title: A randomized controlled trial to provide adherence information and motivational interviewing to improve diabetes and lipid control.
abstract: The purpose of this study was to assess whether providing medication adherence information with or without motivational interviewing improves diabetes and lipid control.
  
  
  
  Study participants were adult members of a health system in southeast Michigan, were using both oral diabetes and lipid-lowering medications, and had glycated hemoglobin (A1C) or low-density lipoprotein cholesterol (LDL-C) levels not at goal. Participants were randomly assigned to receive usual care (UC), n = 567; have medication adherence information (AI) provided to their physician, n = 569; or have AI and receive motivational interviewing (MI) though trained staff (AI + MI), n = 556. Primary outcomes were A1C and LDL-C levels at 18 months post randomization.
  
  
  
  Primary outcomes were not significantly different between patients in the AI or AI + MI study arms when compared with UC. Similarly, neither oral diabetes nor lipid-lowering medication adherence was significantly different between groups. Patient participation in the AI + MI arm was low and limit the interpretation of the study results, but post hoc analysis of the AI + MI study arm showed that the number of MI sessions received was positively associated with only oral diabetes medication adherence.
  
  
  
  Neither AI nor MI significantly improved diabetes and lipid control when compared with UC. Moreover, patient participation appeared to be a particular barrier for MI.
authors.affiliation: Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit, Michigan (Dr Pladevall, Dr Williams)|Research Triangle Institute Health Solutions, Barcelona, Spain (Dr Pladevall)
authors.forename: Manel
authors.initials: M
authors.lastname: Pladevall
authors.affiliation: Department of Public Health Sciences, Henry Ford Health System, Detroit, Michigan (Dr Divine, Ms Wells)
authors.forename: George
authors.initials: G
authors.lastname: Divine
authors.affiliation: Department of Public Health Sciences, Henry Ford Health System, Detroit, Michigan (Dr Divine, Ms Wells)
authors.forename: Karen E
authors.initials: KE
authors.lastname: Wells
authors.affiliation: Center for Health Communications Research, University of Michigan, Ann Arbor, Michigan (Dr Resnicow)
authors.forename: Ken
authors.initials: K
authors.lastname: Resnicow
authors.affiliation: Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit, Michigan (Dr Pladevall, Dr Williams)|Department of Internal Medicine, Henry Ford Health System, Detroit, Michigan (Dr Williams)
authors.forename: L Keoki
authors.initials: LK
authors.lastname: Williams
mesh_terms: D000328:Adult; D000368:Aged; D008078:Cholesterol, LDL / Q000032:analysis; D003920:Diabetes Mellitus / Q000097:blood / Q000523:psychology* / Q000628:therapy; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D008297:Male; D055118:Medication Adherence; D008824:Michigan; D008875:Middle Aged; D062405:Motivational Interviewing / Q000379:methods*; D010358:Patient Participation / Q000523:psychology*; D012648:Self Care / Q000523:psychology
chemical_list: D008078:Cholesterol, LDL; D006442:Glycated Hemoglobin; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D007004:Hypoglycemic Agents; C517652:hemoglobin A1c protein, human