PMID- 31502239 OWN - NLM STAT- MEDLINE DCOM- 20210119 LR - 20210119 IS - 1178-1661 (Electronic) IS - 1178-1653 (Linking) VI - 13 IP - 1 DP - 2020 Feb TI - Motivational Interviewing as a Strategy to Impact Outcomes in Heart Failure Patients: A Systematic Review. PG - 43-55 LID - 10.1007/s40271-019-00387-6 [doi] AB - BACKGROUND: Heart failure (HF) hospitalization is an expensive healthcare utilization event. Motivational interviewing (MI) has been studied for effects on HF self-management behaviors. OBJECTIVE: The objective of this systematic review was to conduct an exploration and report of evidence and gaps in the literature regarding the impact of MI on HF outcomes. DATA SOURCES: A modified Cochrane systematic review was conducted via a literature search in the MEDLINE, CINAHL, Cochrane Collaborative Systematic Reviews, PsycINFO, Health Source: Nursing/Academic Edition, and Google Scholar databases. STUDY ELIGIBILITY CRITERIA, PARTICIPANTS, AND INTERVENTIONS: Randomized controlled trials (RCTs) or controlled experimental studies published in English from January 1990 to February 2019 that included adults (18 years and older) diagnosed with HF New York Heart Association (NYHA) class I, II, II, or IV were eligible for inclusion. Interventions evaluated were an MI-based face-to-face communication or telephone-based conversation provided by any healthcare provider type. STUDY APPRAISAL AND SYNTHESIS METHODS: The Cochrane method for assessing risk of bias was used to analyze the methodological quality of retained studies. RESULTS: Of 167 initial articles, nine were retained, describing eight unique studies (758 total patients, range 30-241; age range 58-79 years; attrition range 13-36%). The impact of MI was examined for general self-care behaviors (SCBs) (physical activity specifically), quality of life (QoL), and/or hospital readmission prevention. Eight of nine articles reported a positive impact of MI over advice-giving, seven being statistically significant. MI interventions used an initial face-to-face encounter with three to five follow-up telephone encounters. LIMITATIONS: This systematic review had the following limitations: most retained studies included intervention activities conducted in hospital/clinic settings, which limits generalizability of the intervention in other care settings; intervention fidelity, blinding, selection, interventionist training, and random assignment were not clear in all studies; retained studies did not include potential covariates such as health literacy, patient age, and perception of disease/health risks; and some retained studies relied on patient self-report of outcomes, which may introduce recall or social desirability bias. CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS: MI demonstrated a positive effect on the SCB hospital readmission prevention factor and on QoL. MI delivered with greater frequency and over a longer duration may improve the immediate risk of hospital readmission as well as long-term outcomes through better medication adherence and SCBs. However, heterogeneity in the methods, design, intervention type, and structure challenged comparisons across studies and further research is warranted. FAU - Poudel, Nabin AU - Poudel N AD - Department of Health Outcomes Research and Policy, Harrison School of Pharmacy, Auburn University, 4306 Walker Building, Auburn, AL, 36849, USA. FAU - Kavookjian, Jan AU - Kavookjian J AUID- ORCID: 0000-0002-2447-3932 AD - Department of Health Outcomes Research and Policy, Harrison School of Pharmacy, Auburn University, 4306 Walker Building, Auburn, AL, 36849, USA. kavooja@auburn.edu. FAU - Scalese, Michael J AU - Scalese MJ AD - Department of Pharmaceutical Services, Prisma Health Richland Hospital, 5 Medical Park Drive, Columbia, SC, 29203, USA. LA - eng PT - Journal Article PT - Systematic Review PL - New Zealand TA - Patient JT - The patient JID - 101309314 SB - IM MH - Aged MH - Communication MH - Exercise MH - Female MH - Heart Failure/*psychology MH - Humans MH - Male MH - Middle Aged MH - Motivational Interviewing/*methods MH - Patient Readmission MH - Patient-Centered Care MH - Quality of Life MH - Randomized Controlled Trials as Topic MH - Self-Management/*psychology MH - Severity of Illness Index MH - Time Factors EDAT- 2019/09/11 06:00 MHDA- 2021/01/20 06:00 CRDT- 2019/09/11 06:00 PHST- 2019/09/11 06:00 [pubmed] PHST- 2021/01/20 06:00 [medline] PHST- 2019/09/11 06:00 [entrez] AID - 10.1007/s40271-019-00387-6 [pii] AID - 10.1007/s40271-019-00387-6 [doi] PST - ppublish SO - Patient. 2020 Feb;13(1):43-55. doi: 10.1007/s40271-019-00387-6.