A randomized controlled trial to provide adherence information and motivational interviewing to improve diabetes and lipid control

Diabetes Educ. 2015 Feb;41(1):136-46. doi: 10.1177/0145721714561031. Epub 2014 Dec 8.

Abstract

Purpose: The purpose of this study was to assess whether providing medication adherence information with or without motivational interviewing improves diabetes and lipid control.

Methods: Study participants were adult members of a health system in southeast Michigan, were using both oral diabetes and lipid-lowering medications, and had glycated hemoglobin (A1C) or low-density lipoprotein cholesterol (LDL-C) levels not at goal. Participants were randomly assigned to receive usual care (UC), n = 567; have medication adherence information (AI) provided to their physician, n = 569; or have AI and receive motivational interviewing (MI) though trained staff (AI + MI), n = 556. Primary outcomes were A1C and LDL-C levels at 18 months post randomization.

Results: Primary outcomes were not significantly different between patients in the AI or AI + MI study arms when compared with UC. Similarly, neither oral diabetes nor lipid-lowering medication adherence was significantly different between groups. Patient participation in the AI + MI arm was low and limit the interpretation of the study results, but post hoc analysis of the AI + MI study arm showed that the number of MI sessions received was positively associated with only oral diabetes medication adherence.

Conclusion: Neither AI nor MI significantly improved diabetes and lipid control when compared with UC. Moreover, patient participation appeared to be a particular barrier for MI.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Cholesterol, LDL / analysis
  • Diabetes Mellitus / blood
  • Diabetes Mellitus / psychology*
  • Diabetes Mellitus / therapy
  • Female
  • Glycated Hemoglobin / analysis
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
  • Hypoglycemic Agents / therapeutic use*
  • Male
  • Medication Adherence*
  • Michigan
  • Middle Aged
  • Motivational Interviewing / methods*
  • Patient Participation / psychology*
  • Self Care / psychology

Substances

  • Cholesterol, LDL
  • Glycated Hemoglobin A
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Hypoglycemic Agents
  • hemoglobin A1c protein, human