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Personalized behavior change program for glaucoma patients with poor adherence: a pilot interventional cohort study with a pre-post design

BACKGROUND: About half of people with glaucoma do not adhere to their recommended medications. Interventions for other chronic conditions have successfully utilized reminder systems and motivational interviewing (MI)-based counseling. This study was designed to pilot a personalized intervention that...

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Autores principales: Newman-Casey, Paula Anne, Niziol, Leslie M., Mackenzie, Chamisa K., Resnicow, Kenneth, Lee, Paul P., Musch, David C., Heisler, Michele
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6055343/
https://www.ncbi.nlm.nih.gov/pubmed/30062043
http://dx.doi.org/10.1186/s40814-018-0320-6
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author Newman-Casey, Paula Anne
Niziol, Leslie M.
Mackenzie, Chamisa K.
Resnicow, Kenneth
Lee, Paul P.
Musch, David C.
Heisler, Michele
author_facet Newman-Casey, Paula Anne
Niziol, Leslie M.
Mackenzie, Chamisa K.
Resnicow, Kenneth
Lee, Paul P.
Musch, David C.
Heisler, Michele
author_sort Newman-Casey, Paula Anne
collection PubMed
description BACKGROUND: About half of people with glaucoma do not adhere to their recommended medications. Interventions for other chronic conditions have successfully utilized reminder systems and motivational interviewing (MI)-based counseling. This study was designed to pilot a personalized intervention that leverages these strategies to assess their impact on medication adherence in glaucoma patients. METHODS: Glaucoma patients taking ≥ 1 medication will be pre-screened by telephone survey for adherence to their medication(s). Those who self-report poor adherence will be enrolled in a 3-month monitoring period to measure medication adherence using electronic medication monitors. Participants who are non-adherent (take </=80% of their medication doses) over the 3-month run in phase will be eligible for the study. We plan to enroll 57 participants who are non-adherent to their medications. Participants’ adherence will then be continuously measured with electronic medication monitors, by self-report, and via pharmacy refill data over 2 years, during which two successively more resource-intensive components of an intervention aimed to improve medication adherence will be administered. The first component is a 3-month period of reminders (audio and/or visual) and text message or automated phone call if a dose of medication is not taken within a pre-specified time frame. The second component is a 6-month MI-based counseling program with a trained glaucoma counselor. This component uses the eyeGuide, a computer-based personalized behavior change program that enables para-professional staff to provide personalized education and counseling for glaucoma. The primary outcome is change in medication adherence. The secondary outcomes include changes in clinical outcomes (intraocular pressure, IOP, and IOP fluctuation) and psychosocial mediators of adherence (e.g., competence, energy for change and satisfaction). Participants will undergo semi-structured interviews at 12 months to give feedback about the counseling program in order to improve it. DISCUSSION: This pilot study will provide insight into ways to deliver more personalized health care to non-adherent glaucoma patients in order to better support them in managing their chronic disease. TRIAL REGISTRATION: Retrospectively registered with ClinicalTrials.gov (NCT03159247). ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s40814-018-0320-6) contains supplementary material, which is available to authorized users.
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spelling pubmed-60553432018-07-30 Personalized behavior change program for glaucoma patients with poor adherence: a pilot interventional cohort study with a pre-post design Newman-Casey, Paula Anne Niziol, Leslie M. Mackenzie, Chamisa K. Resnicow, Kenneth Lee, Paul P. Musch, David C. Heisler, Michele Pilot Feasibility Stud Study Protocol BACKGROUND: About half of people with glaucoma do not adhere to their recommended medications. Interventions for other chronic conditions have successfully utilized reminder systems and motivational interviewing (MI)-based counseling. This study was designed to pilot a personalized intervention that leverages these strategies to assess their impact on medication adherence in glaucoma patients. METHODS: Glaucoma patients taking ≥ 1 medication will be pre-screened by telephone survey for adherence to their medication(s). Those who self-report poor adherence will be enrolled in a 3-month monitoring period to measure medication adherence using electronic medication monitors. Participants who are non-adherent (take </=80% of their medication doses) over the 3-month run in phase will be eligible for the study. We plan to enroll 57 participants who are non-adherent to their medications. Participants’ adherence will then be continuously measured with electronic medication monitors, by self-report, and via pharmacy refill data over 2 years, during which two successively more resource-intensive components of an intervention aimed to improve medication adherence will be administered. The first component is a 3-month period of reminders (audio and/or visual) and text message or automated phone call if a dose of medication is not taken within a pre-specified time frame. The second component is a 6-month MI-based counseling program with a trained glaucoma counselor. This component uses the eyeGuide, a computer-based personalized behavior change program that enables para-professional staff to provide personalized education and counseling for glaucoma. The primary outcome is change in medication adherence. The secondary outcomes include changes in clinical outcomes (intraocular pressure, IOP, and IOP fluctuation) and psychosocial mediators of adherence (e.g., competence, energy for change and satisfaction). Participants will undergo semi-structured interviews at 12 months to give feedback about the counseling program in order to improve it. DISCUSSION: This pilot study will provide insight into ways to deliver more personalized health care to non-adherent glaucoma patients in order to better support them in managing their chronic disease. TRIAL REGISTRATION: Retrospectively registered with ClinicalTrials.gov (NCT03159247). ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s40814-018-0320-6) contains supplementary material, which is available to authorized users. BioMed Central 2018-07-23 /pmc/articles/PMC6055343/ /pubmed/30062043 http://dx.doi.org/10.1186/s40814-018-0320-6 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Study Protocol
Newman-Casey, Paula Anne
Niziol, Leslie M.
Mackenzie, Chamisa K.
Resnicow, Kenneth
Lee, Paul P.
Musch, David C.
Heisler, Michele
Personalized behavior change program for glaucoma patients with poor adherence: a pilot interventional cohort study with a pre-post design
title Personalized behavior change program for glaucoma patients with poor adherence: a pilot interventional cohort study with a pre-post design
title_full Personalized behavior change program for glaucoma patients with poor adherence: a pilot interventional cohort study with a pre-post design
title_fullStr Personalized behavior change program for glaucoma patients with poor adherence: a pilot interventional cohort study with a pre-post design
title_full_unstemmed Personalized behavior change program for glaucoma patients with poor adherence: a pilot interventional cohort study with a pre-post design
title_short Personalized behavior change program for glaucoma patients with poor adherence: a pilot interventional cohort study with a pre-post design
title_sort personalized behavior change program for glaucoma patients with poor adherence: a pilot interventional cohort study with a pre-post design
topic Study Protocol
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6055343/
https://www.ncbi.nlm.nih.gov/pubmed/30062043
http://dx.doi.org/10.1186/s40814-018-0320-6
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