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Motivational interviewing reduces blood pressure and improves self-care behaviors in adults with hypertension- MIdNIgHT - a randomized controlled trial

Session Moderated poster session - Public health and cardiac rehabilitation

Speaker Luana Claudia Jacoby Silveira

Event : EuroHeartCare 2019

  • Topic : hypertension
  • Sub-topic : Hypertension - Treatment
  • Session type : Moderated Posters

Authors : LCS Jacoby (Porto Alegre,BR), RH De Souza (Porto Alegre,BR), GB Aliti (Porto Alegre,BR), E Vellone (Rome,IT), ER Rabelo-Silva (Porto Alegre,BR)

Authors:
LCS Jacoby1 , RH De Souza1 , GB Aliti1 , E Vellone2 , ER Rabelo-Silva1 , 1Federal University of Rio Grande do Sul - Porto Alegre - Brazil , 2University of Rome Tor Vergata, Nursing - Rome - Italy ,

Citation:

Background: Uncontrolled hypertension is the main risk factor for cardiovascular diseases. This lack of control is often due to poor self-care behaviors that patients find difficult to achieve. Motivational interviewing (MI) has been proposed as an approach to enhance intrinsic motivation to change, develop autonomy, and promote helthy behaviors but few randomized controlled trial (RCT) have explored this approach.

Purpose: The aim of this study was twofold: 1) To evaluate the effectiveness of MI in reducing blood pressure (BP) in patients with hypertension and 2) to evaluate the effectiveness of MI in improving self-care behaviors.

Design and methods: Single-center, parallel, RCT, blinded to outcome assessment. The study included 120 adult patients diagnosed with hypertension, who receive regular follow-up in an outpatient hypertension clinic during six months. Patients were randomly allocated to two groups: the intervention group (IG) that received MI by a trained nurse, and control group (CG) that received standard care. All patients in the IG and the CG were monitored face-to-face, once a month for six months. Primary outcome was the reduction in systolic blood pressure and changes in the mean blood pressure measured by 24-hour ambulatory blood pressure monitoring. Secondary outcomes included the self-care behaviors measured with the Self-Care of Hypertension Inventory that measure self-care in the dimensions of self-care maintenance (behaviors aimed at BP stability), self-care management (behaviors aimed at responding to high blood pressure levels) and self-care confidence (self-efficacy in managing the self-care process). The outcomes were measured at baseline and at the end of six month follow-up.

Results: The enrolled patients were mostly females (70%) with a mean age of 62 years old (SD=10), white (72%) who suffered from hypertension for = 13 years. No statistically significant differences were between the IG and the CG at baseline characteristics. At baseline, systolic and diastolic BP in the IG were 127.78 and 75.02 mmHg respectively; Systolic and diastolic BP in the CG were 123.36 and 72.82 mmHg respectively (p>0,05 between the groups). At the 6-month follow-up, systolic and diastolic BP in the IG decreased to 121.84 and 70.85 respectively (p<0.001); Systolic and diastolic BP in the CG did not change significantly (p>0.05). Regarding self-care, patients in the IG improved in all dimensions of the self-care (p<0.05), whereas patients in the CG did not (p>0.05).

Conclusion: This RCT has proved that MI is effective in improving BP and self-care in patients with hypertension. Since only few studies have evaluated the effectiveness of MI in improving BP and self-care behaviors in patients with hypertension, further studies are needed in larger and multicenter samples.

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