The Efficacy of Motivational Interviewing in Adults With Chronic Pain: A Meta-Analysis and Systematic Review

Abstract

Motivational interviewing (MI) has become a popular approach for increasing adherence. In this study we investigated whether MI is effective in improving adherence, and pain and physical function for patients with chronic pain. A literature search of randomized controlled trials identified 7 eligible studies with 962 participants with chronic pain. There was a small to moderate overall effect of MI on increased adherence to treatment from baseline to after intervention, but not from baseline to follow-up. Although significant short-term effects of MI were also observed for pain intensity, analyses revealed that this finding might be due to publication bias. There were insufficient studies to examine physical functioning meta-analytically, however, none of the 3 available studies showed that MI resulted in gains in physical function compared with the control group. These results indicate that MI can probably increase short-term adherence to chronic pain treatments, although publication bias cannot be ruled out. Further, it is as yet unclear whether these effects result in improvements in patient function. Although the studies were methodologically strong, they investigated MI in relation to a number of treatments for chronic pain. Future research on the efficacy of MI on adherence to evidence-based self-management interventions for chronic pain is needed.

Perspective: MI significantly increased adherence to prescribed chronic pain treatments in the short term, however, effect sizes were small to moderate and publication bias was likely. MI showed some promise in promotion of adherence to pain treatments, but more research is required to confirm its efficacy.

Keywords: Motivational interviewing; chronic pain; meta-analysis; motivational enhancement; systematic review.