Abstract 19245: Motivational Interviewing Tailored Intervention to Promote Heart Failure Self-care (MITI-HF): Primary Study Results
Background: Self-care is important for optimizing heart failure (HF) patient health and the best strategy for promoting self-care is unclear.
Methods: This was a single blind pilot randomized control trial with two groups. Patients with HF were recruited from an urban hospital and randomized 2:1 to the motivational interviewing (MI) intervention or usual care. Eligibility criteria included having a diagnosis of HF, living within 30 miles of the hospital, not being on milrinone or a pre-transplant list. The MI intervention was provided during a single home visit and 3-4 follow-up phone calls over 90 days by a nurse. Self-care was measured with the Self Care of Heart Failure Index, which uses a standardized 0-100 score. Higher scores indicate better self-care; an 8 point change is clinically relevant.
Results: A total of 67 participants completed the study (mean age 62 ± 12.8 years), 54% were black, 30% female and 63% educated at ≤ high school level. Most were symptomatic (84% NYHA III or IV), with 5.5 ± 2.8 additional comorbid conditions. Participants in the intervention group had a 9-point improvement in self-care maintenance compared to the usual care group (p=0.026). Participants who self-reported worse compared to better general health at baseline had a 10-point improvement in self-care maintenance (p=0.013). Participants with worse compared to better support quality had an 11.5-point improvement in self-care maintenance (p=0.028). Having sleep apnea was associated with > 20-point increase in self-care maintenance (p=<0.001) and having insufficient financial resources was associated with a decline of 13-points in self-care maintenance over 90 days (p=0.002).
Conclusions: Patients with HF who received the MI intervention had a clinically and statistically significant improvement in self-care maintenance over 90 days. More vulnerable patients, including those with comorbid illnesses such as sleep apnea, worsening general health, and poor support quality also responded well to the MI intervention and improved in self-care maintenance. Overall, MI is an effective approach for improving self-care maintenance.
Author Disclosures: R.M. Masterson Creber: Research Grant; Significant; F31NR014086-01, Edna G Kynett Memorial Foundation. Other Research Support; Significant; Patricia G. Archbold pre-doctoral Scholarship National Hartford Centers of Geriatric Nursing Excellence. Other; Significant; Krames Staywell. M. Patey: None. B. Riegel: None.
- © 2014 by American Heart Association, Inc.