The reasons why fibromyalgia (FM) patients fail to adhere to medical advice are complex and multifactorial, with consequent challenge to effective medical care. While adherence to medication treatments is generally poor, adherence to lifestyle intervention recommendations may be even poorer1,2. FM is a condition without cure at this time and with symptoms expected to be lifelong for most. Current guidelines recommend regular physical activity as a critical and necessary treatment strategy for FM; both short-term and longterm benefits of exercise have been demonstrated, emphasizing the need to promote adherence to these recommendations3,4,5,6. Nevertheless, continued practice of exercise by FM patients remains poor7. Strategies proposed to maintain adherence include patient education and empowerment, encouragement to participate in an activity that is pleasurable and convenient, and psychological interventions that may include cognitive behavioral training or motivational interviewing (MI)8.
MI is a patient-centered technique that aims to facilitate patient involvement in maintaining good, health-centered behavior patterns. This psychological strategy, developed in the 1980s, was initially used in the management of substance abuse disorders9. As the popularity of MI increased, along with the appreciation of the importance of active patient/person participation in health care, it was used in various other health-related settings such as prevention programs for smoking and alcohol use in youth, and then to a wider application to promote adherence to treatment recommendations in diverse diseases. The objective of MI is to sufficiently motivate a person to develop a closed loop of achievement, whereby a person is able to set and achieve goals that will continue to provide personal motivation by generating a self-sustaining loop.
MI may be delivered in various formats, including face-to-face encounter, telephone contact or online groups, as well …
Address correspondence to Dr. M.A. Fitzcharles, Montreal General Hospital, 1650 Cedar Ave., Montreal, Quebec H3G 1A4, Canada. E-mail: mary-ann.fitzcharles{at}muhc.mcgill.ca