Improving patient’s motivation: an unrated skill in treatment’s adherence?

Abstract

A patient's motivation has known implications for the process of therapeutic’s adherence. In clinical practice, the patient’s weak motivation difficults his proactivity. Consequently, it interferes negatively with behaviours such as compliance with medication or adoption of healthy lifestyles, impairing the approach to various chronic pathologies. In general, studies reveal that patient motivation is a concept widely used by health professionals, albeit with an imprecise definition. Mostly, it is seen as a characteristic trait, translating into the dichotomy between motivated patients/and unmotivated patients, with a bias towards the second categorization. This perspective places the capacity for change only on the patient's side, with negative consequences for both actors in the doctor-patient relationship. However, since the publication of the Motivational Interviewing Model, in the 1980s, specific techniques have been documented to assess patients' motivational status, in order to modify them. Traditionally applied to substance use disorders, these models have shown benefit in several chronic illnesses’ rehabilitative programs. Understanding a patient’s motivational state as a dynamic path, permeable to external modification and subject to control by the health professional, combined with the training of skills in this area, can improve prognoses, increase patients’ and health professional’s satisfaction, and reduce health systems’ costs.