z-logo
open-access-imgOpen Access
Motivational interviewing to improve self‐care in heart failure patients (MOTIVATE‐HF): a randomized controlled trial
Author(s) -
Vellone Ercole,
Rebora Paola,
Ausili Davide,
Zeffiro Valentina,
Pucciarelli Gianluca,
Caggianelli Gabriele,
Masci Stefano,
Alvaro Rosaria,
Riegel Barbara
Publication year - 2020
Publication title -
esc heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.787
H-Index - 25
ISSN - 2055-5822
DOI - 10.1002/ehf2.12733
Subject(s) - medicine , randomized controlled trial , motivational interviewing , heart failure , clinical endpoint , confidence interval , self care , physical therapy , self management , emergency medicine , health care , machine learning , computer science , economics , economic growth
Aims Self‐care, an essential component of heart failure (HF) treatment, is inadequate in most patients. We evaluated if motivational interviewing (MI) (i) improves patient self‐care maintenance (primary endpoint; e.g. taking medications), self‐care management (e.g. responding to symptoms) and self‐care confidence (or self‐efficacy) 3 months after enrolment; (ii) changes self‐care over 1 year, and (iii) augments patient self‐care if informal caregivers are involved. Methods and results Parallel randomized controlled trial (1:1:1). A sample of 510 patients (median 74 years, 58% male) and caregivers (median 55 years, 75% female) was randomized to Arm 1 (MI only for patients), Arm 2 (MI for patients and caregivers), or Arm 3 (usual care). The intervention in Arms 1 and 2 consisted of one face‐to‐face MI session with three telephone contacts. Self‐care was evaluated with the Self‐Care of HF Index measuring self‐care maintenance, management, and confidence. Scores on each scale range from 0 to 100 with higher scores indicating better self‐care; ≥70 is considered adequate. At 3 months, self‐care maintenance improved 6.99, 7.42 and 2.58 points in Arms 1, 2, and 3, respectively ( P  = 0.028). Self‐care maintenance was adequate in 18.4%, 19.4%, and 9.2% of patients in Arms 1, 2 and 3, respectively ( P  = 0.016). Over 1 year, self‐care maintenance, management, and confidence scores in Arms 1 and 2 were significantly higher than in Arm 3 in several follow‐ups. Over 1 year, Arm 2 had the best scores in self‐care management. Conclusions MI significantly improved self‐care in HF patients. Including caregivers may potentiate the effect, especially in self‐care management. ClinicalTrial.gov , identifier: NCT02894502.

The content you want is available to Zendy users.

Already have an account? Click here to sign in.
Having issues? You can contact us here