Health Coaches Help Practices Win at Chronic Care, Study Shows

CLEVELAND — With primary-care physicians under ever-increasing pressure to engage patients in proactively managing their own health, medical assistants (MAs) trained as health coaches may offer a cost-effective approach that pleases patients and fellow clinicians alike, according to a study published in Annals of Family Medicine.

To arrive at this promising conclusion, researchers assigned 441 patients between the ages of 18 and 75 to one of two groups: usual care or coaching/intervention. The three coaches who worked with the interventional group were all younger than 40 and spoke both English and Spanish. None had graduated from a four-year college, but all had earned diplomas from MA educational programs of three months to one year.

During the experiment, health coaches met with patients before visits, attended the visits, and reviewed care plans with patients immediately after visits. They also followed up with patients between visits and conducted their own face-to-face visits every three months. Meanwhile, patients in the control group still had full access to appointments with their clinicians, diabetes educators, and chronic-care nurses, and also participated in educational classes, the authors noted.

The benefits to the group receiving health coaching, however, were substantial. Nearly half (46{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5}) of coached patients met one clinical goal, compared to 34{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of the usual care group. Forty-nine percent of coached patients achieved their hemoglobin A1c goal, versus 28{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of the uncoached patients. And in two of the three clinics studied, 42{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of coached patients met their LDL cholesterol goal, compared to 25{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of uncoached patients.

“Medical assistants are one of the fastest-growing allied-health professions and are available and affordable in many settings,” David Thom, research director for the UCSF Department of Family and Community Medicine and principal investigator for the study, told AAFP News Now. “Health coaching by medical assistants could provide an answer to the barriers of time, resources, and cultural concordance faced by many primary-care practices seeking to provide chronic disease support for their patients.”