Mechanisms of Action of Combination Motivational Interviewing-Cognitive Behavior Therapy for Reversing Medication Non-Adherence in Patients With Multiple Sclerosis.

Document Type

Article

Publication Date

7-2025

Identifier

DOI: 10.1002/jclp.23796

Abstract

OBJECTIVE: Despite disease modifying therapies' (DMT) demonstrated efficacy for treating relapsing MS, around 40% of patients discontinue use. This study aimed to understand the mechanism of action of Motivational Interviewing plus cognitive behavioral therapy (MI-CBT) in a previously conducted randomized controlled trial in which the MI-CBT intervention successfully promoted DMT re-initiation of participants compared to a treatment as usual (TAU) condition.

METHODS: This secondary analysis (N = 91) explored changes in motivation (a single item motivation "ruler" [Mot∆], and the Brief Motivation Scale [BMS∆]), autonomous motivation (AR∆), personal control (PC∆), treatment control (TC∆), and confidence to reinitiate (Con∆) as potential mediators of the treatment effect, using logistic regression.

RESULTS: Logistic regression analysis including all potential mediators as predictors of initiation indicated the BMS∆ was the only statistically significant predictor (OR = 1.61, p = 0.010). When BMS∆ was removed Mot∆ (OR = 1.22, p = 0.002) and PC∆ (OR = 1.67, p = 0.002) were statistically significant predictors of initiation.

CONCLUSION: The MI-CBT intervention appeared to work primarily by increasing motivation to initiate DMT.

Journal Title

Journal of clinical psychology

Volume

81

Issue

7

First Page

609

Last Page

618

MeSH Keywords

Humans; Motivational Interviewing; Cognitive Behavioral Therapy; Female; Male; Adult; Middle Aged; Motivation; Medication Adherence; Combined Modality Therapy; Multiple Sclerosis

PubMed ID

40176571

Keywords

MI‐CBT; adherence; behavioral medicine; chronic illness; health behavior; health promotion; mediator

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