FROM PHYSICIAN-DRIVEN TO PATIENT-DRIVEN HEALTH EDUCATION: THE NEED TO INCORPORATE MOTIVATIONAL INTERVIEWING IN THE MANAGEMENT OF HYPERTENSION IN NIGERIA – A REVIEW

Hypertension and other chronic diseases like heart diseases, diabetes, cancers and chronic lung diseases are a significant cause of morbidity and mortality globally. Management of hypertension has been mainly pharmacological. Non pharmacological management through effective health education on healthy lifestyle modification and medication adherence has been shown to improve outcome in the management of chronic diseases including hypertension. Health education in Nigeria is currently physician driven making it difficult for patient to comply with treatment protocol and follow up. This has led to poor treatment outcome in the management of hypertension and other chronic diseases. Adopting shared decision making (SDM) through the use of motivational interviewing, a patient-driven, physician-directed counselling approach that helps patient resolves ambivalence through collaboration, evocation and autonomy. Motivational interviewing has been used successfully in other countries to effect positive behavioural change and improved health outcome. It has also been shown to improve adoption of healthy lifestyle and medication adherence. When incorporated into primary care practice in Nigeria, it will help improve outcome in the management of chronic diseases like hypertension