Randomized Controlled Trial of Motivational Interviewing to Improve Medication Adherence of Heart Failure Patients in Mainland China: A Pilot Study

Purpose: To evaluate the effects of motivational interview for improving heart failure patients' (1) beliefs about medication, (2) adherence confidence and motivation, (3) medication adherence.

Methods: Purposive sampling was used to recruit 120 inpatients who were in Fuwai cardiovascular diseases hospital in Beijing and randomly assigned to an intervention group (IG) or control group (CG). Patients from the IG received 60~80min one to one motivational interview on the basis of routine care and a handbook of heart failure and medication usage. Data on beliefs about medication, adherence confidence and motivation, and medication adherence behavior were collected at baseline, before discharge by interview, one and three months after discharge by phone. The effects of motivational interview were assessed by testing changes in the medication adherence beliefs about medication, adherence confidence and motivation ratings over time using repeated measures ANOVAs and by comparing the ratings of IG to that of CG using t test or X² test.

Results:

97 patients (49 from IG, 48 from CG) completed data collection three months after discharge. The results were (1) Compared to baseline, medication adherence of IG had significant improvement one and three months after discharge (P<0.017); Compared to that of control group, the medication adherence of IG had significantly higher score at discharge, one and three months after discharge (P<0.05). (2) Compared to baseline, beliefs about medication of IG had significant improvement one and three months after discharge (P<0.008); Compared to that of control group, the beliefs about medication of IG had significantly higher score at discharge, one and three months after discharge (P<0.05). (3) Compared to baseline, motivation and confidence of adherence of IG had significant improvement one and three months after discharge (P<0.008); Compared to that of control group, motivation and confidence of medication adherence of IG had significantly higher score at discharge, one and three months after discharge (P<0.05).

Conclusion: It is necessary to have one to one motivational interview among heart failure patients, which can improve beliefs about medication, adherence confidence and motivation, and medication adherence three month after discharge. 

Conclusion: Motivational interview is useful to improve patients' medication adherence and could be used in clinical practice.