Interventions combining motivational interviewing and cognitive behaviour to promote medication adherence: a literature review.
Interventions combining motivational interviewing and cognitive behaviour to promote medication adherence: a literature review.
复制标题
结合动机访谈和认知行为以促进药物依从性的干预措施：文献综述。
DOI：
10.1111/jocn.12738
复制
发表时间：
2015
影响因子：
4.2
通讯作者：
K. Ridenour
中科院分区：
文献类型：
--
作者：
S. Spoelstra;Monica Schueller;Melissa Hilton;K. Ridenour
宗旨和目标
本文提出了一个综合审查的证据相结合的动机访谈和认知行为干预，促进药物治疗的依从性。我们进行了这项审查，以建立一个科学的基础，发展干预措施，以促进服药依从性和指导临床实践。
背景
世界卫生组织已将药物依从性指定为全球性问题。动机访谈和认知行为干预已被发现单独促进药物依从性。然而，有一个差距，在文献中的效果相结合的动机访谈和认知行为的方法，以促进服药依从性。
设计
综合审查。
方法
检索了科克伦、PubMed和CINAHL，以获得2004-2014年间的相关研究。纳入标准是将动机访谈和认知行为疗法与药物依从性相结合的干预措施作为结果。对文章进行了依从性和方法学严谨性的评估。使用综合审查过程进行分析。
结果
6篇文章符合纳入标准。一项随机对照试验报告，治疗前漏服剂量为5.58，治疗后漏服剂量为0.92，且有显著性趋势。4项队列研究的效应量为0.19 - 0.35（p <0.05）。一项病例研究的治疗前依从率为25%，治疗后为77%（p <0.01）。
结论
尽管关于动机访谈和认知行为干预相结合的研究数量有限，但六分之五的研究在改善药物依从性方面有效。未来需要进行大规模严格的随机试验研究。
与临床实践的相关性
这篇综述为临床医生提供了与促进药物依从性的动机性访谈和认知行为治疗干预相结合的科学状况。提供了干预组成部分和谈话要点的摘要，以帮助护士在知情决策和将证据转化为实践。
AIMS AND OBJECTIVES
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.
DESIGN
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.
RELEVANCE TO CLINICAL PRACTICE
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.