Effectiveness of motivational interviewing to improve therapeutic adherence in patients over 65 years old with chronic diseases: A cluster randomized clinical trial in primary care

• Published in: Patient education and counseling Vol. 98; no. 8; pp. 977 - 983
• Main Authors: Moral, Roger Ruiz, Torres, Luis Angel Pérula de, Ortega, Laura Pulido, Larumbe, Margarita Criado, Villalobos, Ana Roldán, García, Jose Angel Fernández, Rejano, Juan Manuel Parras
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier Ireland Ltd 01.08.2015
• Subjects: Aged; Aged, 80 and over; Chronic Disease - drug therapy; Communication; Double-Blind Method; Female; General practice/family medicine; Geriatrics; Health Personnel; Humans; Internal Medicine; Male; Medication Adherence; Motivation; Motivational Interviewing; Outcome and Process Assessment (Health Care); Patient involvement (empowerment, self-management); Patient-Centered Care - methods; Polypharmacy; Primary Health Care; Professional-Patient Relations; Spain; Treatment/intervention research; Spain; Medication adherence; Patient involvement (empowerment, self-management); General practice/family medicine; Treatment/intervention research; Communication; Geriatrics
• ISSN: 0738-3991; 1873-5134; 1873-5134
• DOI: 10.1016/j.pec.2015.03.008

•The most common intervention used by doctors is to prescribe drugs.•Related to this is the problem of poor medication adherence.•Motivational interviewing, is an interview style designed to promote behavioural changes.•Motivational Interviewing is a patient-centered methods that can be used to improve medication adherence en primary care. To evaluate the effectiveness of motivational interviewing (MI) in improving medication adherence in older patients being treated by polypharmacy. Cluster randomized clinical trial in 16 primary care centers with 27 health care providers and 154 patients. Thirty-two health care providers were assigned to an experimental (EG) or control group (CG). Interventions: MI training program and review of patient treatments. Providers in the EG carried out MI, whereas those in the CG used an “advice approach”. Three follow-up visits were completed, at 15 days and at 3 and 6 months. Medication adherence in both groups was compared (p<0.05). Patients recruited: 70/84 (EG/CG). Mean age: 76 years; female: 68.8%. The proportion of subjects changing to adherence was 7.6% higher in the EG (p<0.001). Therapeutic adherence was higher for patients in the EG (OR=2.84), women (OR=0.24) and those with high educational levels (OR=3.93). A face-to-face motivational approach in primary care helps elderly patients with chronic diseases who are being treated by polypharmacy to achieve an improved level of treatment adherence than traditional strategies of providing information and advice. MI is a patient-centered approach that can be used to improve medication adherence in primary care. Trial registration: This trial is registered at ClinicalTrials.gov (NCT01291966)