior to Improve Health

According to Anjana Sharma, M.D., a clinical fellow in the department of family and community medicine at the University of California, San Francisco School of Medicine, “Currently, there is increasing emphasis on how patients can be better engaged in their own care and how to help patients manage chronic illness day to day when they are outside the clinic walls. Interventions such as health coaching are gaining attention as a strategy to promote this patient engagement.”

Health coaching has emerged as a promising intervention to target behavior change which is required to successfully manage many chronic diseases.

Coaching isn’t just about reminding a patient to take a pill every day. What makes the approach so effective is that it encompasses a broader reach, taking into account a patient’s individual lifestyle and behavior, health goals, what motivates them, what stresses them out and so forth.

Health interventions, such as coaching, that target individual motivation using a patient’s personal values and goals, lead to significant behavior changes that appear sustainable. Studies of integrative health coaching (IHC) specifically have shown lower risk for cardiovascular disease, diabetes and stroke, improved weight control, better management of intractable tinnitus, and experienced improvements in diabetes-related psychosocial measures.

Health coaches have a vast knowledge about health issues, but their prowess lies in their ability to empower chronically ill patients to gain the knowledge, skills, motivation and confidence necessary to ultimately reach and maintain their self-identified health goals.

An article from the American Academy of Family Physicians referenced the familiar saying, “Give a man a fish, and he eats for a day. Teach a man to fish, and he eats for a lifetime,” to explain the role of a health coach and the impact in equipping patients with the skills necessary to learn effective disease self-management as opposed to “rescuing” a patient.

Years of research is showing this approach to be effective. It is also potentially arming patients with the tools they need to maintain their health long-term.

Helping Patients Build Skills to Last a Lifetime

Generally, a chronic disease is something that cannot be cured and will span the greater part of a patient’s life, sometimes permanently. We know that health coaching motivates change in patient lifestyle and improves physical and mental health outcomes but recent research is showing the potential for patients to do so over longer periods of time.

The study, conducted at two safety-net clinics, looked at whether the effects of health coaching on patients managing diabetes, hypertension and hyperlipidemia, could be sustained one year later. It was discovered that the majority of patients who received a year of health coaching were in fact able to maintain most health benefits a full year later.

Part of what makes chronic illness so difficult to manage is the constant care required for patients to maintain health, coupled with the fact that patients have to completely transform their previous way of life. An entire year is a long time for a chronically ill person to maintain their health. The findings are encouraging that health coaching has the ability to offer chronically ill patients improved health for the long-term.

The research also reveals the potential advantages of health coaching for vulnerable populations who may need and benefit from it most.

Utilizing Health Coaching and Technology to Empower Vulnerable Populations

Adopting healthier lifestyle behaviors can be difficult for anyone. For individuals with limited resources, living with a chronic disease like diabetes requires vigilant attention, so maintaining behaviors like exercise and a balanced diet can seem impossible.

Yet, health coaching combined with the use of technology has shown to be an effective tool in improving outcomes for those with chronic disease living in lower-socioeconomic communities.

A study evaluating the benefits of health coaching on lower income patients with type 2 diabetes, with and without the use of mobile technology, found that not only did health coaching improve glucoregulation and mental health in both groups of patients, but the use of mobile technology accelerated patient improvement in changing behavior and maintaining those healthy lifestyle changes.

However, this begs the question, do people living on limited resources have access to mobile technology? Research indicates that the Medicaid population use their mobile phone as their primary means of communication. Given that Medicaid beneficiaries have higher rates of chronic disease, it seems likely that an approach combining health coaching with technology could produce significant health outcomes for this population.

Growing evidence suggests that people who have the “skills, ability and willingness to manage their own health and healthcare tend to have better outcomes and generate lower healthcare costs.” Health coaching provides these tools, offering the millions of Americans affected by chronic disease the potential to improve their health for the long haul.