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

PATIENT EDUCATION AND COUNSELING

卷:98

Article

Ruiz Moral, Roger¹  Perula de Torres, Luis Angel²  Pulido Ortega, Laura²  Criado Larumbe, Margarita²  Roldan Villalobos, Ana²  Fernandez Garcia, Jose Angel³  Parras Rejano, Juan Manuel⁴ 

[1] Francisco de Vitoria Univ, Fac Med, Madrid, Spain

[2] Reins Sofia Univ Hosp, Maimonides Inst Biomed Res Cordoba IMIBIC Univ Co, Teaching Unit Family & Community Med Cordoba Cord, Cordoba 14011, Spain

[3] Maimonides Inst Biomed Res Cordoba IMIBIC Univ Co, Villarrubia Hlth Ctr, UGC Occidente Cordoba Guadalquivir Hlth Dist, Cordoba, Spain

[4] Maimonides Inst Biomed Res Cordoba IMIBIC Univ Co, Villanueva Rey Hlth Ctr, UGC Pueblonuevo Penyarroya Northern Cordoba Hlth, Cordoba, Spain

关键词: Medication adherence;    Communication;    Geriatrics;    General practice/family medicine;    Treatment/intervention research;    Patient involvement (empowerment, self-management);   

DOI  :  10.1016/j.pec.2015.03.008

来源: Elsevier

【 摘 要 】

Objective: To evaluate the effectiveness of motivational interviewing (MI) in improving medication adherence in older patients being treated by polypharmacy. Methods: Cluster randomized clinical trial in 16 primary care centers with 27 healthcare 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). Results: 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). Conclusion: A face-tb-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. Practice implications: 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) (C) 2015 Elsevier Ireland Ltd. All rights reserved.

【 授权许可】

Free