TY - JOUR
T1 - Medication adherence in patients with schizophrenia
T2 - a qualitative study of the patient process in motivational interviewing
AU - Dobber, Jos
AU - Latour, Corine
AU - de Haan, Lieuwe
AU - Scholte op Reimer, Wilma
AU - Peters, Ron
AU - Barkhof, Emile
AU - van Meijel, Berno
PY - 2018/5/18
Y1 - 2018/5/18
N2 - Background: Motivational interviewing (MI) may be an effective intervention to improve medication adherence in patients with schizophrenia. However, for this patient group, mixed results have been found in randomized controlled trials. Furthermore, the process of becoming (more) motivated for long-term medication adherence in patients with schizophrenia is largely unexplored. Method: We performed a qualitative multiple case study of MI-sessions to analyse the interaction process affecting motivation in patients with schizophrenia. Fourteen cases of patients with schizophrenia, who recently experienced a psychotic relapse after medication-nonadherence, were studied, comprising 66 audio-recorded MI-sessions. In the MI-sessions, the patients expressed their cognitions on medication. We used these cognitions to detect the different courses (or patterns) of the patients' ambivalence during the MI-intervention. We distinguished successful and unsuccessful cases, and used the cross-case-analysis to identify success factors to reach positive effects of MI. Results: Based on the expressed cognitions on medication, we found four different patterns of the patient process. We also found three success factors for the intervention, which were a trusting relationship between patient and therapist, the therapist's ability to adapt his MI-strategy to the patient's process, and relating patient values to long-term medication adherence. Conclusions: The success of an MI-intervention for medication adherence in patients with schizophrenia can be explained by well-defined success factors. Adherence may improve if therapists consider these factors during MI-sessions.
AB - Background: Motivational interviewing (MI) may be an effective intervention to improve medication adherence in patients with schizophrenia. However, for this patient group, mixed results have been found in randomized controlled trials. Furthermore, the process of becoming (more) motivated for long-term medication adherence in patients with schizophrenia is largely unexplored. Method: We performed a qualitative multiple case study of MI-sessions to analyse the interaction process affecting motivation in patients with schizophrenia. Fourteen cases of patients with schizophrenia, who recently experienced a psychotic relapse after medication-nonadherence, were studied, comprising 66 audio-recorded MI-sessions. In the MI-sessions, the patients expressed their cognitions on medication. We used these cognitions to detect the different courses (or patterns) of the patients' ambivalence during the MI-intervention. We distinguished successful and unsuccessful cases, and used the cross-case-analysis to identify success factors to reach positive effects of MI. Results: Based on the expressed cognitions on medication, we found four different patterns of the patient process. We also found three success factors for the intervention, which were a trusting relationship between patient and therapist, the therapist's ability to adapt his MI-strategy to the patient's process, and relating patient values to long-term medication adherence. Conclusions: The success of an MI-intervention for medication adherence in patients with schizophrenia can be explained by well-defined success factors. Adherence may improve if therapists consider these factors during MI-sessions.
KW - Medication-adherence
KW - Motivational Interviewing
KW - Patient process
KW - Schizophrenia
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85047061096&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/29776393
U2 - https://doi.org/10.1186/s12888-018-1724-9
DO - https://doi.org/10.1186/s12888-018-1724-9
M3 - Article
C2 - 29776393
SN - 1471-244X
VL - 18
JO - BMC psychiatry
JF - BMC psychiatry
IS - 135
M1 - 135
ER -