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Table 1 Articles included in the review and CASP scores

From: Health coaching provided by registered nurses described: a systematic review and narrative synthesis

References & location of study undertaken Aim Health areas Design Sample Main outcome variables/
scales used
Primary result CASP score
To evaluate the effectiveness of goal focused telephone coaching by practice nurses in improving glycaemic control in patients with type 2 diabetes in Australia. Chronic illness Prospective, cluster RCT with GP as the unit of randomisation 59 GP clinics, 437 patients Mean absolute change in HbA1c level At 18 months follow-up, the effect on glycaemic control did not differ significantly.
The median number of coaching sessions received by the 236 intervention was 3, of which 25 % did not receive any coaching sessions.
(related to [33])
To explore experiences about how health coaching motivated behaviour change. Chronic illness Qualitative 10 control participants and 20 intervention participants - Participants positively enacted behaviour change to become more physically active. Participants took advantage of environmental affordances to pull themselves toward activity targets or relied on being pushed to be more active by the health coach or significant others. Behaviour change was maintained where efforts to be more active were built into the everyday lifeworld of participants. 16
To explore different types of successes experienced by adults with type-2 diabetes participating in a health technology and nurse coaching clinical trial. Chronic illness Qualitative 132 cases reviewed Participants survey results
Notes by nurse coaches
(1) change in health behaviours; (2) change in mindset or awareness; (3) change in engagement with healthcare resources; (4) change in physical or emotional health; and (5) change in health indicators. 13
To evaluate a behaviour support intervention for patients with poorly controlled diabetes. Chronic illness RCT with repeated measures 201 patients with poorly controlled type2 diabetes mellitus HbA1c value
Participant’s review of intervention material
Diabetes Knowledge Test
Summary of Diabetes Self-Care Activities Measure
There was a significant overall reduction in mean haemoglobin A1c value from baseline to 6 months but differences between groups, diabetes knowledge, and selfcare were not significant. 16
To evaluate the effectiveness of telephone health coaching delivered by a nurse to support self-management in a primary care population with mild symptoms of chronic obstructive pulmonary disease (COPD). Chronic illness RCT 71 GP clinics, 577 patients with dyspnoea Quality of life (St George’s Respiratory Questionnaire) No difference in SGRQ-C total score at 12 months.
Compared with patients in the usual care group, at six months follow-up, the intervention group reported greater physical activity, more had received a care plan, rescue packs of antibiotics, and inhaler use technique check.
To test the hypothesis that ambulatory arthroscopic surgery patients who receive a nurse-coached telephone intervention will have significantly less symptom distress and better functional health status than a comparable group who receive usual practice. Post-surgery RCT 102 participants (52 intervention; 50 usual care) Symptom distress scale
Medical Outcomes Study 36-item short-Form health survey general health perceptions
Mental health subscales
Intervention participants had significantly less symptom distress at 72 h and 1-week post-surgery and significantly better overall physical and mental health at 1-week post-surgery. 14
To determine if metabolic risk factors can be stabilized or improved with weekly motivational interviewing/coaching and medical follow-up care focused on lifestyle behavioural change in individuals with serious mental illness. Mental Health Prospective, longitudinal study 11 participants Weight
waist circumference
blood pressure
blood glucose levels
Quality of life (Healthy Days Health-related Quality of Life questionnaire)
While some individuals showed improvement, others showed deterioration in the physiological markers for metabolic syndrome. Only a small number completed the 18-week study. 14
To assess the feasibility of conducting a trial of a psychoeducational intervention involving the provision of tailored information and coaching to improve management of a cancer-related symptom cluster and reduce symptom cluster impacts on patient health outcomes in the Vietnamese context and to undertake a preliminary evaluation of the intervention. Chronic illness Parallel-group single-blind pilot quasi-experimental trial 102 cancer patients in one hospital Numerical Analogue Scales for each symptom
Brief Fatigue Inventory
Pittsburgh Sleep Quality Index
Karnofsky Performance Scale
Hospital Anxiety and Depression Scale
EuroQol-5D-5 L
Intervention Rating Profile-15
The intervention group showed a significant reduction in symptom cluster severity, fatigue severity, fatigue interference, sleep disturbance, depression, and anxiety. 15
[5] (related to [9])
To evaluate a cost-effective analysis of a tele-based health coaching intervention among patients with type 2 diabetes, coronary artery disease, and congestive heart failure. Chronic illness RCT 998 participants with type 2 diabetes, coronary artery disease, or congestive heart failure Health-Related quality of life
Cost data: social and healthcare services
Cost effectiveness of the health coaching was highest in type 2 diabetes group. The probability of health coaching being cost effective was 55 % in the whole study group.
Health coaching improved the quality of life for type 2 diabetes and coronary artery disease patients with moderate cost.
To examine the effectiveness of a health coaching self-management program for older adults with multimorbidity in nursing homes Chronic illness RCT 43 older adults with multimorbidity in nursing homes Self-management behaviours
Health status
Chronic Disease Self-Management Program Questionnaire (42 items)
Health goal setting and attainment scales (intervention group only)
Intervention group had better exercise behaviour, cognitive symptom management, mental stress management/relaxation, self-rated health, reduced illness intrusiveness, depression, and social/role activities limitations. Improved oral health and stress reduction. 15
To evaluate the effect of a 12-month individualized health coaching intervention by telephone on clinical outcomes. Chronic illness An open-label cluster-randomized parallel groups trial 1221 participants with type 2 diabetes, coronary artery disease or congestive heart failure, and unmet treatment goals Systolic and diastolic blood pressure
serum total and LDL cholesterol concentration
waist circumference for all patients,
The diastolic blood pressure decreased to 85 mmHg or lower (48 % in the intervention group and 37 % in the control group). No significant differences emerged between two groups in the other primary outcomes. However, the target levels of systolic blood pressure and waist circumference were reached non-significantly more frequently in the intervention group. 16
To evaluate the effectiveness of transitional care coaching intervention offered to clinically ill medical patients during the transition from hospital to home (primary care). Chronic illness 2 arm randomised pilot study; experimental post-test only 88 participants (60 intervention; 20 control) Brief literacy measure
Morisky Medical Adherence Scale
Medication discrepancy tool
At home setting, many participants were unable or unwilling to discuss about goal setting and behaviour change. Those who were not able to participate had multiple distractions. 8
To test the effect of a telephone health coaching service (Birmingham Own Health) during primary nursing care on hospital use and associated costs. Chronic illness Retrospective design using person level administrative data and difference-in-difference analysis with matched controls. 2698 patients recruited from local general practices before 2009 with heart failure, coronary heart disease, diabetes, or chronic obstructive pulmonary disease Hospital bed days
Elective hospital admissions
Outpatient attendances
Secondary care costs
Emergency admission rates and outpatient attendance rate increased rapidly in intervention group. 17
To test the implementation of nurse-telephone coaching for families of children with asthma. Chronic illness RCT 12 families, 175 participants 4 targeted behaviours (Controller medications; asthma action plan; rescue meds; planning visits)
Interview with parents
Nurse telephone coaching was successful in promoting improved asthma self-management behaviours in parents of children with asthma. 13
To test the effectiveness of two interventions compared to usual care in decreasing attitudinal barriers to cancer pain management, decreasing pain intensity, and improving functional status and quality of life. Pain RCT 318 adults with various type of cancer-related pain Pain intensity
Pain relief
Pain interference
Attitudinal barriers
Functional status
Quality of life
Attitudinal barrier scores did not change over time among groups. Patients randomised to the coaching group reported significant improvement in their ratings of pain-related interference with function, general health, vitality, and mental health. 15
To determine the efficacy of the Power Over Pain-Coaching intervention to improve functional status among African American outpatients with cancer pain. Pain Two-group randomised design with repeated measures 310 African American cancer patients Pain
Pain-related distress
Functional status
Perceived control over pain
Functional status improved. Distress also was differentially decreased. Pain intensity ratings decreased. The largest effects were observed in the living with pain component. 16
To evaluate telephone coaching undertaken by practice nurses in a randomised controlled trial of self-management support for people with type 2 diabetes. Chronic illness Grounded theory 14 coaching session by 6 GP employed practice nurses - Patient-participants had complex multiple medical conditions to manage while maintaining daily lives. Two approaches to working with this complexity: treat to target; and personalised care. 14
  1. CASP Critical Appraisal Skill Program, GP General Practice, LDL Low-density lipoprotein, RCT Randomised Controlled Trial, UK The United Kingdom, USA The United States of America