Title

A comparison of usual care, a patient-centred education intervention and motivational interviewing to improve medication adherence and readmissions of adults in an acute-care setting.

Document Type

Article

Publication Date

4-1-2014

Institution/Department

Nursing

Journal Title

Journal of nursing management

MeSH Headings

Adult, Aged, Aged, 80 and over, Female, Humans, Male, Medication Adherence, Middle Aged, Motivational Interviewing, Patient Education as Topic, Patient Readmission, Primary Health Care, Self Medication, Treatment Outcome

ISSN

1365-2834

Abstract

AIM: To compare medication adherence and readmissions in patients who received usual care vs. patient-centred interventions.

BACKGROUND: Medication adherence is a complex behaviour that may be improved with patient-centred strategies.

METHOD: A non-concurrent convenience sample of 303 hospitalised patients received either usual care (n = 98) or patient-centred interventions (n = 205). Intervention patients received teach-back and medication tools (n = 137) or motivational interviewing (n = 68). Data were collected at discharge (T1), at 48-72 hours (T2) and 30 days after discharge (T3).

RESULTS: No significant differences were found in medication adherence, therapeutic alliance, patients' experience and readmissions between groups. Patients in the motivational interview group reported lower confidence with medication adherence at T1 (P = 0.01) and T2 (P = 0.00) than the patient-centred intervention group. Motivational interviewing was a significant predictor (β = -1.55, P = 0.01, OR 0.21, 95% CI 0.06, 0.72) of fewer readmissions.

CONCLUSION: Overall, patients reported very low levels of non-adherence and very high levels of confidence and importance of medication adherence.

IMPLICATIONS FOR NURSING MANAGEMENT: Medication adherence continues to be an important area for clinical inquiry. For those patients who lack confidence for medication adherence, comprehensive patient-centred strategies such as motivational interviewing may improve treatment outcomes.

First Page

350

Last Page

361

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