A comparison of usual care, a patient-centred education intervention and motivational interviewing to improve medication adherence and readmissions of adults in an acute-care setting

Abstract

Aim: To compare medication adherence and readmissions in patients who received usual care vs. patient-centred interventions.

Background: Medication adherence is a complex behaviour that may be improved with patient-centred strategies.

Method: A non-concurrent convenience sample of 303 hospitalised patients received either usual care (n = 98) or patient-centred interventions (n = 205). Intervention patients received teach-back and medication tools (n = 137) or motivational interviewing (n = 68). Data were collected at discharge (T1), at 48-72 hours (T2) and 30 days after discharge (T3).

Results: No significant differences were found in medication adherence, therapeutic alliance, patients' experience and readmissions between groups. Patients in the motivational interview group reported lower confidence with medication adherence at T1 (P = 0.01) and T2 (P = 0.00) than the patient-centred intervention group. Motivational interviewing was a significant predictor (β = -1.55, P = 0.01, OR 0.21, 95% CI 0.06, 0.72) of fewer readmissions.

Conclusion: Overall, patients reported very low levels of non-adherence and very high levels of confidence and importance of medication adherence.

Implications for nursing management: Medication adherence continues to be an important area for clinical inquiry. For those patients who lack confidence for medication adherence, comprehensive patient-centred strategies such as motivational interviewing may improve treatment outcomes.

Keywords: hospital readmissions; medication adherence; motivational interviewing; patient-centred care.