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Effect of motivational interviewing in hypertensive patients (MIdNIgHT): study protocol for a randomized controlled
Luana Claudia Jacoby Silveira1,2, Graziella Badin Aliti3,2, Elisabeth Meyer Da Silva4
1Graduate Program in Health Sciences: Cardiology and Cardiovascular Sciences, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos 2400, Porto Alegre, RS, 90035-003, Brazil.
Insights
Motivational interviewing can improve blood pressure control in hypertensive patients by enhancing treatment adherence. This approach fosters lasting behavioral changes for better health outcomes.
Area of Science:
- Cardiology
- Behavioral Science
Background:
- Hypertension management is challenging, with only one-third of patients achieving blood pressure control.
- Low treatment adherence significantly impacts clinical outcomes in hypertensive individuals.
- Motivational interviewing is a promising strategy to enhance patient motivation and promote lasting behavioral changes.
Purpose of the Study:
- To evaluate the effectiveness of motivational interviewing in improving blood pressure control among hypertensive patients.
- To assess the impact of motivational interviewing on treatment adherence and self-care behaviors.
Main Methods:
- A single-center, parallel, randomized controlled trial involving 120 adult hypertensive patients.
- Patients were randomized into an intervention group (motivational interviewing) or a control group (traditional appointments).
- Outcomes measured included systolic blood pressure reduction, 24-h ambulatory blood pressure monitoring, and adherence to diet, medication, and lifestyle modifications over six months.
Main Results:
- Primary outcomes focus on a significant reduction in systolic blood pressure (≥8 mmHg) and overall blood pressure changes.
- Secondary outcomes assess improvements in dietary adherence, self-care, medication adherence, physical activity, weight management, sleepiness, and smoking cessation.
Conclusions:
- This study will test an innovative intervention strategy for hypertension management.
- If effective, this approach could be replicated for other chronic disease monitoring and management.
Background:
Only one-third of hypertensive patients achieve and maintain blood-pressure control. This is attributed to low treatment adherence and has a negative impact on clinical outcomes. Adherence is multidimensional and involves aspects both related to patient characteristics and to the chronic nature of the disease. In this context, motivational interviewing has been proposed as an approach to foster patients' motivations to change their behavior for the benefit of their own health, thus providing more lasting behavioral changes.
Design And Methods:
Single-center, parallel, randomized controlled trial with outcome-assessor blinding. This study will select adult patients (n = 120) diagnosed with hypertension who receive regular follow-up in a specialized outpatient clinic. Patients will be randomly allocated across two groups: the intervention group will have appointments focused on motivational interviewing, while the control group will have traditional appointments. Patients will be monitored face-to-face, once monthly for six months. The primary outcomes will be a reduction of at least 8 mmHg in systolic blood pressure and changes in mean blood pressure measured by 24-h ambulatory blood pressure monitoring. Secondary outcomes include improvement of adherence to a low-sodium diet, adherence to self-care behaviors, regular use of antihypertensive medications, increase or maintenance of physical activity, weight reduction, evaluation of changes in daytime sleepiness, and cessation of smoking.
Discussion:
This study shows an intervention strategy that will be tested and, if effective, warrant replication in monitoring of other chronic diseases.
Trial Registration:
ClinicalTrials.gov, NCT02892929 . Registered on 24 August 2016.
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