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The use of motivational interviewing in improving medication adherence for individuals with asthma: a systematic review

OBJECTIVE:

This review was conducted to examine current literature on the use of motivational interviewing (MI) as a strategy to promote individuals with asthma to make behavioral changes and improve health outcomes. This article systematically reviews empirical MI studies which were used to promote asthma medication adherence in children, adolescents, and adults.

METHODS:

Studies were obtained from several databases. We searched CINAHL, MEDLINE, PyscINFO, PubMed, and Cochrane database for articles on the use of MI to improve asthma medication adherence in individuals diagnosed with moderate to severe asthma. Various combinations of the following search terms were used: motivational interviewing, asthma, medication adherence, medication non-adherence, and MI.

RESULTS:

MI intervention showed evidence of improved self-efficacy, asthma, self-management, and positive behavior change for individuals diagnosed with asthma. The results suggest that MI is a feasible and promising approach to improve attitudes toward asthma medication adherence.

CONCLUSION:

The generally favorable results indicate MI merged with other interventions and support is effective in improving medication adherence and is also more sustainable than MI as a stand-alone intervention. Additional research is necessary to assess the effectiveness of MI in ensuring individuals fill their prescriptions and use their medications as recommended.

Socioeconomic and Environmental Predictors of Asthma-Related Mortality

The prevalence of asthma-related mortality (ARM) varies significantly among different countries, possibly influenced by various socioeconomic and environmental conditions (SEC). In-depth epidemiological research is necessary to understand the causal relationship between different SECs and ARM and to develop public health strategies to reduce the global burden of asthma. Our research aimed to identify the key SECs which may be attributed to ARM worldwide and to study the relationship between ARM and asthma prevalence. We included twenty-two countries with available data on SECs (2014-2015) and divided them into four groups: Asia, Africa, Europe, and Miscellaneous (Australia and North and South America). Tertiary school enrollment (TSE), gross domestic product (GDP), air pollution index, and male and female smoking prevalence rates were analyzed as predictors of ARM, using multiple linear regression. We found that ARM and asthma prevalence had an inverse relationship and developing countries compared to developed countries experienced higher ARM despite having lower asthma prevalence. Asian and African countries, compared to Europe and Miscellaneous countries, experienced poorer SECs, possibly associated with higher ARM. Among SECs, TSE and GDP had strongest association with ARM. In conclusion, lack of education and uneven distribution of resources may have an influence on the increased ARM in developing countries.