THE EFFECTS OF MOTIVATIONAL INTERVIEWING ON HYPERTENSION MANAGEMENT: A SYSTEMATIC REVIEW AND META-ANALYSIS

Abstract

Objective: Motivational interviewing is a patient-centered, directive counselling method designed to enhance behavior changes and has been widely applied in chronic disease management. However, the effectiveness of motivational interviewing on hypertension management has been not yet conclusive. This systematic review aimed to examine the effects of motivational interviewing-based interventions on hypertension management. Design and method: We conducted a systematic literature search in the following databases: PubMed, Embase, CINHAL, Cochrane Central Register of Controlled Trials, PsycINFO, and Web of Science from inception to 25 July, 2022. Randomized controlled trials involving adults diagnosed with hypertension and including motivational interviewing in the treatment interventions were included. Study selection process, data abstraction, and risk of bias assessment were completed independently by two researchers. When feasible, meta-analyses were conducted to estimate the pooled effects using Review Manager (Version 5.4). Results: In total, 14 studies with 5122 participants were included. Compared with no or minimal additional intervention, motivational interviewing-based intervention showed greater reduction in systolic blood pressure (MD: -5.28, 95% CI: -8.70, -1.86, P = 0.002) and diastolic blood pressure (MD: -2.34, 95% CI: -4.05, -0.63, P = 0.007) (Figure). Compared with the lower intensity intervention, motivational interviewing-based intervention produced statistically significant effect on reducing systolic blood pressure (MD: -2.72, 95% CI: -5.34, -0.10, P = 0.040); while there was no significant effect on reducing diastolic blood pressure (MD: -0.47, 95% CI: -2.21, 1.28, P = 0.600) (Figure). Qualitative synthesis suggests that motivational interviewing may improve medication adherence, self-efficacy, and quality of life, but the evidence was uncertain. Conclusions: Patients with hypertension could benefit from motivational interviewing-based interventions in blood pressure control. Motivational interviewing could be applied as a promising intervention strategy among patients with hypertension. Future research is warranted to evaluate the effects of motivational interviewing on improving medication adherence and psychological well-being.