Effectiveness of motivational interviewing on medication adherence for the prevention of recurrent stroke or transient ischemic attack: Systematic review of randomized controlled trials

Kathrin Wandscher, Falk Hoffmann, Christoph Heesen, Götz Thomalla, Anne Christin Rahn, Jasmin Helbach

Abstract

BACKGROUND AND PURPOSE: This systematic review examines the effectiveness of motivational interviewing (MI) on medication adherence for preventing recurrent stroke and transient ischemic attack (TIA).

METHODS: MEDLINE (via PubMed), CINAHL, PsycINFO, CENTRAL, and ClinicalTrials.gov were searched from inception to 12 June 2023. Randomized controlled trials comparing MI with usual care or interventions without MI in participants with any stroke type were identified and summarized descriptively. Primary outcome was medication adherence. Secondary outcomes were quality of life (QoL) and different clinical outcomes. We assessed risk of bias with RoB 2 (revised Cochrane risk-of-bias tool) and intervention complexity with the iCAT_SR (intervention Complexity Assessment Tool for Systematic Reviews).

RESULTS: We screened 691 records for eligibility and included four studies published in five articles. The studies included a total of 2751 participants, and three were multicentric. Three studies had a high risk of bias, and interventions varied in complexity. Two studies found significantly improved medication adherence, one at 9 (96.9% vs. 88.2%, risk ratio = 1.098, 95% confidence interval = 1.03-1.17) and one at 12 months (97.0% vs. 95.0%, p = 0.026), but not at other time points, whereas two other studies reported no significant changes. No significant differences were found in QoL or clinical outcomes.

CONCLUSIONS: Evidence on MI appears inconclusive for improving medication adherence for recurrent stroke and TIA prevention, with no benefits on QoL and clinical outcomes. There is a need for robustly designed studies and process evaluations of MI as a complex intervention for people with stroke.

REGISTRATION: PROSPERO (CRD42023433284).

OriginalspracheEnglisch
Aufsatznummere16313
ZeitschriftEuropean Journal of Neurology
Jahrgang31
Ausgabenummer8
Seiten (von - bis)e16313
ISSN1351-5101
DOIs
PublikationsstatusVeröffentlicht - 08.2024

Strategische Forschungsbereiche und Zentren

  • Profilbereich: Zentrum für Bevölkerungsmedizin und Versorgungsforschung (ZBV)

Fingerprint

Untersuchen Sie die Forschungsthemen von „Effectiveness of motivational interviewing on medication adherence for the prevention of recurrent stroke or transient ischemic attack: Systematic review of randomized controlled trials“. Zusammen bilden sie einen einzigartigen Fingerprint.

Zitieren