Shared decision-making and patient engagement program during acute exacerbation of COPD hospitalization: A randomized control trial

• Published in: Patient education and counseling 2020-04, Vol.103 (4), p.702-708
• Main Authors: Granados-Santiago, María, Valenza, Marie Carmen, López-López, Laura, Prados-Román, Esther, Rodríguez-Torres, Janet, Cabrera-Martos, Irene
• Format: Article
• Language: English
• Subjects: Chronic obstructive; Decision Making; Decision Making, Shared; Hospital medicine; Hospitalization; Humans; Nursing; Patient Participation; Patient Preference; Pulmonary disease; Pulmonary Disease, Chronic Obstructive - therapy
• ISSN: 0738-3991; 1873-5134
• DOI: 10.1016/j.pec.2019.12.004

•During hospitalization COPD patients need medical and rehabilitative care.•Share decision programs allow patients collaborate deciding about the health care.•SDM-PE program improve significantly all the clinical measures.•Main outcomes significantly improve at 3-month follow up after intervention. To evaluate the effectiveness of a shared decision-making and patient engagement (SDM-PE) program concerning in-hospital stay during acute exacerbation of COPD and determine its impact on patients’ perceived health status. Patients were randomly allocated to a control group that received standard treatment or an intervention group that received an individualized SDM-PE program in addition to standard treatment. The SDM-PE program included personalized health care focused on information about the disease, healthcare management, and reinforcement of behaviors regarding nutrition and exercise taking into account patients’ preferences. A comparative analysis between groups showed a significant improvement in perceived health status at discharge in patients included in the experimental group compared to those in the control group (60.28 ± 21.65 vs. 54.13 ± 22.69, p = 0.036). In addition, perceived health status, COPD knowledge, adherence to pharmacological treatment, general functionality, and healthy lifestyle measures were significantly better at 3-month follow-up in the intervention group. An SDM-PE program significantly enhanced all the clinical measures assessed during hospitalization at 3-month follow-up. COPD patients and professionals need to work together to select the best care and treatment model for patients, taking into account individual values and preferences.