Abstract 12984: Technology-Delivered Motivational Interviewing Interventions for Patients With Cardiovascular Diseases - A Systematic Review
2.21.2 - L’impatto del tele-nursing sui comportamenti di self-care dei pazienti con scompenso cardiaco
Cardiovascular diseases (CVD) are a major source of burden worldwide. COVID-19 pandemic has renewed the importance of remote psychoeducational interventions to improve outcomes in these patients. Technology-delivered motivational interviewing (TD-MI) has proven to be effective in chronic disease populations, yet there has been no attempt to summarize TD-MI characteristics and effectiveness in CVD populations.
We searched PubMed, CINHAL, PsychInfo and Web of Science (from inception to May 1, 2021) for randomized controlled trials that enrolled adults with CVD. Record screening, data extraction and risk of bias assessment were performed in duplicate. This review is registered in PROSPERO, CRD42021241516.
Of the 2,742 records identified, 7 studies were eligible for qualitative synthesis. Participants (n=12,053, mean age = 62.25, 37.5% females) enrolled from community settings and prevalently affected by coronary artery disease (n. studies=5), hypertension (n=3) and heart failure (n=3), received an average of 11 phone (n=6) or video calls (n=1) over an average of 7 months. Interventionists were mostly nurses (n=4), followed by psychologists (n=2) and a social worker (n=1). Treatment fidelity was assessed in 5 trials; 2 trials reported the intervention to be based on a theoretical framework, and 2 studies specified if the interventionist underwent some training before TD-MI administration. Caregivers were never involved. Most targeted outcomes were medication adherence (n=5), quality of life (n=4), disease-related parameters (n=4), and depression (n=3). Risk of bias varied markedly, with the largest source resulting from lack of blinding of participants and assessors (performance bias). The only feasible meta-analysis showed no significant effects of TD-MI on depression (n=3; Z=1.18, p=0.24; I2=42%).
The number of trials involving TD-MI interventions across CVD populations is scarce and their effectiveness is inconclusive. There was lack of reporting of interventionists’ training, description of treatment fidelity, and blinding procedures. More trials with stronger designs and better reporting are needed in the CVD field to inform clinical decision making and research.