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. 2010 Oct 5:4:1091-101.
doi: 10.2147/OPTH.S12765.

Feasibility of motivational interviewing delivered by a glaucoma educator to improve medication adherence

Paul F Cook  1 , Robert W Bremer, A J Ayala, Malik Y Kahook
Affiliations

Feasibility of motivational interviewing delivered by a glaucoma educator to improve medication adherence

Paul F Cook et al. Clin Ophthalmol. .

Abstract

Introduction: Adherence to glaucoma treatment is poor, potentially reducing therapeutic effects. A glaucoma educator was trained to use motivational interviewing (MI), a patient-centered counseling style, to improve adherence. This study was designed to evaluate whether MI was feasible in a busy ophthalmology practice.

Methods: Feasibility was assessed using five criteria from the National Institutes of Health Behavior Change consortium: fidelity of intervention components to MI theory; success of the training process; delivery of MI-consistent interventions by the glaucoma educator; patient receipt of the intervention based on enrollment, attrition, and satisfaction; and patient enactment of changes in motivation and adherence over the course of the intervention.

Results: A treatment manual was designed by a multidisciplinary team with expertise in health psychology, public health, and ophthalmology. The glaucoma educator received 6 hours of training including role-play exercises, self-study, and individual supervision. His MI-related knowledge and skills increased following training, and he delivered exclusively MI-consistent interventions in 66% of patient encounters. 86% (12/14) of eligible patients agreed to be randomized into glaucoma educator support or a control condition. All 8 patients assigned to the glaucoma educator completed at least 2 of 6 planned contacts, and 50% (4/8) completed all 6 contacts. Patients assigned to the glaucoma educator improved over time in both motivation and adherence.

Conclusion: The introduction of a glaucoma educator was feasible in a busy ophthalmology practice. Patients improved their adherence while participating in the glaucoma educator program, although this study was not designed to show a causal effect. The use of a glaucoma educator to improve glaucoma patients' medication adherence may be feasible at other ophthalmology clinics, and can be implemented with a standardized training approach. Pilot data show the intervention can be implemented with fidelity, is acceptable to patients and providers, and has the potential to improve adherence.

Keywords: adherence; counseling; glaucoma; medication; training.

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Figures

Figure 1
Figure 1
Study recruitment and participant flow.
See this image and copyright information in PMC

References

    1. Hyman L, Wu SY, Connell AM, et al. Prevalence and causes of visual impairment in the Barbados Eye Study. Ophthalmology. 2001;108(10):1751–1756. - PubMed
    1. Quigley HA. Number of people with glaucoma worldwide. Br J Ophthalmol. 1996;80(5):389–393. - PMC - PubMed
    1. Friedman DS, Wolfs RC, Colmain BJ, et al. Prevalence of open-angle glaucoma among adults in the United States. Arch Ophthalmol. 2004;122(4):532–538. - PMC - PubMed
    1. Quigley HA, Vitale S. Models of open-angle glaucoma prevalence and incidence in the United States. Invest Ophthalmol Vis Sci. 1997;38(1):83–91. - PubMed
    1. Meichenbaum DC, Turk D. Facilitating Treatment Adherence: A Practitioner’s Guidebook. New York, NY: Plenum Press; 1987.