Clinical Focus
Motivational Interviewing Increases Retention and Adherence
Since 2005, Magellan Health Services has employed motivational interviewing (MI)—a patient-centered communication approach with documented effectiveness in helping people move toward healthier lifestyle choices. Addressing patient ambivalence and motivation for change, MI is an empathetic, supportive strategy used to help patients bring their behavior in line with self-identified goals and values. Magellan embraces the MI strategy as a best practice in clinical interactions between patients and providers.
According to Magellan Chief Clinical Officer Dr. Fred Waxenberg, “MI is an evidenced-based research methodology that can be used as a stand-alone approach or combined with other therapeutic methods.”
A recent meta-analysis of 72 MI clinical trials by Hettima, Steel and Miller in 2005 revealed that, along with its positive effects on treatment retention and adherence, the MI approach—when combined with other treatments—yielded a consistent increase in patient motivation as well as overall improvement in outcomes and patient prognosis. Studies also indicated increases in post-treatment abstinence rates and increased sessions attended.
Specifically for Magellan, MI has become a critical feature of our Intensive Care Management (ICM) program—where our care managers’ ability to swiftly engage and enroll patients at risk for subsequent acute treatment is crucial.
Between May of 2005 and May of 2008, Dr. Waxenberg and colleagues conducted 28 MI training sessions in 12 Magellan Care Management Centers throughout the United States. A total of 318 clinical staff, including ICM care managers, coaches, concurrent care managers, ambulatory follow-up specialists and field care managers participated.
After the care manager training, we observed positive changes in patient engagement rates as a result of MI techniques. Measurement of the engagement rate began 60 days after training through May 1, 2008. The average pre-training engagement rate per care manager was 81 percent, and the average post-training engagement rate was approximately 88 percent—resulting in a statistically significant mean increase in the engagement rate of ICM care managers in the post-training period.
Learn more about motivational interviewing by visiting www.motivationalinterview.org.