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A Motivational Interviewing Intervention by Pharmacy Students to Improve Medication Adherence
Susan Abughosh1, Xin Wang1, Omar Serna2
11 Department of Pharmaceutical Health Outcomes and Policy, University of Houston College of Pharmacy, Houston, Texas.
Journal of Managed Care & Specialty Pharmacy
|April 28, 2017
Summary
Motivational interviewing (MI) telephone calls by pharmacy students improved medication adherence for patients with diabetes and hypertension. Patients receiving at least two calls showed significantly better adherence to ACEIs/ARBs and less discontinuation.
Area of Science:
- Pharmacology
- Patient Adherence Research
- Health Intervention Studies
Background:
- Patients with diabetes mellitus (DM) and hypertension (HTN) face elevated risks for microvascular and macrovascular complications.
- Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) are recommended, but adherence is often suboptimal.
- Motivational interviewing (MI) is a patient-centered approach to enhance motivation for behavior change.
Purpose of the Study:
- To assess the impact of a motivational interviewing (MI) telephone intervention delivered by pharmacy students on adherence to ACEIs/ARBs.
- The study focused on Medicare Advantage Plan (MAP) patients diagnosed with both DM and HTN.
Main Methods:
- A prospective study identified DM and HTN patients using medical claims data.
- Nonadherent patients (proportion of days covered [PDC] < 0.80) were randomized into intervention (telephone calls) and control groups.
- Intervention involved initial MI calls and 5 monthly follow-ups by trained pharmacy students; adherence was measured by PDC and discontinuation rates over 6 months post-intervention.
Main Results:
- Patients receiving two or more MI calls demonstrated significantly lower discontinuation rates (OR = 0.29) and improved adherence (OR = 1.53).
- Higher baseline PDC and a greater number of medications were associated with better adherence.
- Depression was linked to lower medication adherence.
Conclusions:
- A motivational interviewing (MI) telephone intervention by pharmacy students can significantly improve medication adherence and reduce discontinuation in patients with DM and HTN.
- Further research is warranted to explore the long-term sustainability of these effects and their impact on clinical outcomes.
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