Healthy Coaching for Long-Term Conditions and Multimorbidity in UK Primary Care

Health coaching boosts patient activation in multimorbidity, reduces demand on acute and GP services and supports system sustainability.

Context

• To evaluate whether StACC increases patient activation in people with long-term conditions with multimorbidity and explore its impact on patient well-being.
• To assess whether improved patient activation supports effective and sustainable self-management. 
• To assess the feasibility and value of a non-disease-specific, psychologically informed coaching approach within UK primary care.

Methods

• Quantitative patient reported outcome measures (PAM-13 and heiQ) 
• Qualitative data from patient statements and feedback (thematic analysis) 
• Exploratory pre-post analysis of health service usage within a small subgroup

Results

• The StACC health coaching intervention led to above-benchmark improvements across all domains and significant improvements in patient activation (PAM-13). 
• Participants who were previously disengaged or overwhelmed were able to develop ownership, confidence, motivation, and problem-solving skills, leading to improved self-management. 
• Subgroup analysis indicated a potential reduction in GP appointments consistent with proactive, planned self-management. 
• Participants had lower baseline activation levels than comparator populations, indicating StACC is effective even for those least engaged initially. 
• Higher completion rates among individuals with anxiety, depression or stress suggest the intervention is acceptable and valued by psychologically complex patients. 

Reference

Henry, K., El-Osta, A. and Leedham-Green, K. (2025). Health coaching for people with long-term conditions and multimorbidity: a mixed methods prospective service evaluation of Structured Agenda-free Coaching Conversations (StACC) in UK primary care. BMC Public Health, 25(1).