Use of Motivational Interviewing Skills to Increase Diabetic Type 2 Compliance

Diabetes is a chronic disease in which patients suffer from low compliance with medical advice. Healthcare professionals are able to motivate diabetes self-management adherence, but sometimes lack the knowledge and resources needed to apply evidenced-based approaches. In this quality improvement project, diabetes educators were taught a technique to increase the compliance of diabetes patients through motivational interviewing (MI). MI has been instrumental in improving HbA1c, weight, BMI, and compliance for diabetes patients; this quality improvement project applied the use of MI techniques to increase compliance for patients in a Utah Diabetes and Endocrinology Clinic (UDEC). This project used a 21-question pretest-posttest survey, pre-observation of the diabetes educators teaching style, two short in-services on the use of MI techniques and hours of shadowing the educators with feedback afterward to support improvement in utilizing the MI techniques. Individual and group feedback was given to the educators regarding MI techniques. The six-month intervention showed an improvement in perception by educators in using MI techniques. When comparing pretest against posttest results, several responses indicated a significant increase in nurse educator ability and confidence using MI. There were also improvements (p=0.04) in the HbA1c levels of patients seen by diabetic educators over the six-month duration of this project. This change was encouraging, however, could not be solely attributed to the efforts of this project. MI techniques have proved effective in other chronic diseases and are showing significant effectiveness in compliance for diabetes. This project was successful in teaching local diabetic educators to use MI as a method for encouraging diabetic patients to manage their disease. Suggested next steps would be to conduct extensive training in the MI technique for all the clinicians in the UDEC clinic and put these techniques into daily practice.