P200. Motivational interviewing in inflammatory bowel disease patients: data from a pilot study
F. Mocciaro1, R. Di Mitri1, S. Leone2, A. Calì1, A. Marino1, 1Gastroenterology and Endoscopy Unit, ARNAS Civico-Di Cristina-Benfratelli Hospital, Palermo, Italy, 2CEO of AMICI, Palermo, Italy
Motivational interviewing (MI) is a patient-centered counseling style developed for eliciting behavior change by helping patients to modify their approach to life. For a successful MI some basic skills should be established: the ability to ask open ended questions, the ability to provide affirmations, the capacity for reflective listening, and the ability to periodically provide summary statements to the patients. We report a pilot experience on MI applied to inflammatory bowel disease (IBD) patients at their first outpatient visit.
Between Jun.-Sep. 2012 we used MI, with the aid of explanatory pictures, during the first visit in all consecutive IBD patients referred to our outpatient clinic. At the end of visit patients filled out a questionnaire, anonymously and in a separate room, comparing the visit with their prior experience.
30 patients (17 males [56.6%]) with a mean age of 32.5±14.5 years were evaluated. The median disease duration was 7 months (range 1–120). Seventeen patients were affected by Crohn's disease (56.6%), 8 by ulcerative colitis (26.6%), and 5 by indeterminate colitis (16.8%). Twenty-two patients had earned a diploma (73.3%) and 63.3% (19/30) were employed full-time. At final analysis only 60% of the patients (18/30) were previously evaluated by a gastroenterologist with a satisfaction rate of 44.4% (8/18); this rate was 16.6% (2/12) in patients evaluated only by general practitioner. Sixteen/30 patients (53.3%) reported an unsatisfactory interview based on the physicians lack of empathy. Younger patients (<40 years) had a significant dissatisfaction compared to older patients (p = 0.2) while no differences were found considering level of education or employment status. After MI all patients (100%) reported a good satisfaction rate (93.3% marked “excellent”) due to the fact that they felt they had complete answers to their questions. All patients expressed excellent physicians' empathy and liking the use of explanatory pictures. The mean duration of visit was 43.2±10.1 minutes.
Our pilot experience showed that MI is very well appreciated by IBD patients. It is a time-consuming technique but considerably useful especially at the first visit of younger patients. Explanatory pictures help patients to better understand their clinical condition. MI can help physicians, especially gastroenterologists, to move from “cure” to “care” with their IBD patients.