Motivational interviewing to promote health outcomes and behaviour change in multiple sclerosis: a systematic review

Abstract

Objective: To examine the evidence for motivational interviewing when used to assist individuals with multiple sclerosis manage their healthcare. Data sources: The Cochrane, Embase, PsycINFO and PubMed databases were searched for studies published between 1983 and December 2019. The reference lists of included studies were additionally examined and Scopus citation searches conducted. Review methods: Study screening and data extraction were independently completed by two reviewers. Randomised controlled trials comparing motivational interviewing interventions for multiple sclerosis to usual care, wait-list or other active intervention controls were examined. Studies were assessed using the Cochrane Risk of Bias tool. Standardised mean differences (Hedges’ g), 95% confidence intervals and P values were calculated for all health and behavioural outcomes. Results: Ten randomised controlled trials, involving a pooled sample of 987 adults with relapsing–remitting or progressive multiple sclerosis and mild to moderate impairment, were identified. Most trials had a low or unclear risk of methodological bias. Motivational interviewing, when used in conjunction with other counselling or rehabilitation techniques, resulted in significant immediate medium-to-very large improvements in multiple physical, psychological, social and behavioural outcomes (range: g = .34–2.68). Maintenance effects were promising (range: g = .41–1.11), although less frequently assessed ( Nstudies = 5) and of limited duration (1–7 months). Individual and group-based interventions, delivered in-person or by telephone, were all effective. Conclusions: Motivational interviewing is a flexible counselling technique that may improve rehabilitation care for multiple sclerosis. However, evidence for persisting benefits to health outcomes and behaviour is currently limited.

Motivational Strategies for Stroke Rehabilitation: A Delphi Study

“…Our results are consistent with those of previous studies regarding motivation strategies for rehabilitation in individuals with other conditions, such as spinal cord injury, cerebral palsy, and low back pain. [5][6][7][8][9] Therefore, effective motivational strategies observed in this study, such as control of task difficulty and goal setting, may be incorporated into rehabilitation programs for these individuals.…”

“…as goal setting therapy are widely used with individuals with acquired brain injury 7 and multiple sclerosis. 8 Furthermore, providing medical information and praise and encouragement helps patients with low back pain resume regular activities. 9 Various strategies are used to motivate stroke patients in clinical practice with positive outcomes.…”

Patients’ and Clinicians’ Perceptions of Motivational Factors in Rehabilitation

“…[11][12][13][14][15] Thus, various strategies, such as motivational interviewing and behavioral therapies, are used to enhance patient motivation for rehabilitation with positive motor and functional outcomes for individuals with a range of neurological and orthopedic disorders. [16][17][18][19][20][21][22][23][24][25][26] Motivation has been defined as the "mental function that produces the incentive to act; the conscious or unconscious driving force for action." 27 Social factors, such as clinicians' attitudes towards the patient and the patient's social support networks, in combination with the personality or clinical characteristics of the individual patient have been considered possible determinants of motivation for rehabilitation.…”

Dental hygienists’ use of motivational interviewing and perceptions of effectiveness in changing patient behaviors

“…Within health disciplines, the use of MI has shown to improve the efficacy of medical interventions for a broad range of behavioral problems and diseases including physiological parameters such as blood pressure, cholesterol, and body mass index, consequently improving health outcomes 12–14 . A systematic review by Rubak et al.…”

“…11 Within health disciplines, the use of MI has shown to improve the efficacy of medical interventions for a broad range of behavioral problems and diseases including physiological parameters such as blood pressure, cholesterol, and body mass index, consequently improving health outcomes. [12][13][14] A systematic review by Rubak et al found MI to outperform traditional advice giving in the clinical environment and demonstrated that MI can promote change in patient behaviors in brief encounters as brief as 15 min making it extremely adaptable in the dental environment. 12 Traditional advice was defined as when a healthcare provider gives advice and defines the patients' problem from a biomedical perspective, not including the patient's perspective.…”