Using Motivational Interviewing for Medication Adherence in Patients with Schizophrenia Spectrum Disorders

Abstract

Schizophrenia spectrum disorders are psychiatric illnesses that have a high incidence of patients not adhering to their antipsychotic medications. There are multiple factors that contribute to medication nonadherence in patients with a schizophrenia spectrum disorders. Nonadherence with antipsychotic medications can cause poor patient outcomes for patients with these psychiatric illnesses. There is evidence to support that the therapeutic communication intervention, motivational interviewing, can improve medication adherence in patients with schizophrenia spectrum disorders. This quality improvement project used a pre- and post-test design to assess medication adherence pre- and post-intervention. The main outcome of this project was to improve the patient outcome, medication adherence. This project included a study sample of two participants that met inclusion criteria. Patient A’s pre-intervention medication adherence rating scale (MARS) score was 7 out of 10 and Patient B’s score was 4 out of 10. The higher the score on the MARS, the more favorable medication adherence. Patient A was unable to receive a therapeutic session of motivational interviewing because he was acutely psychotic and paranoid. Patient B received one face-to-face motivational interview session and behavioral changes were discussed on how to maintain medication adherence. The one-month follow up post- intervention could not be completed due to appointments being rescheduled by the patients and provider. The post-intervention MARS were not completed and motivational interviewing was unable to be evaluated for effectiveness. Despite the lack of result findings on medication adherence, administering the MARS and utilizing motivational interviewing offered insight about the patient’s beliefs and feelings about their antipsychotic medication. It is recommended for future projects to expand the PDSA cycle to recruit more participants and fully implement the study protocol. Keywords: motivational interviewing, medication adherence, schizophrenia spectrum disorders, and therapeutic communication.