Brief motivational interviewing as a clinical strategy to promote asthma medication adherence

Borrelli, Belinda; Riekert, Kristin A.; Weinstein, Andrew; Rathier, Lucille

doi:10.1016/j.jaci.2007.08.017

Cited by 103 publications

(61 citation statements)

References 85 publications

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“…Motivational interviewing (MI) may be such an intervention. Using this technique, a healthcare provider asks nonthreatening open-ended questions in an attempt to foster intrinsic motivation in patients ambivalent to change (33). MI has been shown to improve adherence to antiretroviral medications in a cohort of low-income men and women with HIV (34) and to a diet and exercise regimen among overweight women with type 2 diabetes (35).…”

Section: Discussionmentioning

confidence: 99%

Race-Ethnic Differences in Factors Associated with Inhaled Steroid Adherence Among Adults with Asthma

2009

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Rationale: Adherence to inhaled corticosteroid (ICS) medication is known to be low overall, but tends to be lower among AfricanAmerican patients when compared with white patients. Objectives: To understand the factors that contribute to ICS adherence among African-American and white adults with asthma. Methods: Eligible individuals had a prior diagnosis of asthma, one or more ICS prescriptions, and were members of a large health maintenance organization in southeast Michigan. Individuals were sent a survey that included questions about internal factors (e.g., patient beliefs, knowledge, and motivation) and external factors (e.g., socioeconomic status, barriers to care, social support, and stressors) potentially related to ICS adherence. Adherence was calculated using electronic prescription and fill data. Stepwise regression was used to identify factors associated with adherence before and after stratifying by race-ethnicity. Measurements and Main Results: Surveys were returned by 1,006 (56.3%) of 1,787 eligible patients. Adjusting for internal factors, but not external factors, diminished the relationship between raceethnicity and ICS adherence. Among African-American patients, readiness to take ICS medication was the only internal or external factor significantly associated with ICS adherence; it explained 5.6% of the variance in adherence. Among white patients, perceived ICS necessity, ICS knowledge, doctors being perceived as the source of asthma control, and readiness to take medication were the internal factors associated with ICS adherence; these accounted for 19.8% of the variance in adherence. Conclusions: Factors associated with ICS adherence appear to differ between African-American and white patients, suggesting that group-specific approaches are needed to improve adherence.

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Section: Discussionmentioning

confidence: 99%

Race-Ethnic Differences in Factors Associated with Inhaled Steroid Adherence Among Adults with Asthma

2009

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“…It aims to help individuals solve their ambivalence about change and boost their intrinsic motivation [23,24]. It assesses a client's 'readiness' to change and attempts to enhance motivation for behavior change [25].…”

Section: Introductionmentioning

confidence: 99%

A randomized controlled multimodal behavioral intervention trial for improving antiepileptic drug adherence

Pakpour

Gholami

Esmaeili

et al. 2015

Epilepsy & Behavior

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Purpose: Medication nonadherence is one of the most important reasons for treatment failure in patients with epilepsy. The present study investigated the effectiveness of a multicomponent intervention to improve adherence to antiepileptic drug (AED) medication in patients with epilepsy. Methods: In a prospective, randomized multicenter trial, three sessions of face-to-face motivational interviewing (MI) in combination with complementary behavior change techniques were compared with standard care. Motivational interviewing prompted change talk and self-motivated statements from the patients, planning their own medication intake regimen and also identifying and overcoming barriers that may prevent adherence. Participants were provided with calendars to self-monitor their medication taking behavior. A family member and the health-care team were invited to attend the last session of MI in order to improve the collaboration and communication between patients, their caregiver or family member, and their health-care provider. At baseline and 6-month follow-up, psychosocial variables and medical adherence were assessed. Results: In total, 275 participants were included in the study. Compared with the active control group, patients in the intervention group reported significantly higher medication adherence, as well as stronger intention and perceptions of control for taking medication regularly. The intervention group also reported higher levels of action planning, coping planning, self-monitoring, and lower medication concerns. Conclusions: This study shows that MI can be effective in clinical practice to improve medication adherence in patients with epilepsy. It also provides evidence that combining volitional interventions, including action planning, coping planning, and self-monitoring with motivational interviewing can promote the effectiveness of the medical treatments for epilepsy by improving adherence.

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“…Provider recommendations boost motivation to tackle weight management [10,27,33,34], and linking overweight-related asthma symptoms could further enhance weight management among adolescents' with asthma. Interventions that assess and bring together adolescents' values and perspectives, patient-centered approaches of providers, and parent/guardian participation will likely amplify weight-related behavior changes that benefit asthma control in overweight teens [18,19,35]. Teen ratings of introduction statements for weight discussion (n = 32).…”

Section: Discussionmentioning

confidence: 99%

“…We report adolescents' views on the most and least effective approaches to introduce discussions on weight management [17]. Our goal is to encourage and guide more effective provider-generated discussions targeting overweight adolescents, using a patientcentered approach [10,18,19]. These findings will facilitate the development and evaluation of patient-centered and culturally appropriate tools that, in turn, facilitate conversations between providers and adolescents which link weight and asthma.…”

Section: Introductionmentioning

confidence: 99%

Overweight adolescents and asthma: Revealing motivations and challenges with adolescent-provider communication

et al. 2017

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Objective-Among teens with asthma, challenges of disease management may be greater in those with a body mass index (BMI) >85th percentile compared to youth within the parameters for normal weight-for-age. This mixed-methods study assessed teens' awareness of the link between weight and asthma management, and perspectives on how medical providers might open a discussion about managing weight.Method-Teens aged 13-18, having BMI >85 percentile and chronic asthma, identified using health system databases and a staff email message board, were invited to complete a semistructured, in-depth phone interview. Interviews were audio taped, transcribed, and qualitatively analyzed, using the Framework Method. Responses were summarized and themes identified. Descriptive summaries were generated for a 16-item survey of weight conversation starters.Results-Of 35 teens interviewed, 24 (69%) were girls, 11 (31%) boys, 20 (63%) AfricanAmerican. All teens reported having "the weight conversation" with their doctors, and preferred that parents be present. Half knew from their doctor about the link between being overweight and asthma, others knew from personal experience. Nearly all expressed the importance of providers initiating a weight management conversation. Most preferred conversation starters that recognized challenges and included parents' participation in weight management; least liked referred to "carrying around too much weight."Conclusions-Most teens responded favorably to initiating weight loss if it impacted asthma management, valued their provider addressing weight and family participation in weight management efforts. Adolescents' views enhance program development fostering more effective communication targeting weight improvement within the overall asthma management plan.

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Brief motivational interviewing as a clinical strategy to promote asthma medication adherence

Cited by 103 publications

References 85 publications

Race-Ethnic Differences in Factors Associated with Inhaled Steroid Adherence Among Adults with Asthma

Race-Ethnic Differences in Factors Associated with Inhaled Steroid Adherence Among Adults with Asthma

A randomized controlled multimodal behavioral intervention trial for improving antiepileptic drug adherence

Overweight adolescents and asthma: Revealing motivations and challenges with adolescent-provider communication

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