Motivational interviewing to improve self-care for patients with chronic heart failure: MITI-HF randomized controlled trial

Abstract

Objective: The purpose of this study was to test the efficacy of a tailored motivational interviewing (MI) intervention versus usual care for improving HF self-care behaviors, physical HF symptoms and quality of life.

Methods: This is a single-center, randomized controlled trial. Participants were enrolled in the hospital. Immediately after discharge, those in the intervention group received a single home visit and 3-4 follow-up phone calls by a nurse over 90 days.

Results: A total of 67 participants completed the study (mean age 62±12.8 years), of which 54% were African American, 30% were female, 84% had class III/IV symptoms, and 63% were educated at a high school level or less. There were no differences between the groups in self-care maintenance, self-care confidence, physical HF symptoms, or quality of life at 90 days.

Conclusion: Patients who received the MI intervention had significant and clinically meaningful improvements in HF self-care maintenance over 90 days that exceeded that of usual care.

Practice implications: These data support the use of a nurse-led MI intervention for improving HF self-care. Identifying methods to improve HF self-care may lead to improved clinical outcomes.

Keywords: Behavior; Diet sodium-restricted; Heart failure; Motivational interviewing; Quality of life; Self care; Self efficacy.

Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Figures

Figure 1

CONSORT diagram.

Figure 2

Absolute change in outcomes at baseline and 90-days in the intervention and usual care groups.