Abstract
Purpose :
Motivational Interviewing (MI), a type of counseling, has improved medication adherence, health outcomes, and patient-centered outcomes in many chronic diseases. The 7-month MI-based Support, Educate, Empower (SEE) personalized glaucoma coaching program improved medication adherence by 21-percentage points in a sample of non-adherent glaucoma patients. The goal of this study was to assess the impact of the SEE program on patient-centered outcome measures.
Methods :
Glaucoma patients (≥40 years old, taking ≥1 medication) self-reporting poor medication adherence were recruited from the University of Michigan. Patients completed 10 validated surveys both before and after their 7-month coaching program. Five of these surveys measured the participants’ skills in managing their glaucoma (Perceived Competence Scale, Glaucoma Knowledge Scale, Glaucoma Medication Self-Efficacy Scale, Goal Setting Scale, Confidence Asking Question Scale). The Treatment Self-Regulation Questionnaire measured participants’ motivation for health behavior change. The Healthcare Climate Questionnaire measured the program’s support for patient autonomy. Three other scales explored satisfaction with care (Satisfaction with Information Scale), glaucoma related distress (Diabetes Distress Scale adopted for glaucoma), and perceived benefit of treatment (Perceived Benefits Scale). Surveys were scored according to official documentation. Pre- and post-intervention scores were compared using paired t-tests and Wilcoxon signed-rank tests. P-values were adjusted for multiple comparisons using Holm’s method.
Results :
39 patients completed the SEE program. Significant positive changes were noted in 8/10 patient centered outcome measures (perceived competence, autonomy support, intrinsic motivation, disease related distress, self-efficacy, satisfaction with information, confidence asking questions, and goal setting). There was no effect on perceived benefits of glaucoma treatment or glaucoma knowledge.
Conclusions :
The SEE Program improved a large number of patient-centered outcome measures such as overall glaucoma related distress, motivation to be adherent, and confidence to ask their ophthalmologist questions. These positive changes will hopefully help participants maintain engagement with glaucoma treatment over their lifetime.
This is a 2021 ARVO Annual Meeting abstract.