Motivational interviewing to improve the self-care behaviors for patients with chronic heart failure: A randomized controlled trial.

The authors call it a pilot study, and only 62 of 72 recruited patients completed follow-up, with some dropouts due to disease exacerbation. From 158 admitted patients, 86 were excluded for age, serious disease, communication difficulty, or refusal, so the sample may be highly selected. The study measured outcomes only 2 months after discharge, so it does not show whether the improvement lasts. MI was delivered by two investigators experienced in MI and cardiovascular nursing, and the authors note it requires substantial training, time, and interpersonal skill, so it may be hard to replicate without trained staff. The trial excluded patients older than 70, patients with cognitive impairment or mental disease, and patients with serious comorbidities, so it says little about frail or severely impaired patients. Both groups received telephone follow-up, so the effect of MI sessions cannot be separated from the effect of individualized phone follow-up. The reported outcome was the self-care questionnaire score.

Do not read the greater score change as proof that motivational interviewing sessions alone caused it. The intervention group also received telephone follow-up, and the control group also received routine telephone follow-up, so the contribution of any single component cannot be separated. Do not assume the benefit lasts beyond the measured follow-up period.