Effectiveness of Transtheoretical Model-Based Motivational Interviewing on Glycemic Control Among Adults With Type 2 Diabetes: A Systematic Review and Meta-Analysis of Randomized Control Trials.
Lizhen Wang, Jing Li, Minghui Zhang and 2 others
PMID 40415259WHAT IT FOUND
In adults with type 2 diabetes, stage-based motivational interviewing lowered HbA1c by 0.92 versus usual care, and improved self-management and self-efficacy.
Session dose varied, so exact frequency is uncertain.
Key findings
01TTM-based motivational interviewing reduced HbA1c compared with usual care or traditional diabetes education (mean difference -0.92, 95% CI -1.08 to -0.75, p < 0.001).
02Fasting plasma glucose and 2-hour postprandial glucose also decreased: standardized mean difference -1.06 and mean difference -1.42 mmol/L, respectively.
03Self-management and self-efficacy scores increased: standardized mean difference 1.47 and 1.53, respectively.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
High heterogeneity was present across trials for all outcomes. Nineteen trials had some concerns and 11 had high risk of bias, especially unclear allocation concealment and inadequate randomization. Publication bias was detected for fasting glucose and 2-hour postprandial glucose. Self-management and self-efficacy relied on self-report scales, and participant blinding was unclear in several trials. Only eight trials reported motivational interviewing fidelity, so quality of delivery was not consistently known. Intervention dose and content varied widely, and most trials were conducted in mainland China.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not assume any motivational interviewing package will reproduce these results. The intervention was TTM-based MI, not MI alone, and the trials did not separate the effects of TTM from MI. Session number, length, total time, and content varied widely, and heterogeneity was high.