Increasing Medication Adherence Using Motivational Interviewing in Patients with Depression

Abstract

Depression is a psychiatric illness with a high incidence of medication non-adherence, which is a challenge in treating patients with depression. Non-adherence influences the effectiveness of treatment and the direct and indirect costs associated with untreated depression. Design: This study used a pre-post one-group design with medical record audit to examine the effectiveness of motivational interviewing (MI) in increasing medication adherence in patients with depression. The main outcome of this quality improvement study was medication adherence, an objective measure of the Medication Possession Ratio (MPR) and Proportion of Days Covered (PDC) of the pharmacy refill records defined as a calculated PDC and MPR ≥ 80%. Sample: The sample of this study consisted of patients with depression (N = 5). Intervention: The patients each received MI sessions that lasted 15-20 minutes in two sessions. The pharmacy refill records were used to determine medication adherence rate through calculations of the MPR and PDC before and after the intervention. Baseline data were obtained by reviewing the pharmacy refill records three months prior to the first MI session and the patient self-report at baseline confirmed the data. The pharmacy refill records were reviewed over a period of one month after each MI session. The percentages of the MPR and PDC of the patients were compared at the pre-test, post-test, and at one-month follow-ups. Result: A significant increase was noted in the medication adherence rate. While there was no statistical increase after the second MI session with the PDC adherence rates, there was an overall significant increase in medication adherence from baseline. Conclusion: MI is an effective intervention for improving adherence to medication but does not determine if the patient is actually taking the medications. Keywords: motivational interviewing, medication adherence, major depressive disorder, adherence, and psychiatric conditions.