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Guiding patients through complexity: Motivational interviewing for patients with multimorbidity
Kylie J McKenzie1, David Pierce2, Jane M Gunn3
1BA (Hons), MPsych (Clinical), MAPS, Clinical Psychologist and Manager, Psychology Department, Ballarat Health Services, Vic; Motivational Interviewing Network of Trainers; PhD candidate, Department of General Practice, University of Melbourne, Carlton, Vic.
Background:
Multimorbidity is an increasing and complex issue in Australian general practice. General practitioners (GPs) face the challenge of navigating multiple potential intervention pathways. Emerging guidelines for multimorbidity recommend patient-centred care and addressing the lifestyle factors of the patient. Motivational interviewing is a patient-centred approach that is focused on behavioural change and effective across a range of lifestyle factors.
Objective:
The aim of this article is to provide a practical introduction to motivational interviewing skills that may be helpful in working with patients who have multimorbidity. Key skills discussed in this article include agenda setting, giving advice, responding to resistance, and asking questions to evoke a patient’s own motivation for change.
Discussion:
GPs are ideally placed to assist patients with multimorbidity to navigate recommendations and identify which recommendations will work. Navigating complexity is at the heart of general practice, and multimorbidity demands more than an ‘assess-and-advise’ model of care. Motivational interviewing provides a promising and readily applicable framework to empower patients living with multimorbidity.
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