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Sarah Miller, OLIVIA JOY KILLEEN, Chamisa MacKenzie, Ken Resnicow, Michele Heisler, Paula Anne Newman-Casey; The Effect of a Brief, Glaucoma-Specific Motivational Interviewing Training Program on Patient Satisfaction and Glaucoma Self-Management. Invest. Ophthalmol. Vis. Sci. 2017;58(8):5044.
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© ARVO (1962-2015); The Authors (2016-present)
Motivational interviewing (MI) is a counseling style that can improve patient-provider communication and patient health self-management. We hypothesized that patients who received glaucoma education for eye drop instillation consistent with MI principles would have increased satisfaction with paraprofessional staff communication as well as improved eye drop instillation self-efficacy and overall health activation.
This was a prospective observational study with a pre-post design. We included a convenience sample of patients ≥18 years of age who were taking ≥1 glaucoma medication. We administered a survey using validated instruments measuring patient satisfaction with glaucoma technician communication, patients’ eye drop instillation self-efficacy and overall health activation. Six glaucoma technicians were trained in glaucoma specific MI through a 16-hour glaucoma-specific MI training, followed by 3 hours of coaching with an MI trainer. After the training was completed, the survey was re-administered to the same patients in order to evaluate the impact of MI techniques. Patients were asked to rate their glaucoma technician’s fidelity to MI counseling principles using a validated instrument.
102 participants were recruited from the glaucoma clinic. 72/102 (71%) patients completed both the baseline and follow-up surveys. 41/72 (57%) patients rated their glaucoma technician as above average in MI compliance. There was no significant change in patient satisfaction with technician communication, eye drop instillation self-efficacy or overall health activation after the intervention (p>0.15 for all comparisons). However, of patients who rated their glaucoma technician as above average in MI compliance, satisfaction with technician communication increased significantly unlike satisfaction scores for technicians who scored below average (mean 0.60 points/12, 95% CI: 0.05, 1.15, p=0.03, two-tailed t-test, vs. mean -0.83 points, 95% CI: -1.78, 0.11).
Patient satisfaction with glaucoma technician communication increased for technicians who learned to communicate with patients in an MI-consistent style through this brief, glaucoma-specific MI training program. Qualitative analysis is needed to understand why MI-consistent patient education for eye drop instillation did not improve patients’ eye drop instillation self-efficacy.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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