An interventional study of Motivational Interviewing in Medication Adherence, Self-care and Heart Failure, sponsored by Karolinska Institutet. Completed at 2 sites in Sweden. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2020-09-23.
Sponsored by Karolinska Institutet · Not applicable, Interventional, and Supportive care
This study evaluates if motivational interviewing sessions aiming to motivate recently discharged patients with either chronic obstructive pulmonary disease or congestive heart failure to be active in post-discharge self-management can reduce re-hospitalization rates.
Included patients transition to home will be bridged through a telephone-call from a patient activation coach two days post-discharge. The patients will thereafter get motivational interviewing sessions by the same patient activation coach with the the goal that the patients are motivated to the knowledge, skills and confidence needed to manage the four main activity areas: 1) medication management; 2) adhere to care plan/ follow-up visits according to the discharge plan; 3) recognize indications (symptoms/signs) that the condition is worsening and how to respond; and 4) contact and manage relations/encounters with health care providers. Patients in control group will receive standard care, i.e. discharge and follow-up as in normal procedures. The investigators will use a randomization in permuted blocks of 10 intervention patients and 10 control patients included. To test the hypothesis that the re-hospitalizations rate is 15 % lower in the intervention group compared to the control group 242 patients (121 per group) are needed for power of 80% with the level of significance set to 5 % using two-sided chi-square.
2,591 studies on the registry are indexed under Lung Diseases, Obstructive; 198 are open to participants now.
This study's enrollment of 118 is above the median of 66 across 1,837 interventional studies indexed under Lung Diseases, Obstructive.
Browse Lung Diseases, Obstructive studies →Karolinska Institutet is the lead sponsor of 1,113 studies on the registry; 267 are open to participants now.
Counted across the registry records on this site, refreshed daily.
Exclusion Criteria:
The exclusion criteria are related to the patients' possibilities to participate in the motivational interviewing sessions by phone.
Motivational Interviewing in five sessions post hospital discharge
Behavioral: Motivational Interviewing
Care as usual
Patients will get motivational interviewing sessions by a patient activation coach (medical social workers and/or nurses trained in motivational interviewing and in the intervention) in five post hospital discharge sessions (whereof one face-to-face, four by phone) aiming to increase patient motivation to become active in self-management (medication management, care plan/follow-up, symptoms/signs of worsening condition, contacts with health care provider).
Re-hospitalization
Registry data from the Swedish Register for Health Care Encounters
Time frame: 90 days
Healthcare usage
Registry data from the Swedish Register for Health Care Encounters: re-hospitalization at 30 and 180 days. Emergency room and primary care visits at 30, 90 and 180 days
Time frame: 30, 90 and 180 days
Medication adherence
Patient reported data using the Morisky Medication Adherence Scale, 8 items, and registry data using medicine data from the Swedish Prescribed Drug Registry
Time frame: 30, 90 and 180 days
Patient activation
Patient reported data using the Patient Activation Measure, 13 item
Time frame: 30, 90 and 180 days
Health related quality of life
Patient reported data using the EQ-5D-5L
Time frame: 30, 90 and 180 days
Basic Psychological Needs
Patient reported data using the the Basic Psychological Need Satisfaction \& Frustration Scale, 18 items
Time frame: 30, 90 and 180 days
Depression
Patient reported data using PHQ-9 (Patient Health Questionnaire)
Time frame: 30, 90 and 180 days
Plan to share: Undecided
This study is completed, as verified in Sep 2020. You cannot join it, but the record below documents what was studied.
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Karolinska Institutet