Work

A Practice-Based Trial of Motivational Interviewing and Adherence in Hypertensive African Americans

Year: 2008

Type: article

Abstract: nature publishing groupAfrican Americans have higher prevalence of hypertension and poorer hypertension-related outcomes than whites.[1][2][3] Poor medication adherence may explain the poor BP control in African Americans.4,5 Behavioral counseling strategies are effective in improving medication adherence of chronic diseases patients, 6,7 with little data in hypertensive African Americans.Successful interventions include those that are emotionally supportive; involve patients in their care; address patients' beliefs about medications; and enhance patients' confidence in their ability to overcome barriers to adherence.[8][9][10][11][12][13] Motivational interviewing (MINT), a counseling approach that has gained increased popularity in primary care practices, 14 encompasses several of these characteristics.MINT is defined as directive, patient-centered counseling designed to motivate patients for change by helping them recognize and resolve the discrepancy between their behavior, personal goals, and values.15 In patients with chronic diseases, MINT is effective in facilitating the adoption and maintenance of recommended health behaviors including weight loss, smoking cessation, and dietary habits.[16][17][18][19][20] Despite its proven efficacy, the effect of MINT on medication adherence remains untested in hypertensive African Americans in primary care settings.In this randomized controlled trial, we tested the effect of a practice-based MINT vs. usual care (UC) on medication adherence and blood pressure (BP), among hypertensive African Americans.We hypothesized a greater effect of MINT on medication adherence compared to UC at 12 months and that this effect would be associated with a significant reduction in clinic BP. Methods Setting and patients.As described elsewhere, 21 patients were recruited from two community-based primary care practices affiliated with New York Presbyterian Hospital Ambulatory Care Network.Eligible patients were identified via electronic medical records (EMRs) and asked to participate during routine office visits by trained research assistants (RAs).Eligibility

Source: American Journal of Hypertension

DOI: 10.1038/ajh.2008.240