motivational interviewing, cognitive behavioral therapy, medication adherence, integrative review


Medicine and Health Sciences


Aims and objectives: The World Health Organization has indicated medication adherence is a global problem. Both motivational interviewing (MI) and cognitive behavioral therapy (CBT) interventions alone have been found to be effective at improving medication adherence. This article summarizes research that has combined motivational interviewing and cognitive behavioral therapy to improve medication adherence.

Background: Projections indicate that by 2015, 33% of cancer treatment will be in pill form, shifting responsibility for managing medication adherence to patients. These regimens are often complex, with multiple doses, drugs, or cycling, and patients often experience side effects from symptoms, making adherence difficult. Patients taking cancer treatment in pill form must strictly adhere to their regimen to achieve a therapeutically effective level for cancer treatment.

Design: Literature review.

Methods: Data were obtained from six studies that combined MI and CBT in an intervention to promote medication adherence. Analysis was performed based on an integrative review process.

Results: Five studies on medication adherence rates using combined MI and CBT reported improved medication adherence rates; and one was trending toward improved medication adherence rates.

Conclusions: Combined MI/CBT interventions improved medication adherence in various conditions; and may be effective in challenging clinical conditions, such as when cancer treatment is prescribed in pill form.

Relevance to clinical practice: This review focused on interventions that combined motivational interviewing and cognitive behavioral therapy to promote medication adherence. Findings provide nurses with an overview of interventions that may be used in developing programs to help patients manage adherence to cancer treatment in pill form; as well as in other challenging conditions where medication adherence is crucial. A detailed description of the interventions found to be effective is provided to assist nurses in translating evidence into practice.


Original Citation:

Spoelstra, S. L., Schueller, M., Hilton, M., & Ridenour, K. (2015). Interventions Combining Motivational Interviewing and Cognitive Behavior to Promote Medication Adherence: A Literature Review. Journal of Clinical Nursing, 24(9–10), 1163–1173.