Shared Decision Making in Asthma Treatment: Using Motivational Communication to Elevate Your Consultations

Authors

  • Anda I. Dragomir, PhD Department of Health, Kinesiology and Applied Physiology, Concordia University; Montréal, Canada Montréal Behavioural Medicine Centre, Hôpital du Sacré-Coeur de Montréal, Montréal, Canada
  • Kim L. Lavoie, PhD Montréal Behavioural Medicine Centre, Hôpital du Sacré-Coeur de Montréal, Montréal, Canada; Department of Psychology, Université du Québec à Montréal, Montréal, Canada

DOI:

https://doi.org/10.58931/cait.2024.4165

Abstract

The extent to which patients are adherent to their medication regimen is critical for achieving good asthma control, preventing exacerbations, and optimizing the likelihood that patients can lead full and productive lives. Knowing this, physicians might perceive that their role is to convince their patients to comply with their prescribed medicines using educational or persuasive advice-giving strategies that focus on the health benefits of treatment compliance and the negative health consequences of non-compliance. However, evidence suggests that evoking fear of negative consequences is a poor motivator for both the adoption, and long-term maintenance, of good health behaviors such as medication adherence. In an effort to make the maladaptive behavior the ‘less desirable choice’, physicians often inadvertently become associated with the fear messages they share (through classical conditioning) and the negative emotions they elicit (through operant conditioning). This may result in physicians themselves becoming aversive to their patients, leading to patients disengaging from the therapeutic relationship and becoming resistant to treatment recommendations. In fact, treatment success depends not on the imperative to convince and control patient behavior (which defines compliance), but on the willingness to collaborate with the patient to co-construct a treatment plan that they agree with and want to follow (which defines adherence). The key takeaway is to recognize that non-collaborative communication is ineffective for behavior change and may actually be counterproductive, if not harmful.

Author Biographies

Anda I. Dragomir, PhD, Department of Health, Kinesiology and Applied Physiology, Concordia University; Montréal, Canada Montréal Behavioural Medicine Centre, Hôpital du Sacré-Coeur de Montréal, Montréal, Canada

Dr. Anda Dragomir is a clinical psychologist and post-doctoral fellow at Concordia University. Her research focuses on behaviour-change counselling training to improve physicians’ efficacy in addressing lifestyle changes with patients suffering from chronic diseases, which she leads in partnership with the Montreal Behavioural Medicine Centre. She has received extensive training in psychophysiology and behavioural trial design and development and was invited to present her work at international conferences in the form of symposiums and workshops. She works as a clinician with adult populations as well as with individuals suffering from chronic pain and other chronic medical conditions. 

Kim L. Lavoie, PhD, Montréal Behavioural Medicine Centre, Hôpital du Sacré-Coeur de Montréal, Montréal, Canada; Department of Psychology, Université du Québec à Montréal, Montréal, Canada

Dr. Kim Lavoie is a professor and Canada Research Chair in Behavioral Medicine at the University of Quebec at Montreal. She is the Co-Director of the Montreal Behavioral Medicine Centre, a fellow of the Academy of Behavioral Medicine Research and co-Lead of the International Behavioral Trials Network (IBTN). She is internationally recognized for her research on chronic disease prevention (with a focus on heart, lung, and metabolic diseases) and the impact of behavioral interventions, such as motivational communication, on health behaviors and chronic disease outcomes. She is an international leader in the training of healthcare providers in motivational communication, having designed multiple training programs resulting in more than 20,000 trained worldwide. 

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Published

2024-06-19

How to Cite

1.
Dragomir AI, Lavoie KL. Shared Decision Making in Asthma Treatment: Using Motivational Communication to Elevate Your Consultations. Can Allergy Immunol Today [Internet]. 2024 Jun. 19 [cited 2024 Oct. 10];4(1):19—24. Available from: https://canadianallergyandimmunologytoday.com/article/view/4-1-dragomir-et-al

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