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

• Published in: Contemporary clinical trials Vol. 62; pp. 159 - 167
• Main Authors: Aboumatar, H., Naqibuddin, M., Chung, S., Adebowale, H., Bone, L., Brown, T., Cooper, L.A., Gurses, A.P., Knowlton, A., Kurtz, D., Piet, L., Putcha, N., Rand, C., Roter, D., Shattuck, E., Sylvester, C., Urteaga-Fuentes, A., Wise, R., Wolff, J.L., Yang, T., Hibbard, J., Howell, E., Myers, M., Shea, K., Sullivan, J., Syron, L., Wang, Nae-Yuh, Pronovost, P.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-11-2017
• Subjects: Age Factors; Aged; Community Health Services - organization & administration; Emergency Service, Hospital - statistics & numerical data; Family; Female; Hospitalization - statistics & numerical data; Humans; Male; Middle Aged; Patient Care Team - organization & administration; Patient Education as Topic - organization & administration; Patient-Centered Care - organization & administration; Pilot Projects; Pulmonary Disease, Chronic Obstructive - therapy; Quality of Life; Research Design; Self Care; Self Efficacy; Sex Factors; Single-Blind Method; Socioeconomic Factors; Transitional Care - organization & administration
• ISSN: 1551-7144; 1559-2030
• DOI: 10.1016/j.cct.2017.08.018

Chronic 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.
In 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.
Unlike 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.