Motivational Interviewing Integrated with Medication Management to Improve Outcomes in Depressed Adults
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Date
2025-05
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The Ohio State University
Abstract
Major Depressive disorder is a leading cause of global disability. In 2019, there were an estimated 280 million individuals suffering from depressive symptoms. The COVID-19 pandemic led to further mental health disparities, with individuals facing death, isolation, illness, and job loss compounding the disease process. Major Depressive Disorder is believed to be a chronic disease with periods of remission and relapse. Despite effective treatment modalities, patient outcomes are suboptimal. Over half of patients respond to antidepressant therapy with medication nonadherence varying from 10% to 60%. Factors influencing medication nonadherence include treatment stigma, negative provider relationships, patient beliefs, lack of social support, and forgetfulness. Motivational interviewing (MI) was identified in the literature review as a supportive therapeutic approach to improve the patient-provider relationship, reduce treatment stigma, improve medication adherence, and improve treatment outcomes for patients diagnosed with Major Depressive Disorder. The DNP project integrated MI with Medication Management in patients diagnosed with Major Depressive Disorder, moderate severity, who struggle with treatment adherence. Moderate severity was identified with a Patient Health Questionnaire-9 (PHQ-9) score of 10-14 and a Medication Adherence Rating Scale (MARS-5) less than 25. The outcome was measured by completing the PHQ-9 and MAR-5 before the initial intervention and between 1-3 months at follow-up visits. Even though the sample size was small (n=6), The PHQ-9 and MARS-5 scores improved, suggesting MI as effective therapeutic intervention when integrated with medication management in depressed patients.
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Keywords
depression, motivational interviewing, mood disorder, medication management, counseling