Motivational interviewing not effective in reducing rehospitalisation and improving patient activation among patients with respiratory failure

1. Standalone motivational interviewing post-discharge did not reduce rehospitalization in older multimorbid patients with heart failure or chronic obstructive pulmonary disease

Evidence Rating Level: 1 (Excellent) 

This randomized controlled trial evaluated the effects of a post-discharge motivational interviewing intervention (Supporting Patient Activation in Transition to Home, sPATH) on rehospitalization and patient activation in 207 Swedish patients with heart failure or chronic obstructive pulmonary disease (COPD). Participants were randomized to receive five motivational interviewing sessions (n=103) or usual care (n=104). The intervention, delivered by trained coaches, focused on self-management areas like medication adherence and symptom recognition. Results showed no significant differences between groups in rehospitalization rates (p=0.33–0.41) or Patient Activation Measure (PAM) scores over 180 days (B=-1.67 to -0.83, p=0.38–0.68). Notably, PAM scores improved over time in both groups, suggesting intrinsic recovery post-discharge. The high disease burden (mean Charlson Comorbidity Index >5) and advanced age (mean 75 years) may have limited intervention efficacy. The study concludes that standalone motivational interviewing post-discharge may not reduce rehospitalization in older, multimorbid patients, highlighting the need for integrated pre- and post-discharge support or alternative care models for this population.  

Click to read the study in BMJ Open

Image: PD

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