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P439 Effectiveness of a training programme on motivational interviewing skills applied to inflammatory bowel disease management

M. Daperno*1, F. Mocciaro2, F. Caprioli3, M. Fantini4, S. Leone5, M. Comberlato6, V. Quercia7

1AO Ordine Mauriziano, Gastroenterology Unit, Torino, Italy, 2ARNAS Ospedale Civico, Gastroenterology Unit, Palermo, Italy, 3IRCCS Ospedale Maggiore, Gastroenterology Unit, Milano, Italy, 4Tor Vergata University, Gastroenterology Department, Roma, Italy, 5EFFCA and AMICI Onlus, Palermo, Italy, 6Bolzano Central Hospital, Department of Gastroenterology, Bolzano, Italy, 7Salesian University Institute, Venezia, Italy

Background

An effective physician–patient communication is essential for adequate patient information, and orienteering of patients towards lifestyle changes and treatment adherence. Traditional physician–patient communication might fail to address correctly some common issues. Compared with non-directed counselling, motivational interviewing (MI) is a more focused and goal-directed, patient-centred counselling style for eliciting behaviour change by helping patients to explore and resolve ambivalence. The IBD CONNECT educational project is a training programme aimed at developing essential MI skills in physicians involved in IBD management.

Methods

A single MI trainer (V.Q.) led the 5 residential courses (and a fifth has been already planned): physicians attending the courses completed an open-question test with 5 clinical scenarios requiring their communicative intervention. The same test was re-administered at the end of a 1-day MI course. All tests were scored according to the Helpful Responses Questionnaire (HRQ), a brief free response questionnaire. Pre-post-educational programme scores were recorded and compared.

Results

In total, 52 physicians attended 5 meetings. Pre-course median HRQ score was 5 (95% CI 5–5), whereas post-course median score was 17 (95% CI 15–19): the difference was highly significant (p < 0.0001). The average score/question raised from 1 (95% CI 1–1) to 3.4 (95% CI 3–3.8), p < 0.0001. After the training, the median increase in HRQ total score was 10.5 points (95% CI 7.5–13), meaning 2.1 (95% CI 1.5–2.6) points/question. In Figure 1, shift of scores is presented graphically. At basal evaluation, 45/52 (86%) did not reach a sufficient MI level in any of the 5 questions, whereas only 6/52 (12%, p < 0.01) did not score a sufficient HRQ score at least in 1 of the 5 questions (and 62% had a sufficient HRQ for 4 to 5 questions).

Figure 1. Distribution of average HRQ scores before and after training.

Conclusion

The IBD CONNECT educational programme demonstrated that a 1-day MI educational programme leads to a significant increase in MI skills of physicians managing IBD. Continuous MI educational programme are advisable to increase proficiency of physicians in MI, to deliver more effectively information, and to contribute to patients’ lifestyle changes and increase their treatment adherence.