Motivational Interviewing

Columbia University

Status: Terminated

Conditions: Essential Hypertension

Treatments: Behavioral: Motivational Interviewing

Study type: Interventional

Funder types: Other; NIH

Identifiers

NCT00208104

AAAA0311

R01HL069408-03 (U.S. NIH Grant/Contract)

Details and patient eligibility

About

The purpose of this project is to study ways to make it more likely that patients will take their blood pressure medicine as recommended by their doctors.

Full description

The objective of this randomized control trial is to evaluate, among 190 African-American patients with poorly controlled hypertension followed in a community-based primary care practice, whether motivational interviewing is more effective than usual care (routine counseling) in achieving adherence to prescribed blood pressure medications at 12 months.

The project aims to: 1) determine whether patients who receive motivational interview counseling have greater reduction in both systolic and diastolic blood pressure than those in the control group at 12 months. Clinic blood pressure readings will be assessed at baseline and at every three months thereafter for one year and 2) assess the effect of self-efficacy and intrinsic motivation as potential mediators of motivational interview on adherence. Self-efficacy and intrinsic motivation will be assessed at baseline and every three months thereafter for one year.

Enrollment: 167 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

The target population consisted of hypertensive African American patients who fulfilled the following eligibility criteria:

• Self-identification as African American
• Age 18 years or older
• Diagnosis of hypertension utilizing ICD-9 codes 401-401.9 (the code for essential hypertension)
• Taking at least one antihypertensive medication
• Uncontrolled hypertension of a clinic blood pressure reading >140/90 mm Hg or 130/80 mm Hg (for those with kidney disease or diabetes) on two successive clinic visits prior to screening (defined per JNC VI criteria)
• Fluent in English language

Exclusion criteria

Participants were excluded if they:

• Had a diagnosis of cognitive impairment or serious medical condition as determined by their primary physician
• Were unable to give informed consent
• Refused to participate

Trial design

167 participants in 2 patient groups

Motivational Interview Condition

Experimental group

Description:

Trained nurses will interview the group using motivational interview counseling techniques. All sessions will be conducted with the aid of an adapted version of a standardized structured adherence counseling script. This script was specifically developed for use in medication adherence studies of HIV positive patients and has been provided for this trial.

Treatment:

Behavioral: Motivational Interviewing

Non-supportive Counseling

No Intervention group

Description:

A non-supportive counseling session will consist of regular nurse-patient interaction.