The Supporting Patient Activation in Transition to Home (sPATH) intervention: a study protocol of a randomised controlled trial using motivational interviewing to decrease re-hospitalisation for patients with COPD or heart failure

BMJ Open. 2017 Jul 10;7(7):e014178. doi: 10.1136/bmjopen-2016-014178.


Introduction: Deficient hospital discharging and patients struggling to handle postdischarge self-management have been identified as potential causes of re-hospitalisation rates. Despite an increased interest in interventions aiming to reduce re-hospitalisation rates, there is yet no best evidence on how to support patients in being active participants in their self-management postdischarge. The aim of this paper is to describe the study protocol for an upcoming randomised controlled trial (RCT) of the Supporting Patient in Activation to Home (sPATH) intervention.

Methods/analysis: The described study is a randomised, controlled, analysis-blinded, two-site trial, with primary outcome re-hospitalisation within 90 days. In total, 290 participants aged 18 years or older with chronic obstructive pulmonary disease or congestive heart failure who are admitted to hospital and who are living in an own home will be eligible for inclusion into an intervention (n=145) or control group (n=145). Patients who need an interpreter to communicate in Swedish, or who have a diagnosis of dementia or cognitive impairment, will be excluded from inclusion. The sPATH intervention, developed with a theoretical base in the self-determination theory, consists of five postdischarge motivational interviewing sessions (face to face or by phone). The intervention covers the self-management areas medication management, follow-up/care plan, symptoms/signs of worsening condition and relations/contacts with healthcare providers. This RCT will add to the literature on evidence to support patient activation in postdischarge self-management.

Ethics and dissemination: The study is approved by the Regional Research Ethics Committee (No. 2014/1498-31/2) in Stockholm, Sweden. The results of the study will be published in peer-reviewed journals and presented at international and national scientific conferences.

Trial registration number: NCT02823795; Pre-results.

Keywords: Chronic airways disease; Heart failure; Protocols & guidelines; motivational interviewing; re-hospitalization.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Continuity of Patient Care*
  • Health Transition*
  • Heart Failure / therapy*
  • Humans
  • Motivational Interviewing*
  • Patient Discharge
  • Patient Readmission / statistics & numerical data*
  • Patient Reported Outcome Measures
  • Pulmonary Disease, Chronic Obstructive / therapy*
  • Quality of Life
  • Research Design
  • Self Care
  • Sweden
  • Time Factors

Associated data