Aides in Respiration Health Coaching for COPD

Inclusion Criteria:

   - Patient at one of the participating primary care clinics (at least 1 visit in past 12
   months)

   - Age 40 and older

   - Speaking English or Spanish

   - Plan to continue to be seen at current clinic and to not leave the area for >2 months
   anytime in the next 9 months or to be absent at 9 or 15 months

   - COPD defined as ever having had a post-bronchodilator Forced Expiratory Volume in 1
   second/Forced Vital Capacity (FEV1/FVC) <.70 of FEV1/FVC of .70 to .74 and diagnosis
   of COPD by the study pulmonologist

   - Willingness to attempt spirometry

   - At least moderate COPD, defined as at least one of the following:

      - Ever Forced Expiratory Volume in 1 second (FEV1) < 80% predicted

      - 1 or more emergency department (ED) visit for COPD exacerbation in past 12 months

      - 1 or more hospital stays for COPD exacerbation in past 12 months

      - 1 or more prescriptions for oral prednisone for a COPD exacerbation in past 12
      months

      - Ever on home oxygen therapy

      - Ever outpatient percutaneous oxygen saturation of
      - Ever outpatient partial pressure of oxygen (ppO2) by arterial blood gas (ABG) of
      
      - At least 3 outpatient visits for COPD in past 12 months AND (a current COPD
      Assessment Test (CAT) score of >/=10 OR an modified Medical Research Council
      (mMRC) score of >/=2).

      - Currently using tiotropium inhaler or combination inhaled corticosteroid and
      long-acting beta agonist

Exclusion Criteria:

   - Unable to participate in the study due to mental or physical impairment

   - Severe or terminal illness that precludes focus on COPD

   - No phone