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Improved Glaucoma Medication Adherence in a Randomized Controlled Trial
Kelly W Muir1, Jullia A Rosdahl2, Aaron M Hein3
1Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina; Durham Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Health Care System, Durham, North Carolina.
Purpose:
To test the effectiveness of an intervention designed to improve glaucoma medication adherence.
Design:
Randomized, controlled trial at a Veterans Affairs (VA) eye clinic.
Participants:
Veterans with medically treated glaucoma who reported poor adherence and their companions if applicable.
Methods:
Participants, and their companions if applicable, were randomized to receive an intervention to improve medication adherence that included glaucoma education, personalized disease management suggestions, and a reminder aid, or the control arm that received education regarding general eye health.
Main Outcome Measures:
The average proportion of prescribed glaucoma medication doses taken on schedule over the 6 months after randomization according to an electronic monitor between participants in the 2 arms.
Results:
The mean proportion of prescribed doses taken on schedule was higher in the intervention group compared with controls (0.85 vs. 0.62, P < 0.0001). The difference in proportions between the 2 groups did not vary in regressions models adjusted for companion status, frequency of dosing, and race. The longitudinal model indicated that the intervention group had significantly higher adherence during the first month after randomization and continued to stay higher through 6 months (month by treatment interaction, P = 0.003).
Conclusions:
A multifaceted intervention can help improve glaucoma medication adherence.
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