Glaucoma patients with poor medication compliance may benefit from a personalized coaching program, a study in Ophthalmology Glaucoma suggests. The approach could help to improve their lax habits.

Researchers from the University of Michigan created the Support, Educate, Empower (SEE) program that includes automated medication reminders, three in-person counseling sessions with a glaucoma coach trained in motivational interviewing and five coaching calls for in-between session support.

Results from the SEE program show promise, as medication adherence improved from 59.9% at baseline to 81.3% by the program’s end. Additionally, 95% of participants reported improved compliance while 59% had adherence rates of more than 80% upon completion of the program.

A multi-pronged approach that supports the patient’s autonomy and includes personalized education, feedback and a reminder system can have a substantial impact on improving adherence, says researcher Paula Anne Newman-Casey, MD, MS, assistant professor and education director of the Kellogg Eye Center for eHealth. “This type of purposeful, increased attention is best delivered by trained glaucoma health coaches who have the time to form deeper relationships with patients,” she says.

 Dr. Newman-Casey describes glaucoma health coaches as a new class of para-professional staff who fulfill a role comparable to diabetes educators, where they support the patient in improving their glaucoma self-management skills.

She and her team recruited 48 patients with self-reported poor medication compliance. Participants were approximately 64 years old, and the group was 54% male and 46% white. Individuals took at least one medication and had a worse eye mean deviation of approximately -7.9dB. The researchers electronically monitored adherence for a three-month baseline period. Individuals with an average adherence of 80% or less were enrolled in SEE.

Participant adherence was also monitored electronically over the course of the seven-month program. The study calculated adherence as the percentage of prescribed doses taken on time.

During the SEE program, the coach used a web-based tool to generate an education plan tailored to the patient’s glaucoma diagnosis, test results and ophthalmologist’s recommendations (www.glaucomaeyeguide.org). The coach used the information to help patients identify barriers to adherence and possible solutions.

The 39 individuals who completed the program didn’t have significant differences in sex, race, age, mean deviation or baseline adherence compared with the nine dropouts, the researchers noted.