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.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  Overall, patients reported very low levels of non-adherence and very high levels of confidence and importance of medication adherence.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Center for Nursing Research and Quality Outcomes, Maine Medical Center, Portland, ME, USA; School of Nursing, University of Southern Maine, Portland, ME, USA.
authors.forename: Kristiina
authors.initials: K
authors.lastname: Hyrkas
authors.forename: Marjorie
authors.initials: M
authors.lastname: Wiggins
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D008875:Middle Aged; D062405:Motivational Interviewing / Q000379:methods*; D010353:Patient Education as Topic / Q000379:methods*; D010359:Patient Readmission; D011320:Primary Health Care; D012651:Self Medication / Q000592:standards*; D016896:Treatment Outcome
keywords: hospital readmissions; medication adherence; motivational interviewing; patient-centred care