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. 2022 Apr;105(4):805-820.
doi: 10.1016/j.pec.2021.07.036. Epub 2021 Jul 24.

Telehealth delivery of motivational interviewing for diabetes management: A systematic review of randomized controlled trials

Cassidi C McDaniel  1 , Jan Kavookjian  2 , Heather P Whitley  3
Affiliations

Telehealth delivery of motivational interviewing for diabetes management: A systematic review of randomized controlled trials

Cassidi C McDaniel et al. Patient Educ Couns. 2022 Apr.

Abstract

Objectives: The objective of this systematic review was to explore and report the evidence and gaps in the literature for randomized controlled trials (RCTs) studying the effects of motivational interviewing (MI)-based telehealth interventions on outcomes among persons with diabetes (PWD) or prediabetes.

Methods: Following a modified Cochrane approach, we searched Pubmed, CENTRAL, CINAHL, PsycINFO, and Clinicaltrials.gov. Included studies were RCTs published in English before March 25, 2021 evaluating MI-based telehealth on outcomes for adults with diabetes or prediabetes.

Results: A total of 21 retained articles captured results for 6436 PWD. Among the most commonly investigated outcomes, 60% of articles documented A1C reductions (ranging from<1% to>3%), 56% documented systolic blood pressure reductions, 57% documented diabetes self-efficacy/empowerment improvements, and 40% documented physical activity improvements. Conversely, diastolic blood pressure, lipid panels, body mass index, depressive symptoms, and quality of life were frequently measured outcomes, where MI-based telehealth yielded minor effects (<30% of articles demonstrating improvements).

Conclusions: MI-based telehealth seems most effective for improving A1C, systolic blood pressure, diabetes self-efficacy, and physical activity behaviors. Variability in outcome assessment and intervention heterogeneity were key challenges impeding comparisons across retained articles.

Practice implications: MI-based telehealth interventions demonstrate promising results for improving outcomes in PWD.

Keywords: Diabetes; Motivational interviewing; Outcomes; Review; Telehealth.

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Conflict of interest statement

Declaration of Interest:

  1. McDaniel: Cassidi C. McDaniel was supported by the National Center for Advancing Translational Sciences of the National Institutes of Health under award number TL1TR003106. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. McDaniel was also supported by the American Foundation for Pharmaceutical Education (AFPE) under the AFPE Pre-Doctoral Fellowship.

  2. Kavookjian: Dr. Kavookjian discloses that she is on the Merck Speakers Bureau for non-product medical education for the topics of motivational interviewing, shared decision-making, and health literacy communication; she also served as a consultant for Merck as motivational interviewing content expert in the person-centered communication line of education materials; she also consults for MediMergent, LLC for its US Food and Drug Administration (FDA)- funded project in training pharmacists in motivational interviewing for medication taking in diabetes.

  3. Whitley: Nothing to disclose.

Figures

Fig. 1.
Fig. 1.
PRISMA Flow Diagram.
See this image and copyright information in PMC

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