Motivational interviewing with primary care populations: a systematic review and meta-analysis

VanBuskirk, Katherine A.; Wetherell, Julie Loebach

doi:10.1007/s10865-013-9527-4

Cited by 237 publications

(199 citation statements)

References 31 publications

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“…20 Moreover, the delivery of simultaneous SUD and chronic pain treatment has been shown to improve both pain functioning and SUD outcomes, 21,22 and brief cliniciandelivered motivational interventions may enhance patients' willingness and readiness to engage in this treatment. 23 As hypothesized, we identified differences in rates of clinician referrals to SUD treatment depending on the type of substance detected on the UDT. Specifically, those who were discontinued because of the presence of cannabis, which was detected in more than half our sample, were less likely than those who tested positive for substances other than cannabis to be referred for SUD treatment (36% vs. 52%).…”

Section: Discussionmentioning

confidence: 94%

Substance Use Disorder Treatment Following Clinician-Initiated Discontinuation of Long-Term Opioid Therapy Resulting from an Aberrant Urine Drug Test

et al. 2017

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BACKGROUND:It is unclear whether substance use disorder (SUD) treatment is offered to, or utilized by, patients who are discontinued from long-term opioid therapy (LTOT) following aberrant urine drug tests (UDTs). OBJECTIVE: To describe the proportion of patients who were referred to, and engaged in, SUD treatment following LTOT discontinuation and to examine differences in SUD treatment referral and engagement based on the substances that led to discontinuation. DESIGN: From a sample of 600 patients selected from a national cohort of Veterans Health Administration patients who were discontinued from LTOT, we used manual chart review to identify 169 patients who were discontinued because of a UDT that was positive for alcohol, cannabis, or other illicit or non-prescribed controlled substances. MAIN MEASURES: We extracted sociodemographic, clinical, and health care utilization data from patients' electronic medical records. KEY RESULTS: Forty-three percent of patients (n = 73) received an SUD treatment referral following LTOT discontinuation and 20% (n = 34) engaged in a new episode of SUD treatment in the year following discontinuation. Logistic regression models controlling for sociodemographic and clinical variables demonstrated that patients who tested positive for cannabis were less likely than patients who tested positive for non-cannabis substances to receive referrals for SUD treatment (aOR = 0.44, 95% CI = 0.23-0.84, p = 0.01) or engage in SUD treatment (aOR = 0.42, 95% CI = 0.19-0.94, p = 0.04). Conversely, those who tested positive for cocaine were more likely to receive an SUD treatment referral (aOR = 3.32, 95% CI = 1.57-7.06, p = 0.002) and engage in SUD treatment (aOR = 2.44, 95% CI = 1.00-5.96, p = 0.05) compared to those who did not have a cocaine-positive UDT. CONCLUSIONS: There may be substance-specific differences in clinician referrals to, and patient engagement in, SUD treatment. This suggests a need for more standardized implementation of clinical guidelines that recommend SUD care, when appropriate, following LTOT discontinuation.KEY WORDS: long-term opioid therapy; chronic pain; substance use treatment; physician referral.

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Section: Discussionmentioning

confidence: 94%

Substance Use Disorder Treatment Following Clinician-Initiated Discontinuation of Long-Term Opioid Therapy Resulting from an Aberrant Urine Drug Test

et al. 2017

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“…Research has demonstrated the efficacy of motivational interviewing on reducing substance use (Dennis, 2004;Jensen et al, 2011;Lundahl et al, 2010;VanBuskirk &Wetherell, 2014). Motivational interviewing fits well within pediatric health care settings (Erickson et al, 2005) and is considered an evidenced-based, frontline approach to reducing substance use through increased levels of patientcentered care, shared decision making, and improved clini-cian-patient relationships (Anstiss, 2009;Rollnick et al, 2008).…”

Section: Motivational Interviewingmentioning

confidence: 96%

Peer Network Counseling as Brief Treatment for Urban Adolescent Heavy Cannabis Users

Mason

Sabo

Zaharakis

2017

J. Stud. Alcohol Drugs

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ABSTRACT. Objective: A small body of evidence supports targeting adolescents who are heavy users of cannabis with brief interventions, yet more research is needed to confirm the effectiveness of these studies. We conducted a secondary analysis of our Peer Network Counseling (PNC) study (Mason et al., 2015), focusing on 46 adolescents of the sample of 119 who reported heavy cannabis use at baseline. Method: Urban adolescents (91% African American) presenting for primary health care were randomized to intervention or control conditions and followed for 6 months. We selected cases (n = 46) to analyze based on heavy cannabis use reported at baseline ( 10 times in past month). The ordinal response data (cannabis use) were modeled using a mixed-effects proportional odds model, including fixed effects for treatment, time, and their interaction, and a subject-level random effect. Results: In the subsample of adolescents with heavy cannabis use, those assigned to PNC had a 35.9% probability of being abstinent at 6 months, compared with a 13.2% probability in the control condition. Adolescents in the PNC condition had a 16.6% probability of using cannabis 10 or more times per month, compared with a 38.1% probability in the control condition. This differs from results of the full sample (N = 119), where no significant effects on cannabis use were found. Conclusions: PNC increased the probability of abstinence and reduced heavy cannabis use. These results provide initial support for PNC as a model for brief treatment with non-treatmentseeking adolescents who are heavy users of cannabis. (J. Stud. Alcohol Drugs, 78, 152-157, 2017)

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“…1 While research indicates primary care providers can be trained to enhance patients' behavioral motivation, [2][3][4][5] evidence-based methods such as motivational interviewing are broad in scope, difficult to learn, and lengthy to apply. [6][7][8][9][10][11][12][13][14] As a result, the approaches are not widely employed in practice, where primary care providers must address multiple issues in office visits, seldom limited to behavioral change.…”

mentioning

confidence: 99%

Training Primary Care Physicians to Employ Self-Efficacy-Enhancing Interviewing Techniques: Randomized Controlled Trial of a Standardized Patient Intervention

et al. 2016

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Motivational interviewing with primary care populations: a systematic review and meta-analysis

Cited by 237 publications

References 31 publications

Substance Use Disorder Treatment Following Clinician-Initiated Discontinuation of Long-Term Opioid Therapy Resulting from an Aberrant Urine Drug Test

Substance Use Disorder Treatment Following Clinician-Initiated Discontinuation of Long-Term Opioid Therapy Resulting from an Aberrant Urine Drug Test

Peer Network Counseling as Brief Treatment for Urban Adolescent Heavy Cannabis Users

Training Primary Care Physicians to Employ Self-Efficacy-Enhancing Interviewing Techniques: Randomized Controlled Trial of a Standardized Patient Intervention

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