Motivational Interviewing for substance abuse. A systematic review.

Rosemarie Schwenker, Carla Dietrich, Selamawit Hirpa, Thomas Frese, Susanne Unverzagt

Keywords: Motivational Interviewing, substance abuse, general practice, systematic review

Motivational Interviewing (MI) is a widely used psychosocial intervention in the addiction treatment field with the aim of building a person’s intrinsic motivation and commitment to change behaviour. MI is considered a fluid intervention that has been operationalized and implemented differently across studies, sites and providers over nearly four decades. As a result, MI is both a versatile intervention used in a variety of clinical settings and challenging in terms of assessing its effectiveness. We conduct an update of the Cochrane review by Smedslund et al., 2011. We consider specific quality conditions in order to include only studies in which MI was performed accurately.

Research questions:
To assess the effectiveness of MI for substance abuse in relation to levels of substance use and readiness to change.

We adapted the search strategy developed by Smedslund et al. A systematic search of five electronic databases and a registry (CENTRAL, MEDLINE, Embase, PsycINFO, Web of Science Core Collection, CDAG registry) was conducted for randomized controlled trials published from 2010 to 2021.

We identified 3451 references through database searching. After removal of duplicates, we screened the title and abstracts of 1664 studies. Of these, 194 were included for full-text review. Extraction is currently underway for 42 studies. At the EGPRN conference, we will provide an overview of the study population and characteristics, as well as the quality criteria that studies had to meet for inclusion.

Our review is a relevant contribution to general practice professionals, as the results will show that MI can be delivered by a range of professionals in a variety of formats and time frames to a broad patient population with diverse substance dependencies. We will also highlight the importance of quality conditions in clinical research that should be considered in future studies.

Points for discussion:
There are a variety of interventions labeled as MI which presents a methodological challenge in terms of comparing and assessing the effectiveness. Future clinical research on MI should consider and report quality conditions with more transparency and accuracy.

What endpoints or findings would be of particular interest to professionals in general practice?

What has been the experience with the use and the feasibility of MI in general practice?