Motivational interviewing to improve self‐care in heart failure patients (MOTIVATE‐HF): a randomized controlled trial
Abstract 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) a...
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| Format: | Article |
| Language: | English |
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Wiley
2020-06-01
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| Series: | ESC Heart Failure |
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| Online Access: | https://doi.org/10.1002/ehf2.12733 |
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| author | Ercole Vellone Paola Rebora Davide Ausili Valentina Zeffiro Gianluca Pucciarelli Gabriele Caggianelli Stefano Masci Rosaria Alvaro Barbara Riegel |
| author_facet | Ercole Vellone Paola Rebora Davide Ausili Valentina Zeffiro Gianluca Pucciarelli Gabriele Caggianelli Stefano Masci Rosaria Alvaro Barbara Riegel |
| author_sort | Ercole Vellone |
| collection | DOAJ |
| description | Abstract 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. |
| format | Article |
| id | doaj-art-1a3985bac46248abafffd00d65610e08 |
| institution | Kabale University |
| issn | 2055-5822 |
| language | English |
| publishDate | 2020-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | ESC Heart Failure |
| spelling | doaj-art-1a3985bac46248abafffd00d65610e082025-02-03T10:25:46ZengWileyESC Heart Failure2055-58222020-06-01731309131810.1002/ehf2.12733Motivational interviewing to improve self‐care in heart failure patients (MOTIVATE‐HF): a randomized controlled trialErcole Vellone0Paola Rebora1Davide Ausili2Valentina Zeffiro3Gianluca Pucciarelli4Gabriele Caggianelli5Stefano Masci6Rosaria Alvaro7Barbara Riegel8Department of Biomedicine and Prevention University of Rome Tor Vergata Via Montpellier 1 00133 Rome ItalyCentre of Biostatistics for Clinical Epidemiology, Department of Medicine and Surgery University of Milan‐Bicocca Monza ItalyCentre of Biostatistics for Clinical Epidemiology, Department of Medicine and Surgery University of Milan‐Bicocca Monza ItalyDepartment of Biomedicine and Prevention University of Rome Tor Vergata Via Montpellier 1 00133 Rome ItalyDepartment of Biomedicine and Prevention University of Rome Tor Vergata Via Montpellier 1 00133 Rome ItalyDepartment of Biomedicine and Prevention University of Rome Tor Vergata Via Montpellier 1 00133 Rome ItalySchool of Counselling University of Rome Tor Vergata Rome ItalyDepartment of Biomedicine and Prevention University of Rome Tor Vergata Via Montpellier 1 00133 Rome ItalySchool of Nursing University of Pennsylvania Philadelphia PA USAAbstract 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.https://doi.org/10.1002/ehf2.12733Motivational interviewingSelf‐careHeart failureCaregivers |
| spellingShingle | Ercole Vellone Paola Rebora Davide Ausili Valentina Zeffiro Gianluca Pucciarelli Gabriele Caggianelli Stefano Masci Rosaria Alvaro Barbara Riegel Motivational interviewing to improve self‐care in heart failure patients (MOTIVATE‐HF): a randomized controlled trial ESC Heart Failure Motivational interviewing Self‐care Heart failure Caregivers |
| title | Motivational interviewing to improve self‐care in heart failure patients (MOTIVATE‐HF): a randomized controlled trial |
| title_full | Motivational interviewing to improve self‐care in heart failure patients (MOTIVATE‐HF): a randomized controlled trial |
| title_fullStr | Motivational interviewing to improve self‐care in heart failure patients (MOTIVATE‐HF): a randomized controlled trial |
| title_full_unstemmed | Motivational interviewing to improve self‐care in heart failure patients (MOTIVATE‐HF): a randomized controlled trial |
| title_short | Motivational interviewing to improve self‐care in heart failure patients (MOTIVATE‐HF): a randomized controlled trial |
| title_sort | motivational interviewing to improve self care in heart failure patients motivate hf a randomized controlled trial |
| topic | Motivational interviewing Self‐care Heart failure Caregivers |
| url | https://doi.org/10.1002/ehf2.12733 |
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