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Motivational Interviewing Improves Medication Adherence: a Systematic Review and Meta-analysis
Ana Palacio1,2,3,4, Desiree Garay5, Benjamin Langer5
1Division of Population Health and Computational Medicine, Department of Medicine, University of Miami, Miami, FL, USA. apalacio2@med.miami.edu.
Journal of General Internal Medicine
|May 11, 2016
Summary
Motivational interviewing (MI) significantly improves medication adherence across various settings. However, further research is needed to clarify the impact of specific MI delivery methods and feedback on adherence outcomes.
Area of Science:
- Behavioral Science
- Clinical Psychology
- Health Services Research
Background:
- Randomized clinical trials (RCTs) indicate motivational interviewing (MI) enhances medication adherence, particularly in minority populations.
- Understanding the factors influencing MI's effectiveness is crucial for optimizing adherence interventions.
Purpose of the Study:
- To assess the impact of MI on medication adherence.
- To evaluate how MI delivery format, fidelity, counselor characteristics, and exposure time influence adherence outcomes.
Main Methods:
- A systematic review and meta-analysis of RCTs comparing MI to control groups was conducted.
- Studies published from 1966 to February 2015 were searched in the MEDLINE database.
- Medication adherence was analyzed using relative risks for categorical data and standardized mean differences for continuous data.
Main Results:
- MI demonstrated a significant positive effect on medication adherence across 17 RCTs.
- Telephonic MI and fidelity-based feedback were associated with adherence in categorical analyses.
- Group MI and fidelity assessment were linked to adherence in continuous analyses, with delivery by nurses or research assistants also noted.
Conclusions:
- Motivational interviewing is an effective strategy for improving medication adherence.
- Specific MI characteristics, such as delivery mode and feedback, show varied associations with adherence, necessitating further investigation.
- Larger, diverse studies are required to elucidate the optimal implementation of MI for chronic condition management.
