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.
Autor: Ruiz Moral, Roger; Pérula de Torres, Luis Ángel; Pulido Ortega, Laura; Criado Larumbe, Margarita; Roldán Villalobos, Ana; Fernández García, José Ángel; Parras Rejano, Juan Manuel
Resumen: 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 health
care 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[0] 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-to-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.
Identificador universal: http://hdl.handle.net/10641/1191
Fecha: 2015
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