Disease-Management in Family Medicine Clinics Through the Addition of a Health Coach: A Pilot Study

Background: In the United States, more than 80% of health care spending is focused on the management of chronic illnesses such as hypertension, diabetes and hyperlipidemia. Controlling these chronic diseases can lead to better health outcomes and decrease the number of preventable deaths. Patient self-management has shown to improve clinical outcomes. In a primary care setting, a multidisciplinary approach can more effectively educate patients on improving their health. Purpose: To assess the impact of a health coach in a primary care setting as it relates to clinical outcomes. Methods: Patients from two Aurora family medicine clinics were referred to a health coach by primary care providers. A total of 40 patients participated and paid out of pocket for the health coaching sessions (intervention). Patients had at least one scheduled session with the health coach that covered topics such as healthy eating, weight loss and exercise. Patient data, including glycohemoglobin, lipid panels and blood pressures, were reviewed pre- and postintervention. Data were obtained 1 year before the intervention date and at least 3 months after. Paired t-tests were used for comparisons. Results: The study population was predominantly Caucasian (90%) and female (90%) with a mean age of 54 years (range 25–79). The mean patient body mass index (kg/m2) was 37 and ranged from 28 to 63. When comparing pre- and postintervention clinical data, several improvements in laboratory values were noted. Low-density-lipoprotein cholesterol levels decreased from an initial mean of 114 preintervention to 105 postintervention, mean high-density-lipoprotein cholesterol levels increased from 47 to 58, and mean glycohemoglobin levels decreased from 6.5 to 6.1. All improvements in clinical data were not statistically significant, but were clinically relevant. Conclusion: Patients showed mild improvements in multiple lab values after their first meeting with a health coach. This pilot study was limited by the small number of patients who chose to have a health coaching session. A limiting factor for patient use of a health coach may be secondary to the cost of each clinic visit and follow-up lab work. Cost may have contributed to our demographic mix. To further assess the impact and benefit of a health coach in a primary care setting, a larger, more diverse patient population is needed