Motivational interviewing for adherence: post-training attitudes and perceptions of physicians who treat asthma patients

Abstract

Objective: The aim of this study was to evaluate the attitudes and perceptions of health care professionals (HCPs) who have been trained in motivational interviewing (MI) to improve adherence. Another objective of this study was to compare groups of HCPs with different levels of training in adherence (trained vs untrained; previous training in adherence education [AdhE] vs specific training in MI). Methods: For this study, a national questionnaire-based survey was conducted among HCPs treating asthma. A total of 360 HCPs were surveyed (allergists: n=110; pulmonologists: n=120; general practitioners: n=130). Of them, 180 physicians had received a training intervention (training in AdhE: n=90; training in MI to promote adherence: n=90). Results: Of the total surveyed HCPs, 92.8% reported adherence is highly important in asthma control. More professionals trained in MI compared to those trained in AdhE considered that simplifying treatment as far as possible (85.6% vs 68.9%, P=0.0077), involving the patient in treatment plans (85.6% vs 71.1%, P=0.0187), giving the patient self-care patterns (52.2% vs 36.7%, P=0.0357) and performing MI (42.2% vs 15.6%, P<0.0001) were the most important interventions to promote adherence. Empathy between doctor and patient (93.3% vs 77.8%, P=0.0036) and concordance of medical and patient treatment goals (96.7% vs 72.2%, P<0.0001) were the factors perceived as having the greatest influence in improving adherence to asthma treatment by the physicians in the MI group as opposed to those in the AdhE group. The use of MI in asthma consultation was the most highly valued resource to promote adherence to treatment among all the professionals, particularly those who had received specific MI training compared to those who had received any kind of previous training in AdhE (96.7% vs 66.7%, P<0.0001). Conclusion: MI is considered an important tool to promote adherence to asthma treatment among HCPs, especially among those specifically trained in that aspect. MI training interventions seem to influence HCPs' approaches to improve self-care and to engage patients in treatment plans rather than approaches solely centered on AdhE.