Effect of motivational interviewing on medication non-adherence for patients with chronic intraoral pain

Motivational interviewing (MI) is a technique for helping clients to recognize and address their problems. This approach is useful for clients who are reluctant to change or who are ambivalent about changing their behaviors. We describe a case of medication non-adherence in a patient with chronic intraoral neuropathic pain. A 54-year-old man visited the Tokyo Women's Medical University Hospital with spontaneous pain on the gingiva and tongue. Although, pharmacotherapy was initiated, pain management was inadequate. The patient was unwilling to take any more medications (medication non-adherence) because of his previous experience, where the medications prescribed were non-effective in controlling his pain. MI was performed for his ambivalent condition (unwilling to take medicine vs. willing to achieve pain relief). The patient's behavior changed after three MI sessions, and then 2 weeks of pharmacotherapy (amitriptyline, 10 mg/day) decreased the pain score from 8 to 4 on the numerical rating scale (0–10). Another 8 weeks on amitriptyline at 20 mg/day further improved pain score from 4 to 0. MI may be effective as a psychological approach for addressing non-adherence to medication in the management of chronic intraoral pain.