Motivational interviewing: theoretical principles and its effectiveness in patients with chronic diseases

Introduction. Motivational interviewing (MI) is a colla­bo­ra­tive, patient-centered approach aimed at stimulating in­trin­sic motivation for behavioral change by resolving am­bi­va­lence. Initially developed by William Miller and Stephen Rollnick, MI has proven effective in managing chro­nic diseases and modifying risk behaviors, such as smoking ces­sation, improving treatment adherence, and adopting a healthier lifestyle. Methodology. Key MI strategies, such as open-ended questions, active listening, affirmations, and summaries, are essential for engaging patients and ad­dres­sing barriers to treatment adherence. Although the ap­pli­ca­tion of these strategies varies across studies, MI has consistently demonstrated improvements in patient out­comes. Results. This review analyzes the fundamental prin­ci­ples, techniques, and effectiveness of MI in primary care, particularly in managing chronic diseases. Data were synthesized from over 1300 randomized studies and 150 systematic reviews and meta-analyses published since 2005, highlighting MI applications in various health be­ha­viors and its minimum requirements for efficiency, 20 mi­nutes per session, 1-4 sessions. For example, the strategy of “examining the benefits and drawbacks of medicine” was reported in only nine studies, while “collaborating with the patient to identify and resolve adherence difficulties” ap­peared in 11 studies. The use of affirmations by therapists was highlighted as a particularly effective component in promoting behavioral change. The meta-analysis con­duc­ted by Zomahoun et al. (2017) showed a significant increase in treatment compliance in groups that received MI. Studies de­mon­stra­ted that MI applied in brief counseling sessions im­proved smoking cessation rates, yielding better results com­pared to traditional counseling methods. Channon et al. (2007) found a significant reduction in glycated hemoglobin va­lues of hemoglobin (HbA1c) in teenagers with type 1 dia­be­tes who participated in MI sessions. The meta-analysis by Vasilaki et al. (2006), which included 22 studies, revealed a 51% reduction in excessive alcohol consumption among MI participants. Hardcastle et al. (2013) demonstrated that 65% of participants in an eight-week MI program reached the recommended levels of physical activity, compared to only 35% in the control group. Local studies, such as the one published in the Journal of School Medicine in 2023 de­mon­stra­ted MI’s effectiveness in promoting a healthy lifestyle. Ad­di­tio­nally, the UNICEF Program for Increasing Vaccination Co­verage utilized MI to improve vaccine acceptance among pa­rents. Discussion. MI increases adherence to chronic di­sease management plans by encouraging patient au­to­no­my, resolving ambivalence, and aligning behaviors with per­so­nal goals and values. Training healthcare professionals to integrate MI into their daily practice enhances com­mu­ni­ca­tion skills and positively impacts patient outcomes. Con­clu­sions. Motivational interviewing is a valuable tool in pri­mary care for supporting chronic disease management. Stu­dies demonstrate its positive impact in various clinical con­texts; however, further research is needed to standardize and optimize its long-term implementation.