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Patient and Provider Perspectives on Glaucoma Treatment Adherence: A Delphi Study in Urban Alabama

SIGNIFICANCE: Patients with glaucoma and providers recognized perceived treatment efficacy, patient-provider relationship, psychological stress, instillation skill, good quality of life, and forgetfulness as key determinants of glaucoma adherence. This shared insight could help shape the development...

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Autores principales: Poleon, Shervonne, Racette, Lyne, Fifolt, Matthew, Schoenberger-Godwin, Yu-Mei, Abu, Sampson Listowell, Twa, Michael D.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8505131/
https://www.ncbi.nlm.nih.gov/pubmed/34524213
http://dx.doi.org/10.1097/OPX.0000000000001776
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author Poleon, Shervonne
Racette, Lyne
Fifolt, Matthew
Schoenberger-Godwin, Yu-Mei
Abu, Sampson Listowell
Twa, Michael D.
author_facet Poleon, Shervonne
Racette, Lyne
Fifolt, Matthew
Schoenberger-Godwin, Yu-Mei
Abu, Sampson Listowell
Twa, Michael D.
author_sort Poleon, Shervonne
collection PubMed
description SIGNIFICANCE: Patients with glaucoma and providers recognized perceived treatment efficacy, patient-provider relationship, psychological stress, instillation skill, good quality of life, and forgetfulness as key determinants of glaucoma adherence. This shared insight could help shape the development of clinical and behavioral interventions for addressing treatment barriers and improving adherence. PURPOSE: Despite their impact on adherence in glaucoma, sociobehavioral factors may not be adequately explored during clinical consultations. We aimed to elicit consensus between patients and providers around key determinants of adherence and hypothesized that patients would place greater emphasis on sociobehavioral factors compared with providers. METHODS: A two-round Delphi survey was used to assess treatment beliefs, barriers, facilitators, motivators, and needs among 18 patients with glaucoma and providers. In round 1, agreement with 46 statements was scored on a 5-point Likert scale (strongly disagree to strongly agree). Statements with which 80% or more of panelists agreed reached consensus and advanced to round 2, where participants were asked to prioritize them based on their importance to treatment. RESULTS: There was consensus regarding the influence of perceived treatment efficacy, good provider relationship, good quality of life, psychological stress, glaucoma knowledge, instillation skill, and forgetfulness on glaucoma adherence. For statements that failed to reach consensus, the Bonferroni-corrected Mann-Whitney U test revealed that the greatest differences between patients and providers pertained to regimen complexity (provider median, 4 [interquartile range {IQR}, 1]; patient median, 1.5 [IQR, 1]; P = .002), instillation skill (providers, 4 [IQR, 0.5]; patients, 2 [IQR, 1]; P = .001), and low motivation (providers, 3 [IQR, 2.25]; patients, 1 [IQR, 0]; P = .003). CONCLUSIONS: Although patients and providers prioritized sociobehavioral factors as key determinants of adherence, disagreement between these groups was observed in other areas. Continued juxtaposition of patient and provider perspectives could spotlight underexplored areas and guide the development of successful interventions for improving adherence.
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spelling pubmed-85051312021-10-13 Patient and Provider Perspectives on Glaucoma Treatment Adherence: A Delphi Study in Urban Alabama Poleon, Shervonne Racette, Lyne Fifolt, Matthew Schoenberger-Godwin, Yu-Mei Abu, Sampson Listowell Twa, Michael D. Optom Vis Sci Original Investigations SIGNIFICANCE: Patients with glaucoma and providers recognized perceived treatment efficacy, patient-provider relationship, psychological stress, instillation skill, good quality of life, and forgetfulness as key determinants of glaucoma adherence. This shared insight could help shape the development of clinical and behavioral interventions for addressing treatment barriers and improving adherence. PURPOSE: Despite their impact on adherence in glaucoma, sociobehavioral factors may not be adequately explored during clinical consultations. We aimed to elicit consensus between patients and providers around key determinants of adherence and hypothesized that patients would place greater emphasis on sociobehavioral factors compared with providers. METHODS: A two-round Delphi survey was used to assess treatment beliefs, barriers, facilitators, motivators, and needs among 18 patients with glaucoma and providers. In round 1, agreement with 46 statements was scored on a 5-point Likert scale (strongly disagree to strongly agree). Statements with which 80% or more of panelists agreed reached consensus and advanced to round 2, where participants were asked to prioritize them based on their importance to treatment. RESULTS: There was consensus regarding the influence of perceived treatment efficacy, good provider relationship, good quality of life, psychological stress, glaucoma knowledge, instillation skill, and forgetfulness on glaucoma adherence. For statements that failed to reach consensus, the Bonferroni-corrected Mann-Whitney U test revealed that the greatest differences between patients and providers pertained to regimen complexity (provider median, 4 [interquartile range {IQR}, 1]; patient median, 1.5 [IQR, 1]; P = .002), instillation skill (providers, 4 [IQR, 0.5]; patients, 2 [IQR, 1]; P = .001), and low motivation (providers, 3 [IQR, 2.25]; patients, 1 [IQR, 0]; P = .003). CONCLUSIONS: Although patients and providers prioritized sociobehavioral factors as key determinants of adherence, disagreement between these groups was observed in other areas. Continued juxtaposition of patient and provider perspectives could spotlight underexplored areas and guide the development of successful interventions for improving adherence. Lippincott Williams & Wilkins 2021-09 2021-09-15 /pmc/articles/PMC8505131/ /pubmed/34524213 http://dx.doi.org/10.1097/OPX.0000000000001776 Text en Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Optometry. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (https://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
spellingShingle Original Investigations
Poleon, Shervonne
Racette, Lyne
Fifolt, Matthew
Schoenberger-Godwin, Yu-Mei
Abu, Sampson Listowell
Twa, Michael D.
Patient and Provider Perspectives on Glaucoma Treatment Adherence: A Delphi Study in Urban Alabama
title Patient and Provider Perspectives on Glaucoma Treatment Adherence: A Delphi Study in Urban Alabama
title_full Patient and Provider Perspectives on Glaucoma Treatment Adherence: A Delphi Study in Urban Alabama
title_fullStr Patient and Provider Perspectives on Glaucoma Treatment Adherence: A Delphi Study in Urban Alabama
title_full_unstemmed Patient and Provider Perspectives on Glaucoma Treatment Adherence: A Delphi Study in Urban Alabama
title_short Patient and Provider Perspectives on Glaucoma Treatment Adherence: A Delphi Study in Urban Alabama
title_sort patient and provider perspectives on glaucoma treatment adherence: a delphi study in urban alabama
topic Original Investigations
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8505131/
https://www.ncbi.nlm.nih.gov/pubmed/34524213
http://dx.doi.org/10.1097/OPX.0000000000001776
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