title: Interventions combining motivational interviewing and cognitive behaviour to promote medication adherence: a literature review.
abstract: OBJECTIVE
  This 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.
  
  
  BACKGROUND
  The 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.
  
  
  METHODS
  Integrative review.
  
  
  METHODS
  COCHRANE, 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.
  
  
  RESULTS
  Six articles met the inclusion criteria. A randomised controlled trial reported pretreatment missed doses of 5·58 and post-treatment of 0·92 and trended towards significance. Four cohort studies had effect sizes of 0·19-0·35 (p < 0·05). A case study had a pretreatment adherence rate of 25% and post-treatment 77% (p < 0·01).
  
  
  CONCLUSIONS
  Although 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.
  
  
  CONCLUSIONS
  This 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.
authors.affiliation: Michigan State University College of Nursing, East Lansing, MI, USA.
authors.forename: Sandra L
authors.initials: SL
authors.lastname: Spoelstra
authors.forename: Monica
authors.initials: M
authors.lastname: Schueller
authors.forename: Melissa
authors.initials: M
authors.lastname: Hilton
authors.forename: Kimberly
authors.initials: K
authors.lastname: Ridenour
mesh_terms: D015928:Cognitive Behavioral Therapy; D006801:Humans; D055118:Medication Adherence; D062405:Motivational Interviewing
keywords: cognitive behavioural therapy; integrative review; intervention; medication adherence; motivational interviewing