The effect of motivational interviewing on glycaemic control and perceived competence of diabetes self-management in patients with type 1 and type 2 diabetes mellitus after attending a group education programme: a randomised controlled trial

Abstract

Aims/hypothesis The aim of this study was to measure the efficacy of motivational interviewing (MI) compared with usual care on changes in glycaemic control and competence of diabetes self-management in patients with diabetes mellitus.Methods Patients were eligible if they had type 1 or 2 diabetes mellitus, were over 18 years of age and had participated in a 4 day group education programme offered at a diabetes clinic at a university hospital in Denmark. Exclusion criteria included pregnancy, severe debilitating disease and cognitive deficit. Out of 469 patients who attended the group education programme, 349 patients were randomised to either a usual care control group or an intervention group, which received up to five individual counselling sessions in 1 year based on MI, in addition to usual care. A randomised parallel design was used and openlabel allocation was done by random permuted blocks, with allocation concealment by sequentially numbered, sealed, opaque envelopes. The primary outcome was glycated haemoglobin (HbA 1c ). Analysis regarding measurements of glycated haemoglobin (HbA 1c ) and competence of selfmanagement (using the Problem Areas in Diabetes Scale [PAID] and Perceived Competence for Diabetes Scale [PCDS]) was based on 298 participants followed for a 24 month period. Data were collected at the Department of Endocrinology at Odense University Hospital. Our hypotheses were that MI could: (1) reduce HbA 1c levels; (2) increase self-efficacy; and (3) increase diabetes self-care, compared with usual care. Results Out of the 176 included in the control group and 173 in the intervention group, 153 and 145 were analysed in the groups, respectively. When using the baseline value as covariate there were no significant differences in change score between the two study groups with regard to mean level of HbA 1c (0.131, p=0.221), PAID scores (−1.793, p=0.191) or PCDS scores (0.017, p=0.903) at the 24 month follow-up, using a mixed effects regression model. TheElectronic supplementary material The online version of this article

The effect of a transtheoretical model–based motivational interview on self‐efficacy, metabolic control, and health behaviour in adults with type 2 diabetes mellitus: A randomized controlled trial

“…The difference in the weight change may be because the participants in the intervention group in West et al () received a group‐based behavioural weight control programme as well as the motivational interview, and this programme might have provided additional benefit for weight loss. In other studies, which differ in working time, there was no difference between groups for VKI (Meybodi et al, ; Rubak, Sandbæk, Lauritzen, Borch‐Johnsen, & Christensen, ), weight, and waist circumference (Rosenbek Minet et al, ). The results of the that studies show that it takes more time for people to make the desired behaviour change at the cognitive level before the effectiveness of the motivational interview than after it (Rubak, Sandback, Lauritzen, & Christensen, ).…”

“…Studies on conducting motivational interviews with patients with T2DM have shown that these interviews improve HbA1C, weight loss, control of diet, and physical activity (Chapman et al, ; Chen et al, ; Heinrich, Candel, Schaper, & de Veries, ; Miller et al, ; Poursharif et al, ). On the other hand, another study reported that motivational interviews had no superiority compared with regular care (Rosenbek Minet, Wagner, Lonving, Hjelmborg, & Henriksen, ).…”

Effectiveness of a Training Course for General Practice Nurses in Motivation Support in Type 2 Diabetes Care: A Cluster-Randomised Trial

“…Recently, a one-year MI programme was evaluated in a Danish diabetes clinic setting including volunteers with type 1 and type 2 diabetes [29]. Although the study did accomplish a rise in health care providers’ MI competences and a high degree of intervention delivery, the study showed no 12- or 24-month effect on PAID or HbA 1c .…”

The potential for motivational interviewing to improve outcomes in the management of diabetes and obesity in paediatric and adult populations: a clinical review

“…In contrast, one study showed a greater improvement in HbA1c in the non‐Motivational Interviewing groups than in the groups receiving Motivational Interviewing . Another study failed to show any benefit of Motivational Interviewing over and above usual care for either T1D or T2D .…”