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dc.contributor.authorBarker-Collo, Sen_NZ
dc.contributor.authorKrishnamurthi, Ren_NZ
dc.contributor.authorWitt, Een_NZ
dc.date.accessioned2016-02-11T23:32:05Z
dc.date.available2016-02-11T23:32:05Z
dc.date.copyright2015en_NZ
dc.identifier.citationStroke, vol.46, pp.3451 - 3458en_NZ
dc.identifier.urihttp://hdl.handle.net/10292/9516
dc.description.abstractBackground and Purpose—Stroke recurrence rates are high (20%–25%) and have not declined over past 3 decades. This study tested effectiveness of motivational interviewing (MI) for reducing stroke recurrence, measured by improving adherence to recommended medication and lifestyle changes compared with usual care. Methods—Single-blind, prospective phase III randomized controlled trial of 386 people with stroke assigned to either MI treatment (4 sessions at 28 days, 3, 6, and 9 months post stroke) or usual care; with outcomes assessed at 28 days, 3, 6, 9, and 12 months post stroke. Primary outcomes were change in systolic blood pressure and low-density lipoprotein cholesterol levels as indicators of adherence at 12 months. Secondary outcomes included self-reported adherence, new stroke, or coronary heart disease events (both fatal and nonfatal); quality of life (Short Form-36); and mood (Hospital Anxiety and Depression Scale). Results—MI did not significantly change measures of blood pressure (mean difference in change, −0.2.35 [95% confidence interval, −6.16 to 1.47]) or cholesterol (mean difference in change, −0.0.12 [95% confidence interval, −0.30 to 0.06]). However, it had positive effects on self-reported medication adherence at 6 months (1.979; 95% confidence interval, 0.98–3.98; P=0.0557) and 9 months (4.295; 95% confidence interval, 1.56–11.84; P=0.0049) post stroke. Improvement across other measures was also observed, but the differences between MI and usual care groups were not statistically significant. Conclusion—MI improved self-reported medication adherence. All other effects were nonsignificant, though in the direction of a treatment effect. Further study is required to determine whether MI leads to improvement in other important areas of functioning (eg, caregiver burden). Clinical Trial Registration—URL: http://www.anzctr.org.au. Australian Clinical Trials Register (ACTRN-12610000715077).
dc.publisherAmerican Heart Association, Inc.
dc.relation.urihttp://dx.doi.org/10.1161/STROKEAHA.115.011003
dc.rightsIf your institution has a policy requiring your manuscript to be deposited in an institutional repository, the AHA CTA grants you those rights. The manuscript should be available in the institutional repository but made publicly accessible no earlier than 6 months after publication.
dc.subjectRecurrent stroke; Secondary prevention; Motivational interviewing; Adherence
dc.titleImproving adherence to secondary stroke prevention strategies through motivational interviewingen_NZ
dc.typeJournal Article
dc.rights.accessrightsOpenAccessen_NZ
dc.identifier.doi10.1161/STROKEAHA.115.011003en_NZ
aut.relation.endpage3458
aut.relation.startpage3451
aut.relation.volume46en_NZ
pubs.elements-id193731


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