Motivational interviewing to support medication adherence in adults with chronic conditions: Systematic review of randomized controlled trials. Issue 11 (November 2022)

• Record Type: Journal Article
• Authors: Papus, Marlène; Dima, Alexandra L.; Viprey, Marie; Schott, Anne-Marie; Schneider, Marie Paule; Novais, Teddy
• Is Part Of: Patient education and counseling. Volume 105:Issue 11(2022)
• Page Start: 3186
• Page End: 3203
• Publication Date: 2022-11
• Subjects: Motivational interviewing -- Medication adherence -- Chronic conditions -- Systematic review; Patient education -- Periodicals; Health counseling -- Periodicals; Health education -- Periodicals; Counseling -- Periodicals; Patient Education -- Periodicals; Éducation des patients -- Périodiques; Counseling -- Périodiques; Éducation sanitaire -- Périodiques; 615.5071
• DOI: 10.1016/j.pec.2022.06.013
• Languages: English
• ISSNs: 0738-3991

Abstract

Abstract: Objectives: To systematically review published randomized controlled trials (RCTs) assessing the efficacy of MI to support medication adherence in adults with chronic conditions. Methods: A systematic review (PROSPERO-CRD42020025374) was performed by searching in Pubmed/MEDLINE, PsycINFO, The Cochrane Library and Web of Science. Studies were included for the following: RCTs assessing the impact of MI on medication adherence among adults with chronic diseases. Two reviewers conducted independent screening of records and full-text articles published until July 2020. Quality was assessed with the Risk of Bias 2 tool for RCTs. Results: From 1262 records identified, 54 RCTs were included. The MI interventions were delivered alone or in combination with other interventions, and varied in mode of delivery (e.g. face-to-face, phone), exposure level (duration, number of sessions), and provider characteristics (profession, training). Most interventions were developed in infectious diseases (n = 16), cardiology (n = 14), psychiatry (n = 8), and endocrinology (n = 7). Medication adherence showed significant improvement in 23 RCTs, and other clinical outcomes were improved in 19 RCTs (e.g. risky behaviors, disease symptoms). Conclusions: MI is an approach to medication adherence support with an increasing evidence base in several clinical domains and further potential for adaptation to different settings. Practice implications: In further studies, particular attention should focus on methodological issues such as the populations of patients to include – patients with suboptimal adherence, the evaluation of fidelity to the MI spirit and components, and a sound measurement of medication adherence and clinical outcomes. Highlights: 54 randomized controlled trials (RCTs) were included in this systematic review. The use of MI in medication adherence has grown significantly over the last years: 25 RCTs published since 2015. Initially developed in HIV, MI is nowadays used in many chronic conditions such as cardiovascular, endocrine and psychiatric conditions. In 23/54 RCTs, MI interventions showed promising results on supporting medication adherence. In 19/54 RCTs, MI interventions showed significant results on other outcomes such as risky behaviors, disease symptoms, and monitoring data.