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Abstract：
OBJECTIVE: This systematic review examines the effectiveness of motivational interviewing (MI) on medication adherence for preventing recurrent stroke and transient ischemic attack (TIA).
METHODS: MEDLINE (via PubMed), CINAHL, PsycINFO, CENTRAL, and ClinicalTrials.gov were searched from inception to 12 June 2023. Randomized controlled trials comparing MI with usual care or interventions without MI in participants with any stroke type were identified and summarized descriptively. Primary outcome was medication adherence. Secondary outcomes were quality of life (QoL) and different clinical outcomes. We assessed risk of bias with RoB 2 (revised Cochrane risk-of-bias tool) and intervention complexity with the iCAT_SR (intervention Complexity Assessment Tool for Systematic Reviews).
RESULTS: We screened 691 records for eligibility and included four studies published in five articles. The studies included a total of 2751 participants, and three were multicentric. Three studies had a high risk of bias, and interventions varied in complexity. Two studies found significantly improved medication adherence, one at 9 (96.9% vs. 88.2%, risk ratio = 1.098, 95% confidence interval = 1.03-1.17) and one at 12 months (97.0% vs. 95.0%, p = 0.026), but not at other time points, whereas two other studies reported no significant changes. No significant differences were found in QoL or clinical outcomes.
CONCLUSIONS: Evidence on MI appears inconclusive for improving medication adherence for recurrent stroke and TIA prevention, with no benefits on QoL and clinical outcomes. There is a need for robustly designed studies and process evaluations of MI as a complex intervention for people with stroke.
BACKGROUND: PROSPERO (CRD42023433284).
METHODS: MEDLINE (via PubMed), CINAHL, PsycINFO, CENTRAL, and ClinicalTrials.gov were searched from inception to 12 June 2023. Randomized controlled trials comparing MI with usual care or interventions without MI in participants with any stroke type were identified and summarized descriptively. Primary outcome was medication adherence. Secondary outcomes were quality of life (QoL) and different clinical outcomes. We assessed risk of bias with RoB 2 (revised Cochrane risk-of-bias tool) and intervention complexity with the iCAT_SR (intervention Complexity Assessment Tool for Systematic Reviews).
RESULTS: We screened 691 records for eligibility and included four studies published in five articles. The studies included a total of 2751 participants, and three were multicentric. Three studies had a high risk of bias, and interventions varied in complexity. Two studies found significantly improved medication adherence, one at 9 (96.9% vs. 88.2%, risk ratio = 1.098, 95% confidence interval = 1.03-1.17) and one at 12 months (97.0% vs. 95.0%, p = 0.026), but not at other time points, whereas two other studies reported no significant changes. No significant differences were found in QoL or clinical outcomes.
CONCLUSIONS: Evidence on MI appears inconclusive for improving medication adherence for recurrent stroke and TIA prevention, with no benefits on QoL and clinical outcomes. There is a need for robustly designed studies and process evaluations of MI as a complex intervention for people with stroke.
BACKGROUND: PROSPERO (CRD42023433284).
摘要：
目的：本系统评价研究了动机性访谈（MI）对预防复发性中风和短暂性脑缺血发作（TIA）的药物依从性的有效性。
方法：MEDLINE（通过PubMed），CINAHL,PsycINFO,中部,和ClinicalTrials.gov从开始到2023年6月12日进行了搜索。对具有任何卒中类型的参与者中MI与常规治疗或无MI干预的随机对照试验进行鉴定和描述性总结。主要结果是药物依从性。次要结果是生活质量（QoL）和不同的临床结果。我们使用RoB2（修订的Cochrane偏差风险工具）评估偏倚风险，并使用iCAT_SR（系统评价干预复杂性评估工具）评估干预复杂性。
结果：我们筛选了691条符合资格的记录，并纳入了发表在五篇文章中的四项研究。这些研究共包括2751名参与者，三个是多中心的。三项研究有很高的偏倚风险，干预措施的复杂性各不相同。两项研究发现，药物依从性显著提高，9岁时一人（96.9%vs.88.2%,风险比=1.098，95%置信区间=1.03-1.17）和12个月时的风险比（97.0%vs.95.0%,p=0.026),但不是在其他时间点，而另外两项研究报告无显著变化.在QoL或临床结果方面没有发现显着差异。
结论：关于MI的证据似乎对改善复发性卒中和TIA预防的药物依从性尚无定论。对QoL和临床结果没有益处。需要对MI进行严格设计的研究和过程评估，以作为中风患者的复杂干预措施。
背景：PROSPERO（CRD42023433284）。
方法：MEDLINE（通过PubMed），CINAHL,PsycINFO,中部,和ClinicalTrials.gov从开始到2023年6月12日进行了搜索。对具有任何卒中类型的参与者中MI与常规治疗或无MI干预的随机对照试验进行鉴定和描述性总结。主要结果是药物依从性。次要结果是生活质量（QoL）和不同的临床结果。我们使用RoB2（修订的Cochrane偏差风险工具）评估偏倚风险，并使用iCAT_SR（系统评价干预复杂性评估工具）评估干预复杂性。
结果：我们筛选了691条符合资格的记录，并纳入了发表在五篇文章中的四项研究。这些研究共包括2751名参与者，三个是多中心的。三项研究有很高的偏倚风险，干预措施的复杂性各不相同。两项研究发现，药物依从性显著提高，9岁时一人（96.9%vs.88.2%,风险比=1.098，95%置信区间=1.03-1.17）和12个月时的风险比（97.0%vs.95.0%,p=0.026),但不是在其他时间点，而另外两项研究报告无显著变化.在QoL或临床结果方面没有发现显着差异。
结论：关于MI的证据似乎对改善复发性卒中和TIA预防的药物依从性尚无定论。对QoL和临床结果没有益处。需要对MI进行严格设计的研究和过程评估，以作为中风患者的复杂干预措施。
背景：PROSPERO（CRD42023433284）。
