Effect of motivational interviewing on lifestyle modification among patients with hypertension attending the family medicine clinics of Irrua Specialist Teaching Hospital, Irrua, Nigeria – A randomized controlled trial (MILMAPH Study)

Abstract

Background Lifestyle modification has been shown to improve blood pressure (BP) control, but its practice is poor among patients with hypertension. Thus, measures that would help patients with hypertension achieve positive lifestyle modification would improve BP control. The study aimed to determine the effect of motivational interviewing on lifestyle modification and blood pressure control among patients with hypertension attending the Family Medicine Clinics of Irrua Specialist Teaching Hospital (ISTH), Irrua, Nigeria. Methods The study was a randomised control trial (PACTR202301917477205) of 250 hypertensive adults between 18 and 65 years presenting to the Family Medicine Clinics of ISTH randomised into intervention and control groups. Those in the intervention group were given monthly motivational interviewing (MI) on lifestyle modification in addition to standard care for the management of hypertension while those in the control group got standard care only for 6 months. Both groups were assessed at baseline and 6 months. Data was analysed with Stata version 17 (StataCorp LLC) with level of significance at 0.05. Primary outcome was lifestyle modification while secondary outcome was BP control both at 6 months. Results The age of the participants ranged from 24 to 65 years with a mean age of 51.5 ± 10.0 years. The blood pressure control at baseline was 24%. At the end of the six-month study, there was a statistically significant improvement in the lifestyle pattern of the intervention group compared to control except smoking in which the difference was not statistically significant (p=0.150). Blood pressure control significantly improved from 24% at baseline to 48% post-intervention (p=0.014). Conclusion The study found a significant positive association between motivational interviewing and lifestyle modification. The study also found a significant improvement in blood pressure control following motivational interviewing. There is a need to incorporate motivational interviewing into the management of hypertension for better outcomes.