title: Communication Predicts Medication Self-Efficacy in Glaucoma Patients.
abstract: Medication self-efficacy, or patients' confidence that they can perform medication-related behaviors, is associated with better glaucoma medication adherence. Little is known about how to enhance glaucoma patients' medication self-efficacy. Our purpose is to examine whether patient-provider communication increases glaucoma patients' medication self-efficacy.
  
  
  
  During an 8-month cohort study of 279 glaucoma patients and 15 providers, two office visits were videotape-recorded, transcribed, and coded for six patient-provider communication behaviors. A validated scale was used at baseline and 8-month follow-up to assess patients' confidence in overcoming adherence barriers (adherence barriers self-efficacy) and carrying out tasks to use eye drops correctly (eye drop task self-efficacy). We ran two generalized estimating equations to examine whether more frequent patient-provider communication during office visits predicted increased patient adherence barriers self-efficacy and eye drop task self-efficacy at 8-month follow-up.
  
  
  
  For each additional topic providers educated about, patients reported an average increase of 0.35 in self-efficacy in overcoming adherence barriers (p < 0.001). Patients also reported an average increase of 1.01 points in eye drop task self-efficacy when providers asked about patients' views of glaucoma and its treatment versus not (p < 0.001). Patients who asked more medication questions (p < 0.001) and African-American patients (p < 0.05) reported lower adherence barriers self-efficacy by 0.30 and 2.15 points, respectively. Women had a 0.63 lower eye drop task self-efficacy than men (p < 0.05).
  
  
  
  When providers educate glaucoma patients and assess patient views about glaucoma and its treatment, patients report higher medication self-efficacy. Providers should be aware that patients who ask more medication questions may have less confidence in their ability to overcome barriers to adherence.
authors.affiliation: *PhD, MSPH †PhD, MPH ‡PharmD §MD ∥PhD Division of Pharmaceutical Outcomes and Policy (DMC), University of North Carolina at Chapel Hill, Asheville Satellite Campus, Asheville, North Carolina; Division of Pharmaceutical Outcomes and Policy (SJB, BLS), University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; School of Medicine (RS), Stanford University, Stanford, California; Duke University School of Medicine & Durham VA Medical Center (KWM), Durham, North Carolina; Wilmer Institute and Bloomberg School of Public Health (ALR), Johns Hopkins University, Baltimore, Maryland; Department of Ophthalmology (ALR), University of Maryland, College Park, Maryland; John A. Moran Eye Center (MEH), University of Utah, Salt Lake City, Utah; School of Medicine (ALG), Emory University, Atlanta, Georgia; and Department of Mathematics and Statistics (GET), Husson University, Bangor, Maine.
authors.forename: Delesha M
authors.initials: DM
authors.lastname: Carpenter
authors.forename: Susan J
authors.initials: SJ
authors.lastname: Blalock
authors.forename: Robyn
authors.initials: R
authors.lastname: Sayner
authors.forename: Kelly W
authors.initials: KW
authors.lastname: Muir
authors.forename: Alan L
authors.initials: AL
authors.lastname: Robin
authors.forename: Mary Elizabeth
authors.initials: ME
authors.lastname: Hartnett
authors.forename: Annette L
authors.initials: AL
authors.lastname: Giangiacomo
authors.forename: Gail E
authors.initials: GE
authors.lastname: Tudor
authors.forename: Betsy L
authors.initials: BL
authors.lastname: Sleath
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D015331:Cohort Studies; D005260:Female; D005901:Glaucoma / Q000188:drug therapy*; D058015:Health Communication / Q000379:methods*; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D009883:Ophthalmic Solutions; D010353:Patient Education as Topic / Q000379:methods*; D010817:Physician-Patient Relations; D020377:Self Efficacy; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D000959:Antihypertensive Agents; D009883:Ophthalmic Solutions