Integrating MI into Routine Patient visits
Motivational Interviewing (MI) visits for smoking cessation should take place during regular patient visits. The data from this capstone project shows that patients are more likely to participate in MI sessions when they were done on the same day following regular visits. Patients were also less likely to miss MI sessions and attend sessions when it was scheduled immediately following their appointment. Also the data from this capstone project suggests that time and other appointments were commonly cited as reasons not to participate in the capstone project. Therefore, integration of MI in regular patient visits may also allow patients with a multitude of appointments as well as those with limited time to be able to be exposed to MI to assist them with smoking cessation.
Participation in the capstone project was low. It is likely that the low participation has several causes. First, getting patients to participate in interventions for smoking cessation is often low. Another cause could have been separating regular visits from MI visits. When patients have to enroll in a separate program for smoking cessation, it requires a certain personal level of motivation for that patient. Many patients contacted in the early stages of change may not have been motivated or in the right frame of mind to join a smoking cessation program, demonstrating a self-selection bias. For example, pre-contemplative smokers often will not talk or even want to think about cessation and many are looking for way to continue to smoke. Therefore, some these patients would not be ready to sign up for a smoking cessation program but could still benefit from MI sessions integrated into primary care. If motivational interviewing was integrated in to primary care visits, the need for self-selection is eliminated.
Research has also demonstrated that MI can be effective at treating a variety of other health problems seen commonly in primary care including: cardiovascular disease, diabetes, overweight/obesity, hypertension, drinking, gambling, medication adherence, as well as HIV (Rollnick & Miller, 2008). Also, since motivational interviewing often starts with an assessment at every visit, tobacco assessment could serve as an opening to use MI for smoking cessation with the patient.
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Motivational Interviewing for Smoking Cessation 