Motivational interviewing or reminders for glaucoma medication adherence: Results of a multi-site randomised...

Nonadherence reduces glaucoma treatment efficacy. Motivational interviewing (MI) is a well-studied adherence intervention, but has not been tested in glaucoma. Reminder interventions also may improve adherence.

201 patients with glaucoma or ocular hypertension were urn-randomised to receive MI delivered by an ophthalmic technician (OT), usual care or a minimal behavioural intervention (reminder calls).

Outcomes included electronic monitoring with Medication Event Monitoring System (MEMS) bottles, two self-report adherence measures, patient satisfaction and clinical outcomes. Multilevel modelling was used to test differences in MEMS results by group over time; ANCOVA was used to compare groups on other measures.

Reminder calls increased adherence compared to usual care based on MEMS, p = .005, and self-report, p = .04. MI had a nonsignificant effect but produced higher satisfaction than reminder calls, p = .007. Treatment fidelity was high on most measures, with observable differences in behaviour between groups. All groups had high baseline adherence that limited opportunities for change.

Reminder calls, but not MI, led to better adherence than usual care. Although a large literature supports MI, reminder calls might be a cost-effective intervention for patients with high baseline adherence. Replication is needed with less adherent participants.