Abstract 10283: Motivational Interviewing Decreases Readmissions in Adults With Heart Failure
Introduction: In chronic heart failure (HF), 70% of patients are readmitted to the hospital within 12 months. At least 63% of these readmissions are for a condition other than HF.
Hypothesis: We hypothesized that motivational interviewing (MI) would be effective in decreasing readmissions unrelated to HF in HF patients.
Methods: Hospitalized adults with HF were enrolled if they were symptomatic (NYHA class II-IV), spoke and read English, lived in a setting where they could independently engage in self-care, and were cognitively intact. We enrolled 100 HF patients (mean age 60 ± 14.3 years; 57% Black, 33% female, 85% NYHA class III/IV symptoms, 64% were educated ≤ high school level) into a randomized controlled trial, using minimization to balance group assignment on NYHA class and gender. Participants in both groups received educational materials emphasizing self-care behavior change. The intervention group received MI emphasizing self-care (e.g. adherence, symptom monitoring) and tailored to individual goals. The intervention was provided by a nurse in a single home visit with 3-4 follow-up phone calls. Participants were followed for 3 months. For the primary outcome, readmission unrelated to HF, a multiple variable regression model was constructed using a backward variable elimination approach.
Results: Over 3 months, 25% of the sample had a HF-readmission and 15% had a readmission unrelated to HF. There was an absolute difference of 21% (9 vs 30) in readmissions unrelated to HF between the MI intervention and control groups (p=0.006). The MI group had 94% lower odds of having a readmission unrelated to HF (p=0.001). Each additional unit of hemoglobin was associated with 48% lower odds of having a readmission unrelated to HF (p=0.006). For each additional year of age, the odds of having a readmission unrelated to HF were 7% lower. Participants with diabetes had 6.7 times the odds (p=0.012) of having a readmission unrelated to HF.
Conclusion: An MI intervention emphasizing self-care and tailored to individual goals significantly reduced readmissions unrelated to HF in adults with HF, even after accounting for the influence of anemia, age, and diabetes.
Author Disclosures: B. Riegel: None. R. Masterson Creber: None. J. Hill: None. M. Stawnychy: None. J. Chittams: None. L. Hoke: None.
- © 2015 by American Heart Association, Inc.