Intended for healthcare professionals


Coaching to support patients in making decisions

BMJ 2008; 336 doi: (Published 31 January 2008) Cite this as: BMJ 2008;336:228
  1. Annette M O’Connor, professor1,
  2. Dawn Stacey, assistant professor1,
  3. France Légaré, assistant professor2
  1. 1University of Ottawa, School of Nursing, Ottawa, ON, Canada K1H 8M5
  2. 2Laval University, Department of Family Medicine, Quebec, QC, Canada G1K 7P4
  1. aoconnor{at}

    Needs to be tailored to individuals, and integrated with existing health systems

    An essential component of high quality clinical care is an informed and engaged patient.1 Although some patients have the necessary confidence and skills to participate in their care, others or their families need coaching to develop their skills. Over the past 15 years, health coaching has been evaluated in research interventions and is now provided mostly in call centres or management programmes for chronic conditions in North America, Europe, and Australia.

    Coaching develops patients’ skills in preparing for a consultation, deliberating about options, and implementing change. Trained facilitators, who are supportive but do not make decisions for the patient, coach patients before or after an encounter with a clinician. Coaches are often nurses, but they may also be other health professionals or trained patients. Coaching is provided face to face between individuals or groups, or over the telephone, email, or internet. Human interaction is usually involved, but automated coaching using telephone or e-tools is evolving.

    Coaching can be used for chronic conditions where the challenge lies in finding common ground between clinical and personal priorities and implementing changes. It is also useful for preference sensitive decisions (such as treatments …

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