Improved Glaucoma Medication Adherence in a Randomized Controlled Trial.
Date
2022-01
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Abstract
Purpose
To test the effectiveness of an intervention designed to improve glaucoma medication adherence.Design
Randomized, controlled trial at a Veterans Affairs (VA) eye clinic.Participants
Veterans with medically treated glaucoma who reported poor adherence and their companions if applicable.Methods
Participants, and their companions if applicable, were randomized to receive an intervention to improve medication adherence that included glaucoma education, personalized disease management suggestions, and a reminder aid, or the control arm that received education regarding general eye health.Main outcome measures
The average proportion of prescribed glaucoma medication doses taken on schedule over the 6 months after randomization according to an electronic monitor between participants in the 2 arms.Results
The mean proportion of prescribed doses taken on schedule was higher in the intervention group compared with controls (0.85 vs. 0.62, P < 0.0001). The difference in proportions between the 2 groups did not vary in regressions models adjusted for companion status, frequency of dosing, and race. The longitudinal model indicated that the intervention group had significantly higher adherence during the first month after randomization and continued to stay higher through 6 months (month by treatment interaction, P = 0.003).Conclusions
A multifaceted intervention can help improve glaucoma medication adherence.Type
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Publication Info
Muir, Kelly W, Jullia A Rosdahl, Aaron M Hein, Sandra Woolson, Maren K Olsen, Miriam Kirshner, Malina Sexton, Hayden B Bosworth, et al. (2022). Improved Glaucoma Medication Adherence in a Randomized Controlled Trial. Ophthalmology. Glaucoma, 5(1). pp. 40–46. 10.1016/j.ogla.2021.04.006 Retrieved from https://hdl.handle.net/10161/29627.
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Scholars@Duke
Kelly Walton Muir
Kelly W. Muir, MD, specializes in the medical and surgical management of glaucoma, cataracts and general eye disease. Her research focuses on optimizing the quality of care that glaucoma patients receive by improving patient education materials, studying patient and physician communication, and developing a novel eye drop bottle that makes it easier for patients to administer their glaucoma drops. Her research has been funded by the American Glaucoma Society, the National Eye Institute, and the Veterans Health Administration. Dr. Muir also teaches medical students, residents, and fellows about glaucoma and other ophthalmologic conditions. Dr. Muir is fellowship-trained, board-certified and a member of the American Academy of Ophthalmology and American Glaucoma Society.
Jullia Ann Rosdahl
I am a glaucoma specialist at the Duke Eye Center.
My passions are teaching, caring for patients and doctors, and saving retinal ganglion cells.
My research interests include patient education and adherence, medical and surgical education, OCT imaging for glaucoma, and physician wellness.
Maren Karine Olsen
Health services research, longitudinal data methods, missing data methods
Hayden Barry Bosworth
Dr. Bosworth is a health services researcher and Deputy Director of the Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT) at the Durham VA Medical Center. He is also Vice Chair of Education and Professor of Population Health Sciences. He is also a Professor of Medicine, Psychiatry, and Nursing at Duke University Medical Center and Adjunct Professor in Health Policy and Administration at the School of Public Health at the University of North Carolina at Chapel Hill. His research interests comprise three overarching areas of research: 1) clinical research that provides knowledge for improving patients’ treatment adherence and self-management in chronic care; 2) translation research to improve access to quality of care; and 3) eliminate health care disparities.
Dr. Bosworth is the recipient of an American Heart Association established investigator award, the 2013 VA Undersecretary Award for Outstanding Achievement in Health Services Research (The annual award is the highest honor for VA health services researchers), and a VA Senior Career Scientist Award. In terms of self-management, Dr. Bosworth has expertise developing interventions to improve health behaviors related to hypertension, coronary artery disease, and depression, and has been developing and implementing tailored patient interventions to reduce the burden of other chronic diseases. These trials focus on motivating individuals to initiate health behaviors and sustaining them long term and use members of the healthcare team, particularly pharmacists and nurses. He has been the Principal Investigator of over 30 trials resulting in over 400 peer reviewed publications and four books. This work has been or is being implemented in multiple arenas including Medicaid of North Carolina, private payers, The United Kingdom National Health System Direct, Kaiser Health care system, and the Veterans Affairs.
Areas of Expertise: Health Behavior, Health Services Research, Implementation Science, Health Measurement, and Health Policy
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