Patient Response to Motivational Interviewing at First Periodontal Visit: A Retrospective Analysis of Associated Factors and Development of a Nomogram-Based Prediction System (GUIDE-MI).

INTRODUCTION: Current knowledge is insufficient to tailor the intensity of motivational interviewing (MI) to individual patients undergoing a periodontal visit. The present study was designed to evaluate the association between patient characteristics and the clinical and psychological outcomes of MI when the latter is administered at the first periodontal consultation. Also, the factors significantly associated with MI outcomes were used to develop a prediction system based on a nomogram (GUIDE-MI).

METHODS: A retrospective analysis was conducted on data from a randomized trial. Changes in Protection Motivation Theory (PMT) scores, assessed immediately after MI, and Plaque Index (PlI), measured after 8-12 weeks, were the primary outcomes. Factors significantly associated with MI outcomes, identified through multiple regression analyses, were combined to develop a nomogram for estimating individual patient responses to MI.

RESULTS: Sixty-six patients were included. MI resulted in significant improvements in both PMT scores and PlI (p < 0.0001 for both). Smaller improvements in PMT scores were associated with lower self-reported shame, higher anxiety/depression levels, greater perceived seriousness and fear of periodontal disease, and higher baseline interest and intention to adhere to treatment (adjusted R2 = 0.56). Reduced PlI improvement was associated with older age, higher daily smoking exposure, less severe periodontal diagnosis, higher fear and pride, and lower determination (adjusted R2 = 0.21).

CONCLUSIONS: MI effectiveness is influenced by patient age, smoking habits, periodontal diagnosis, anxiety/depression, and specific psychological traits. Although exploratory and requiring further validation, the GUIDE-MI nomogram is of potential interest for clinical practice and future research.