Motivational Interviewing as a Strategy to Improve Adherence in IBD Treatment: An Integrative Review Amidst COVID-19 Disruptions

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

Regarding the article entitled: Motivational Interviewing as a Strategy to Improve Adherence in IBD Treatment: An Integrative Review Amidst COVID-19 Disruptions, I continue with some considerations:

- references need to be reviewed, for example, in the introduction, the authors cite Schoefs et al., 2023; Chassaing et al., 2015, Damião et al., 2019 to characterize IBD, however, I recommend using classic references and reviews on the topic, which are more suitable for the purpose. Readjust all references.

- In the references item, they appear numbered, however, in the text, they are not. It needs to be readjusted.

- The introduction is very long, it could be more cohesive, issues such as COVID could be better used to discuss the results, considering that the work covers periods unrelated to the pandemic,

- The formatting of tables and charts must be reviewed to facilitate understanding,

 

Regarding the article, the way in which the authors use references is extremely relevant. In much of the introduction, it was possible to see that they use citations of citations, in an attempt to present updated references.
For example, in the sentence: Inflammatory bowel disease (IBD) is a common term for a series of clinical phenotypes caused by chronic, relapsing, and remitting inflammation of the gastrointestinal tract
(Schoefs, E., Vermeire, S., Ferrante, M., Sabino, J., Lambrechts, T., Avedano, L., Haaf, I., De Rocchis, M.S., Broggi, A., Sajak-Szczerba, M., Saldaña, R., Janssens, R., Huys, I., 2023. What are the Unmet Needs and Most Relevant Treatment Outcomes According to Patients with Inflammatory Bowel Disease? A Qualitative Patient Preference Study. J. Crohn’s Colitis 17, 379–388) there is a mistake in placing Schoefs’ authorship of this statement, even more so, as the work does not deal with a review of the disease itself. I found the same problem in several quotes. There are updated reviews that can be used to contextualize the disease and provide relevant epidemiological data. The mistaken way of citing works caught my attention, therefore, I consider that all references must be properly reviewed and therefore, I considered that the work is not appropriate, considering that the scientific basis is extremely important to support any new result that you want to show.
Another question is about the year of the works presented and the relationship with COVID. I believe that one should be careful with the associations that were described in the paper.

Author Response

Dear Editor and Reviewers, thank you for your valuable suggestions and comments. We have tried to respond to all your comments regarding our article, confident that the changes we made have strengthened the manuscript

REVIEWER 1:

Regarding the article entitled: Motivational Interviewing as a Strategy to Improve Adherence in IBD Treatment: An Integrative Review Amidst COVID-19 Disruptions, I continue with some considerations:

• References need to be reviewed, for example, in the introduction, the authors cite Schoefs et al., 2023; Chassaing et al., 2015, Damião et al., 2019 to characterize IBD, however, I recommend using classic references and reviews on the topic, which are more suitable for the purpose. Readjust all references.

Thank you for your valuable observations. To improve the quality of the references, the selection has been reconsidered and the mentioned citation has been replaced with more accredited and recognized sources in the field of Inflammatory Bowel Disease (IBD). As you will see in the new version of the manuscript, classic references and authoritative reviews have been included to provide a solid foundation for our work.

• In the references item, they appear numbered, however, in the text, they are not. It needs to be readjusted.

Thanks for the valuable suggestion. As you will see in this new version of the manuscript the bibliographic style has been made uniform.

• The introduction is very long, it could be more cohesive, issues such as COVID could be better used to discuss the results, considering that the work covers periods unrelated to the pandemic.

Thank you for the important suggestion. The introduction has been made more cohesive, briefly exploring the implications of the pandemic for chronic patients such as those with IBD. The manuscript has now gained greater strength. As you will read in the new version of the manuscript, in the discussion section, the results have been further contextualized, highlighting the difficulties encountered during the COVID period:   ”However, these results need to be interpreted in light of the current healthcare landscape, which has been significantly impacted by the COVID-19 pandemic [65]. The COVID-19 pandemic has caused unprecedented disruptions in various aspects of gastroenterology healthcare services worldwide [66], emphasizing the need to modify the delivery methods of healthcare services [67] to implement a proactive approach to care. The health services most affected were those dealing with the management of chronic diseases [68]”.

• The formatting of tables and charts must be reviewed to facilitate understanding.

Thank you for your valuable feedback. The tables concerning data extraction and quality appraisal have been formatted to facilitate its comprehension.

• Regarding the article, the way in which the authors use references is extremely relevant. In much of the introduction, it was possible to see that they use citations of citations, in an attempt to present updated references. For example, in the sentence: Inflammatory bowel disease (IBD) is a common term for a series of clinical phenotypes caused by chronic, relapsing, and remitting inflammation of the gastrointestinal tract (Schoefs, E., Vermeire, S., Ferrante, M., Sabino, J., Lambrechts, T., Avedano, L., Haaf, I., De Rocchis, M.S., Broggi, A., Sajak-Szczerba, M., Saldaña, R., Janssens, R., Huys, I., 2023. What are the Unmet Needs and Most Relevant Treatment Outcomes According to Patients with Inflammatory Bowel Disease? A QualitativePatient Preference Study. J. Crohn’s Colitis 17, 379–388) there is a mistake in placing Schoefs’ authorship of this statement, even more so, as the work does not deal with a review of the disease itself. I found the same problem in several quotes. There are updated reviews that can be used to contextualize the disease and provide relevant epidemiological data. The mistaken way of citing works caught my attention, therefore, I consider that all references must be properly reviewed and therefore, I considered that the work is not appropriate, considering that the scientific basis is extremely important to support any new result that you want to show.

Thank you for your valuable feedback. We understand the importance of accurately citing sources to support the scientific foundation of manuscript; sorry for mistake.The necessary revisions have been made to address any inaccuracies or misattributions in source citation. Your feedback has been instrumental in improving the quality of the manuscript.

• Another question is about the year of the works presented and the relationship with COVID. I believe that one should be careful with the associations that were described in the paper.

Thank you for your valuable feedback. In this new version of the manuscript, it has been clarified how the pandemic period has influenced healthcare services and the need to adapt care approaches for patients with IBD. In particular, we have sought to make it clearer how Motivational Interviewing has been identified as a potentially advantageous strategy for improving patient adherence and compliance, even when implemented through remote methods (e.g., telephone counseling), representing the preferred alternative to treatments prior to the pandemic period (Pellegrino et al., 2022).

Reviewer 2 Report

Comments and Suggestions for Authors

This review by Caterina Mercuri et al. analyzed the effectiveness of Motivational Interviewing (MI) in enhancing therapeutic adherence and compliance in adult patients with Inflammatory Bowel Disease (IBD), especially considering the disruptions caused by the COVID-19 pandemic. The authors utilized an integrative methodology that combines qualitative and quantitative research, following a 7-step framework. The authors conclude that MI shows promise in enhancing adherence among adult IBD patients. The work is scientifically sound and study methods are appropriate. The manuscript is well written overall and adequate references are included. The manuscript can be improved by addressing the following concerns.

-       Introduction section needs a bit more work. The authors may want to focus on adherence and compliance issues in IBD patients and the role if MI in improving those concerns.

-       The studies included demonstrated MI’s effectiveness in enhancing adherence among IBD patients. However, included studies were all published prior to COVID-19 pandemic and 2 of them were case reports. The authors may want to discuss in detail how these results could be applied to improve adherence and compliance issues in IBD patients during the pandemic era. Consider discussing each study and how the results can improve adherence and compliance now in the Discussion section.

Author Response

Dear Editor and Reviewers, thank you for your valuable suggestions and comments. We have tried to respond to all your comments regarding our article, confident that the changes we made have strengthened the manuscript.

This review by Caterina Mercuri et al. analyzed the effectiveness of Motivational Interviewing (MI) in enhancing therapeutic adherence and compliance in adult patients with Inflammatory Bowel Disease (IBD), especially considering the disruptions caused by the COVID-19 pandemic. The authors utilized an integrative methodology that combines qualitative and quantitative research, following a 7-step framework. The authors conclude that MI shows promise in enhancing adherence among adult IBD patients. The work is scientifically sound and study methods are appropriate. The manuscript is well written overall and adequate references are included.

Thank you very much for your feedback.  We are pleased to hear that you found our work scientifically sound and that our study methods were deemed appropriate. We are committed to addressing your suggestions comprehensively to enhance the quality of our manuscript. The manuscript can be improved by addressing the following concerns.

• Introduction section needs a bit more work. The authors may want to focus on adherence and compliance issues in IBD patients and the role if MI in improving those concerns.

Thank you for your precious advice. As you can now read in this new version of the manuscript, in the introduction section, greater emphasis was placed on the challenges related to adherence and compliance in patients with IBD, highlighting the fundamental role of motivational interviewing in addressing these concerns. The importance of addressing these challenges was emphasized, considering their significant impact on the long-term management of the disease and the quality of life of patients. This introductory context provides a foundation for exploring how motivational interviewing represents a promising approach to address these challenges and improve treatment adherence in patients with IBD.

• The studies included demonstrated MI’s effectiveness in enhancing adherence among IBD patients. However, included studies were all published prior to COVID-19 pandemic and 2 of them were case reports. The authors may want to discuss in detail how these results could be applied to improve adherence and compliance issues in IBD patients during the pandemic era. Consider discussing each study and how the results can improve adherence and compliance now in the Discussion section.

Thank you for the valuable feedback. In this new version of maniscript the discussion section has been revised to provide a more detailed examination of how the findings from pre-pandemic studies on the effectiveness of MI in improving adherence among patients with IBD can be applied to the current healthcare landscape shaped by the pandemic. Each of the included studies has been discussed, highlighting key findings related to the impact of MI on adherence and compliance. Additionally, we explored how these results can be extended to the pandemic era, particularly in the context of remote healthcare delivery modalities such as telemedicine. Issues such as increased psychological distress among patients, disruptions to healthcare services, and the need for innovative approaches to support medication adherence and disease management remotely have been addressed. Thank you for the opportunity to address these important considerations.

Reviewer 3 Report

Comments and Suggestions for Authors

Dear Editor

 This is an study regarding motivational interviewing among IBD patients. The followings are my comments. 

#1. The final study includes two case reports and one systematic review. Why the content in the systematic review excluded during your literature research?

#2. Base on your PRISMA Flowchart, please provide reasons why articles excluded in each steps of search.  

 

Comments on the Quality of English Language

Dear Editor

 This is an study regarding motivational interviewing among IBD patients. The followings are my comments. 

#1. The final study includes two case reports and one systematic review. Why the content in the systematic review excluded during your literature research?

#2. Base on your PRISMA Flowchart, please provide reasons why articles excluded in each steps of search.  

Author Response

Dear Editor and Reviewers, thank you for your valuable suggestions and comments. We have tried to respond to all your comments regarding our article, confident that the changes we made have strengthened the manuscript.

This is an study regarding motivational interviewing among IBD patients. The followings are my comments. 

• The final study includes two case reports and one systematic review. Why the content in the systematic review excluded during your literature research?

Thank you for your valuable feedback. The exclusion of articles included in the systematic review during the literature research was a methodological choice based on the design of the paper. As articulated by Dhollande and colleagues, "Whittemore and Knafl (2005) suggest that randomized controlled trials, prospective and retrospective cohort studies, case-control studies, cross-sectional studies, systematic reviews, and meta-analyses should all be included within the search strategy. Therefore, there are no biases based on the type of publication sourced (Hammerstrøm et al. 2017)". Given that the study follows the integrative review framework outlined by Dhollande and colleagues, the objective was to synthesize findings from diverse sources, encompassing both empirical studies and theoretical literature, to offer a comprehensive understanding of the topic. Indeed, "integrative reviews assimilate research data from various research designs to reach conclusions that are comprehensive and reliable (Soares et al. 2014)". Hence, the decision was made to incorporate the systematic review summarizing the four papers aligned with the research scope. We hope that this clarification adequately addresses the concerns raised.

• Base on your PRISMA Flowchart, please provide reasons why articles excluded in each steps of search.

Thank you for your comment. The exclusion reasons have been clarified at each step of the search reported in the PRISMA Flowchart.

Round 2

Reviewer 3 Report

Comments and Suggestions for Authors

Dear Editor

 The authors respond to questions raised. I have no more comments. 

Comments on the Quality of English Language

 The authors respond to questions raised. I have no more comments.