Ophthalmologist-patient communication, self-efficacy, and glaucoma medication adherence

Ophthalmology. 2015 Apr;122(4):748-54. doi: 10.1016/j.ophtha.2014.11.001. Epub 2014 Dec 24.

Abstract

Objective: To examine the associations of provider-patient communication, glaucoma medication adherence self-efficacy, and outcome expectations with glaucoma medication adherence.

Design: Prospective, observational cohort study.

Participants: Two hundred seventy-nine patients with glaucoma who were newly prescribed or taking glaucoma medications were recruited at 6 ophthalmology clinics.

Methods: Patients' visits were video recorded and communication variables were coded using a detailed coding tool developed by the authors. Adherence was measured using Medication Event Monitoring Systems for 60 days after their visits.

Main outcome measures: The following adherence variables were measured for the 60-day period after their visits: whether the patient took 80% or more of the prescribed doses, percentage of the correct number of prescribed doses taken each day, and percentage of the prescribed doses taken on time.

Results: Higher glaucoma medication adherence self-efficacy was associated positively with better adherence with all 3 measures. Black race was associated negatively with percentage of the correct number of doses taken each day (β = -0.16; P < 0.05) and whether the patient took 80% or more of the prescribed doses (odds ratio, 0.37; 95% confidence interval, 0.16-0.86). Physician education about how to administer drops was associated positively with percentage of the correct number of doses taken each day (β = 0.18; P < 0.01) and percentage of the prescribed doses taken on time (β = 0.15; P < 0.05).

Conclusions: These findings indicate that provider education about how to administer glaucoma drops and patient glaucoma medication adherence self-efficacy are associated positively with adherence.

Publication types

  • Multicenter Study
  • Observational Study
  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Administration, Topical
  • Adult
  • Aged
  • Aged, 80 and over
  • Antihypertensive Agents / administration & dosage*
  • Drug Monitoring
  • Female
  • Glaucoma / drug therapy*
  • Glaucoma / psychology
  • Health Communication*
  • Health Knowledge, Attitudes, Practice
  • Health Personnel
  • Humans
  • Male
  • Medication Adherence / statistics & numerical data*
  • Middle Aged
  • Ophthalmic Solutions
  • Ophthalmology*
  • Patient Education as Topic*
  • Physician-Patient Relations*
  • Prospective Studies
  • Self Efficacy*
  • Surveys and Questionnaires
  • Young Adult

Substances

  • Antihypertensive Agents
  • Ophthalmic Solutions