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Motivational Interviewing Impact on Cardiac Rehabilitation Program Outcomes: A Systematic Review of Randomized Controlled Trials

Darby J. Winkler, Kameron B. Suire, Jan. Kavookjian, Danielle D. Wadsworth

Objectives: Cardiovascular disease (CVD) is the leading cause of death globally but can be prevented and treated with lifestyle modifications or health behavior changes. A modified Cochrane method of systematic review was implemented to explore and report evidence and gaps in the literature for studies of motivational interviewing (MI) influence on outpatient cardiac rehabilitation (OPCR) patient outcomes.

Methods: The literature search was conducted using several databases (Medline, Academic Search Premier, Psych Info, PubMed, Sport Discus, Science Direct, CINAHL, Web of Science, APA Psych Articles, Complementary Index, Education Research Complete, Health Source, and Directory Open Access Journals) with a combination of the search terms, ‘cardiac rehab’ and ‘motivational interviewing’. Inclusion criteria included studies that used MI as part of an intervention, conducted in the OPCR setting, randomized control trials (RCT), results for behavioral, psychosocial/humanistic, and/or clinical outcomes were reported, and written in English. Search/review tiers included titles/abstracts and full text.

Results: Of the 398 studies from the initial search, nine RCTs met the criteria and were retained for this review. Of the 9 studies, 7 reported a significant difference in at least one behavioral, psychological/humanistic, and/or clinical outcome such as OPCR attendance, anxiety or depressive symptoms scores, cholesterol values, and/or blood pressure.

Conclusion: MI demonstrated a positive effect on behavioral, psychosocial, humanistic, or clinical outcomes. Heterogeneity in study designs, measures, and outcomes suggest that further research is warranted to elucidate optimal intervention structure in terms of contact frequency and study duration.