title: Effectiveness of motivational interviewing to improve therapeutic adherence in patients over 65 years old with chronic diseases: A cluster randomized clinical trial in primary care.
abstract: OBJECTIVE
  To evaluate the effectiveness of motivational interviewing (MI) in improving medication adherence in older patients being treated by polypharmacy.
  
  
  METHODS
  Cluster randomized clinical trial in 16 primary care centers with 27 health care providers and 154 patients. Thirty-two health care providers were assigned to an experimental (EG) or control group (CG).
  
  
  METHODS
  MI training program and review of patient treatments. Providers in the EG carried out MI, whereas those in the CG used an "advice approach". Three follow-up visits were completed, at 15 days and at 3 and 6 months. Medication adherence in both groups was compared (p<0.05).
  
  
  RESULTS
  Patients recruited: 70/84 (EG/CG). Mean age: 76 years; female: 68.8%. The proportion of subjects changing to adherence was 7.6% higher in the EG (p<0.001). Therapeutic adherence was higher for patients in the EG (OR=2.84), women (OR=0.24) and those with high educational levels (OR=3.93).
  
  
  CONCLUSIONS
  A face-to-face motivational approach in primary care helps elderly patients with chronic diseases who are being treated by polypharmacy to achieve an improved level of treatment adherence than traditional strategies of providing information and advice.
  
  
  CONCLUSIONS
  MI is a patient-centered approach that can be used to improve medication adherence in primary care.
  
  
  BACKGROUND
  This trial is registered at ClinicalTrials.gov (NCT01291966).
authors: Faculty of Medicine, Francisco de Vitoria University, Madrid, Spain. Electronic address: r.ruiz.prof@ufv.es.
authors: Roger Ruiz
authors: RR
authors: Moral
authors: Teaching Unit of Family and Community Medicine of Córdoba (Córdoba-Guadalquivir Health District), Maimonides Institute for Biomedical Research Córdoba (IMIBIC)/University of Cordoba, Reina Sofia University Hospital, Cordoba, Spain. Electronic address: luisangel.perula@gmail.com.
authors: Luis Angel Pérula de
authors: LA
authors: Torres
authors: Teaching Unit of Family and Community Medicine of Córdoba (Córdoba-Guadalquivir Health District), Maimonides Institute for Biomedical Research Córdoba (IMIBIC)/University of Cordoba, Reina Sofia University Hospital, Cordoba, Spain. Electronic address: laurapulidoortega@yahoo.es.
authors: Laura Pulido
authors: LP
authors: Ortega
authors: Teaching Unit of Family and Community Medicine of Córdoba (Córdoba-Guadalquivir Health District), Maimonides Institute for Biomedical Research Córdoba (IMIBIC)/University of Cordoba, Reina Sofia University Hospital, Cordoba, Spain. Electronic address: margarita.criado.exts@juntadeandalucia.es.
authors: Margarita Criado
authors: MC
authors: Larumbe
authors: Teaching Unit of Family and Community Medicine of Córdoba (Córdoba-Guadalquivir Health District), Maimonides Institute for Biomedical Research Córdoba (IMIBIC)/University of Cordoba, Reina Sofia University Hospital, Cordoba, Spain. Electronic address: anab.roldan.sspa@juntadeandalucia.es.
authors: Ana Roldán
authors: AR
authors: Villalobos
authors: Villarrubia Health Center, UGC Occidente (Córdoba-Guadalquivir Health District), Maimonides Institute for Biomedical Research Córdoba (IMIBIC)/University of Córdoba/Reina Sofia University Hospital, Córdoba, Spain. Electronic address: joseangelfernandezgarcia@hotmail.com.
authors: Jose Angel Fernández
authors: JA
authors: García
authors: Villanueva del Rey Health Center, UGC-Pueblonuevo Penyarroya (Northern Córdoba Health District), Maimonides Institute for Biomedical Research Córdoba (IMIBIC)/University of Córdoba/Reina Sofia University Hospital, Córdoba, Spain. Electronic address: juanprj@gmail.com.
authors: Juan Manuel Parras
authors: JM
authors: Rejano
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease / Q000188:drug therapy*; D004311:Double-Blind Method; D005260:Female; D006282:Health Personnel; D006801:Humans; D008297:Male; D055118:Medication Adherence; D009042:Motivation; D062405:Motivational Interviewing; D010043:Outcome and Process Assessment, Health Care; D018802:Patient-Centered Care / Q000379:methods*; D019338:Polypharmacy; D011320:Primary Health Care; D011369:Professional-Patient Relations; D013030:Spain
keywords: Communication; General practice/family medicine; Geriatrics; Medication adherence; Patient involvement (empowerment, self-management); Treatment/intervention research