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IIR 15-113 – HSR&D Study

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IIR 15-113
Improving Glaucoma Medication Adherence
Kelly W. Muir MD MHSc
Durham VA Medical Center, Durham, NC
Durham, NC
Funding Period: March 2017 - February 2021

BACKGROUND/RATIONALE:
Glaucoma is the leading cause of irreversible blindness worldwide1,,,,,2 and the leading cause of blindness in African Americans.3 Despite advancements in the diagnosis and treatment of glaucoma, no cure exists. The only intervention that has been proven to reduce the risk of progressive loss of vision from glaucoma is lowering the intraocular pressure. Although surgery and laser treatment may be used to reduce intraocular pressure, the most common treatment for glaucoma is the prescription of topical eye drops.5 The proposed study is a randomized controlled trial enrolling Veterans with medically treated glaucoma who report less than 100% adherence to the prescribed glaucoma therapy.

OBJECTIVE(S):
The purpose if this study is to improve glaucoma medication adherence in Veterans with medically-treated glaucoma.. The proposed intervention is novel in that it was developed through a prior pilot study with input from Veterans with glaucoma and with a multidisciplinary team that includes local and national operations partners. With this collaborative approach and careful attention to cost we hope to facilitate implementation of the program should the intervention prove effective.

METHODS:
The proposed study is a randomized controlled trial enrolling Veterans with medically treated glaucoma who report less than 100% adherence to the prescribed glaucoma therapy. Participants will be randomized to receive either a one-on-one session with a member of the research team discussing the disease process and strategies for administering eye drops (intervention) or a one-on-one session with a member of the research team discussing general eye health (control). All participants will be provided with a "smart bottle" to house their glaucoma medications. The smart bottle records the date and time that the bottle is opened. For participants in the intervention arm only, a reminder function will be activated. The proportion or prescribed doses taken according to the monitor will be compared for the two groups.

FINDINGS/RESULTS:
There are no findings as of yet

IMPACT:
The long-term goal of this research program is to reduce glaucoma-related blindness in Veterans. This study will expand upon previous work and incorporate the most current evidence-based strategies into the design. ). The educational components of the intervention address the potential for irreversible blindness from glaucoma and increase understanding that eye drops reduce the risk of blindness. The self-reported adherence and self-efficacy surveys create the personalized response component of the intervention, which incorporates patient experience and preferences regarding most convenient dosing regimen. In addition, personalized responses are used to increase participants' self-efficacy with eye drop use.

PUBLICATIONS:

Journal Articles

  1. Hein AM, Rosdahl JA, Bosworth HB, Woolson SL, Olsen MK, Kirshner MA, Muir KW. The Association of an Upper Extremity Functional Survey and Glaucoma Medication Administration Success. Current eye research. 2019 Jun 11; 1-7.
  2. Davis SA, Carpenter DM, Blalock SJ, Budenz DL, Lee C, Muir KW, Robin AL, Sleath B. Glaucoma Patient Preferences for Video Education on Eye Drop Technique. Optometry and vision science : official publication of the American Academy of Optometry. 2019 May 1; 96(5):325-330.
  3. Hein AM, Rosdahl JA, Bosworth HB, Woolson SL, Olsen MK, Kirshner MA, Muir KW. The Relationship of Self-Report and Medication Possession With Glaucoma Medication Administration Success. Journal of glaucoma. 2019 Mar 1; 28(3):e46-e48.
  4. Davies I, Williams AM, Muir KW. Aids for eye drop administration. Survey of ophthalmology. 2017 May 1; 62(3):332-345.


DRA: Health Systems, Aging, Older Veterans' Health and Care
DRE: Technology Development and Assessment, Treatment - Efficacy/Effectiveness Clinical Trial, TRL - Applied/Translational
Keywords: Medication Management, Outcomes - Patient
MeSH Terms: none