Interventions combining motivational interviewing and cognitive behaviour to promote medication adherence: a literature review

Aims and objectivesThis article presents an integrative review of the evidence for combined motivational interviewing and cognitive behavioural interventions that promote medication adherence. We undertook this review to establish a scientific foundation for development of interventions to promote medication adherence and to guide clinical practice. BackgroundThe World Health Organization has designated medication adherence as a global problem. Motivational interviewing and cognitive behaviour interventions have been found to individually promote medication adherence. However, there is a gap in the literature on the effect of combined motivational interviewing and cognitive behavioural approaches to promote medication adherence. DesignIntegrative review. MethodsCOCHRANE, PubMed and CINAHL were searched to access relevant studies between 2004-2014. Inclusion criteria were interventions combining motivational interviewing and cognitive behavioural therapy with medication adherence as the outcome. Articles were assessed for measures of adherence and methodological rigour. Analysis was performed using an integrative review process. ResultsSix articles met the inclusion criteria. A randomised controlled trial reported pretreatment missed doses of 558 and post-treatment of 092 and trended towards significance. Four cohort studies had effect sizes of 019-035 (p<005). A case study had a pretreatment adherence rate of 25% and post-treatment 77% (p<001). ConclusionsAlthough there were a limited number of studies on combined motivational interviewing and cognitive behavioural interventions, five out of six were effective at improving medication adherence. Future studies with large rigorous randomised trials are needed. Relevance to clinical practiceThis review provides clinicians with the state of the science in relation to combined motivational interviewing and cognitive behavioural therapy interventions that promote medication adherence. A summary of intervention components and talking points are provided to aid nurses in informing decision-making and translating evidence into practice.