Conflict of interest: None declared.
Reducing recurrent stroke: Methodology of the motivational interviewing in stroke (MIST) randomized clinical trial
Article first published online: 27 OCT 2013
© 2013 The Authors. International Journal of Stroke © 2013 World Stroke Organization
International Journal of Stroke
Special Issue: Global Stroke Statistics Edition
Volume 9, Issue 1, pages 133–139, January 2014
How to Cite
Krishnamurthi, R., Witt, E., Barker-Collo, S., McPherson, K., Davis-Martin, K., Bennett, D., Rush, E., Suh, F., Starkey, N., Parag, V., Rathnasabapathy, Y., Jones, A., Brown, P., Te Ao, B., Feigin, V. L. and ARCOS IV Programme Group (2014), Reducing recurrent stroke: Methodology of the motivational interviewing in stroke (MIST) randomized clinical trial. International Journal of Stroke, 9: 133–139. doi: 10.1111/ijs.12107
- Issue published online: 19 DEC 2013
- Article first published online: 27 OCT 2013
- Health Research Council of New Zealand
- motivational interviewing;
- recurrent stroke;
- secondary prevention
Recurrent stroke is prevalent in both developed and developing countries, contributing significantly to disability and death. Recurrent stroke rates can be reduced by adequate risk factor management. However, adherence to prescribed medications and lifestyle changes recommended by physicians at discharge after stroke is poor, leading to a large number of preventable recurrent strokes. Using behavior change methods such as Motivational Interviewing early after stroke occurrence has the potential to prevent recurrent stroke.
Aims and/or hypothesis
The overall aim of the study is to determine the effectiveness of motivational interviewing in improving adherence to medication and lifestyle changes recommended by treating physicians at and after hospital discharge in stroke patients 12 months poststroke to reduce risk factors for recurrent stroke.
Recruitment of 430 first-ever stroke participants will occur in the Auckland and Waikato regions. Randomization will be to intervention or usual care groups. Participants randomized to intervention will receive four motivational interviews and five follow-up assessments over 12 months. Nonintervention participants will be assessed at the same time points.
Primary outcome measures are changes in systolic blood pressure and low-density lipoprotein levels 12 months poststroke. Secondary outcomes include self-reported adherence and barriers to prescribed medications, new cardiovascular events (including stroke), changes in quality of life, and mood.
The results of the motivational interviewing in stroke trial will add to our understanding of whether motivational interviewing may be potentially beneficial in the management of stroke and other diseases where similar lifestyle factors or medication adherence are relevant.