Applying the resources and supports in self-management framework to examine ophthalmologist-patient communication and glaucoma medication adherence.
Little is known about how ophthalmologist-patient communication over time is associated with glaucoma patient long-term adherence. The purpose of our study was to examine the association between provider use of components of the resources and supports in self-management model when communicating with patients and adherence to glaucoma medications measured electronically over an 8-month period. In this longitudinal prospective cohort study, the main variables studied were ophthalmologist communication-individualized assessment, collaborative goal setting and skills enhancement. Patients with glaucoma who were newly prescribed or on glaucoma medications were recruited from six ophthalmology clinics. Patients' baseline and next follow-up visits were videotape-recorded. Patients were interviewed after their visits. Patients used medication event monitoring systems (MEMS) for 8 months after enrollment into the study, and adherence was measured electronically using MEMS for 240 days after their visits. Two hundred and seventy-nine patients participated. Patient race and regimen complexity were negatively associated with glaucoma medication adherence over an 8-month period. Provider communication behaviors, including providing education and positive reinforcement, can improve patient adherence to glaucoma medications over an 8-month period.
UNC Eshelman School of Pharmacy & Cecil G. Sheps Center for Health Services Research, betsy_sleath@unc.edu.
B
B
Sleath
Division of Pharmaceutical Outcomes and Policy, UNC Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC 27599, USA.
D M
DM
Carpenter
Division of Pharmaceutical Outcomes and Policy, UNC Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC 27599, USA.
S J
SJ
Blalock
Division of Pharmaceutical Outcomes and Policy, UNC Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC 27599, USA.
R
R
Sayner
Department of Ophthalmology, School of Medicine, Duke University, Durham VA Medical Center, Health Services Research and Development, Durham, NC, USA.
K W
KW
Muir
Division of Pharmaceutical Outcomes and Policy, UNC Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC 27599, USA.
C
C
Slota
Department of Ophthalmology, Emory University School of Medicine, Atlanta, GA 30322, USA.
A L
AL
Giangiacomo
Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, UT 84132, USA.
M E
ME
Hartnett
Department of Science and Mathematics, Director of Institutional Research, Husson University, Bangor, ME 04401, USA.
G
G
Tudor
Department of Ophthalmology, University of Maryland, Baltimore, MD, USA, Department of Ophthalmology, University of Michigan, Ann Arbor, MI, USA, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA, Department of Ophthalmology, Johns Hopkins School of Medicine, Baltimore, MD 21215, USA.
A L
AL
Robin
D000328:Adult; D000368:Aged; D003142:Communication; D005260:Female; D005901:Glaucoma / Q000188:drug therapy*; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D010817:Physician-Patient Relations; D011795:Surveys and Questionnaires; D014743:Videotape Recording