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

• Clinically significant difference in self-care maintenance in the MI group.
• MI is a promising approach for improving self-care maintenance.
• No difference between groups in physical HF symptoms or quality of life.

ObjectiveThe 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.MethodsThis 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.ResultsA 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.ConclusionPatients 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 ImplicationsThese 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.