Effectiveness of Motivational Interviewing in Decreasing Hospital Readmission in Adults With Heart Failure and Multimorbidity

Abstract

Hospitalizations are common in heart failure (HF). Multimorbidity, defined as ≥2 comorbid conditions, drives many readmissions. The purpose of this pilot study was to test the effectiveness of motivational interviewing (MI) in decreasing these hospital readmissions. We enrolled 100 hospitalized HF patients into a randomized controlled trial, randomizing in a 2:1 ratio: intervention (n = 70) and control (n = 30). The intervention group received MI tailored to reports of self-care during one home visit and three to four follow-up phone calls. After 3 months, 34 participants had at least one hospital readmission. The proportion of patients readmitted for a condition unrelated to HF was lower in the intervention (7.1%) compared with the control group (30%, p = .003). Significant predictors of a non-HF readmission were intervention group, age, diabetes, and hemoglobin. Together, these variables explained 35% of the variance in multimorbidity readmissions. These preliminary results are promising in suggesting that MI may be an effective method of decreasing multimorbidity hospital readmissions in HF patients.

Toma de decisiones para el manejo de los síntomas de falla cardíaca: protocolo de intervención

“…La educación y el autocuidado en pacientes con FC son elementos positivos de las intervenciones para disminuir el riesgo de morbimortalidad (12)(13)(14)(15)(16). Es primordial que se implementen programas específicos para pacientes con FC, ya que existe suficiente evidencia de programas exitosos y costo-efectivos (11).…”

The impact of motivational interviewing on self‐perceived burden in patients receiving therapeutic plasma exchange

“…A recently published study showed that patients with multiple sclerosis improved adherence to an exercise program with the use of MI . A randomized controlled study showed a significant decrease in re‐admission of heart failure patients when MI was conducted by nurses with patients . Another study in heart failure patients specifically trained nurses to provide the MI sessions .…”

“…12 A randomized controlled study showed a significant decrease in re-admission of heart failure patients when MI was conducted by nurses with patients. 16 Another study in heart failure patients specifically trained nurses to provide the MI sessions. 5 These studies support that clinicians, including nurses, can be trained to provide MI in multiple settings and little training is needed to conduct MI interventions.…”

Mechanisms of change in self-care in adults with heart failure receiving a tailored, motivational interviewing intervention

“…MI was developed in psychology and only recently has the approach been used in chronically ill patient populations. Studies among adults with HF have examined the effect of MI on exercise [6], hospital readmissions [7], self-care [8], and quality of life [9], revealing that MI is an effective approach for improving self-care and outcomes in this patient population. Unfortunately, little is known regarding the specific mechanisms through which MI influences HF self-care.…”