title: Ophthalmologist-patient communication, self-efficacy, and glaucoma medication adherence.
abstract: OBJECTIVE
  To examine the associations of provider-patient communication, glaucoma medication adherence self-efficacy, and outcome expectations with glaucoma medication adherence.
  
  
  METHODS
  Prospective, observational cohort study.
  
  
  METHODS
  Two hundred seventy-nine patients with glaucoma who were newly prescribed or taking glaucoma medications were recruited at 6 ophthalmology clinics.
  
  
  METHODS
  Patients' visits were video recorded and communication variables were coded using a detailed coding tool developed by the authors. Adherence was measured using Medication Event Monitoring Systems for 60 days after their visits.
  
  
  METHODS
  The following adherence variables were measured for the 60-day period after their visits: whether the patient took 80% or more of the prescribed doses, percentage of the correct number of prescribed doses taken each day, and percentage of the prescribed doses taken on time.
  
  
  RESULTS
  Higher glaucoma medication adherence self-efficacy was associated positively with better adherence with all 3 measures. Black race was associated negatively with percentage of the correct number of doses taken each day (β = -0.16; P < 0.05) and whether the patient took 80% or more of the prescribed doses (odds ratio, 0.37; 95% confidence interval, 0.16-0.86). Physician education about how to administer drops was associated positively with percentage of the correct number of doses taken each day (β = 0.18; P < 0.01) and percentage of the prescribed doses taken on time (β = 0.15; P < 0.05).
  
  
  CONCLUSIONS
  These findings indicate that provider education about how to administer glaucoma drops and patient glaucoma medication adherence self-efficacy are associated positively with adherence.
authors.affiliation: Division of Pharmaceutical Outcomes and Policy, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. Electronic address: betsy_sleath@unc.edu.
authors.forename: Betsy
authors.initials: B
authors.lastname: Sleath
authors.affiliation: Division of Pharmaceutical Outcomes and Policy, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
authors.forename: Susan J
authors.initials: SJ
authors.lastname: Blalock
authors.affiliation: Division of Pharmaceutical Outcomes and Policy, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
authors.forename: Delesha M
authors.initials: DM
authors.lastname: Carpenter
authors.affiliation: Division of Pharmaceutical Outcomes and Policy, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
authors.forename: Robyn
authors.initials: R
authors.lastname: Sayner
authors.affiliation: Department of Ophthalmology, School of Medicine, Duke University, and Durham VA Medical Center, Health Services Research and Development, Durham, North Carolina.
authors.forename: Kelly W
authors.initials: KW
authors.lastname: Muir
authors.affiliation: Division of Pharmaceutical Outcomes and Policy, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
authors.forename: Catherine
authors.initials: C
authors.lastname: Slota
authors.affiliation: Glaucoma Service, Kittner Eye Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
authors.forename: Scott D
authors.initials: SD
authors.lastname: Lawrence
authors.affiliation: Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia.
authors.forename: Annette L
authors.initials: AL
authors.lastname: Giangiacomo
authors.affiliation: Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah.
authors.forename: Mary Elizabeth
authors.initials: ME
authors.lastname: Hartnett
authors.affiliation: Department of Science and Mathematics, Husson University, Bangor, Maine.
authors.forename: Gail
authors.initials: G
authors.lastname: Tudor
authors.affiliation: Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah.
authors.forename: Jason A
authors.initials: JA
authors.lastname: Goldsmith
authors.affiliation: Department of Ophthalmology, University of Maryland, Baltimore, Maryland; Department of Ophthalmology, University of Michigan, Ann Arbor, Michigan; Department of International Health, Bloomberg School of Public Health, and Department of Ophthalmology, School of Medicine, Johns Hopkins University, Baltimore, Maryland.
authors.forename: Alan L
authors.initials: AL
authors.lastname: Robin
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000008:administration & dosage*; D016903:Drug Monitoring; D005260:Female; D005901:Glaucoma / Q000188:drug therapy* / Q000523:psychology; D058015:Health Communication; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel; D006801:Humans; D008297:Male; D008875:Middle Aged; D009883:Ophthalmic Solutions; D009885:Ophthalmology; D010353:Patient Education as Topic; D010817:Physician-Patient Relations; D011446:Prospective Studies; D020377:Self Efficacy; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D000959:Antihypertensive Agents; D009883:Ophthalmic Solutions