- Caregiver presence and strong family engagement help patients adhere to their chronic care self-management plans, according to recent research from the American Thoracic Society.
The study, published in the Journal of the American Thoracic Society, explored the differences in at-home self-management compliance in patients with strong social supports and those without.
Over 200 patients with COPD filled out questionnaires offering their perceptions of their caregiver and social supports. The researchers also collected data about whether study participants lived with someone else or had a spouse or life partner.
Ninety percent of the patients, who were predominantly white, male, and over the age of 68, lived with someone or had a spouse or life partner. The researchers also found that patients who lived with others reported more support than those who did not live with someone.
Patients who had high social supports ended up engaging in more healthy behaviors, the researchers found. Those with social support took on average 903 more steps daily than those without. However, the researchers acknowledged that more information is necessary for understanding family caregiver roles in physical activity over time.
“Living with others may be one of many important factors that contribute to maintaining patients’ daily physical activities through greater opportunities for reciprocal social interactions,” the team noted. “It is therefore important to consider how to incorporate social support and interactions into interventions that aim to increase physical activity.”
Patients with high social supports were also 11 times more likely to participate in pulmonary rehabilitation, were more likely to receive a pneumococcal vaccination, and less likely to smoke.
Although the study found that most patients participated in and adhered to pulmonary rehabilitation programs, this is not the national standard. This finding may have been reflective of the patient sample, which overwhelmingly had family and other social supports acting as caregiver, the research team said.
“We found that while living with others and being partnered were not associated with having participated in a pulmonary rehabilitation program prior to enrollment in our study, having a spouse or partner as a caregiver had a strong relationship with participation,” the investigators explained.
The researchers found that higher functional support – how patients perceive social support – was a better predictor of smoking cessation than structural support, or official relationships such as marriage.
There was negligible difference in patients with and without social supports who received an influenza vaccination. Influenza vaccination is a critical part of COPD preventive care that most patients typically receive, the researchers said. As such, it is unsurprising that 85 percent of all patients received a vaccination as a part of the standard self-management process.
These results suggest that all chronic disease management patients should have some sort of social support assisting them in self-management strategies. Whether that support come in the form of a family caregiver, spouse, or home care specialist, it will be essential for treating physicians to help patients identify supporting individuals, according to research lead Huong Q. Nguyen, PhD, RN.
The care team is integral in “in marshalling social support,” said Nguyen, who is a research scientist at Kaiser Permanente Southern California and an affiliate associate professor at the University of Washington.
“Similarly, health and social policies should acknowledge and consider ways to support the nearly 45 million unpaid family caregivers in the United States who are responsible for the vast majority of the day-to-day care of their loved ones,” she continued.
A separate study published by the University of Pittsburgh Medical Center (UPMC) showed that strong family member engagement can also reduce readmissions, ultimately cutting healthcare costs.
When parents, spouses, and adult children became involved in patient care and the discharge process, the likelihood of 90-day readmission decreased by 25 percent, and the likelihood of 180-day readmission was cut by 24 percent.
This has a positive effect on hospital costs and helps hospitals avoid penalties issued for high readmission rates.
Due to the care quality and financial implications of family and caregiver engagement, it would benefit healthcare organizations to help patients identify social support systems, said A. Everette James, JD, MBA, lead author on the UPMC study.
“While integrating informal caregivers into the patient discharge process may require additional efforts to identify and educate a patient’s family member, it is likely to pay dividends through improved patient outcomes and helping providers avoid economic penalties for patient readmissions,” James concluded.