A Taxonomy of Behavior Change Techniques for Improving Medication Adherence in Primary Open-Angle Glaucoma

Many interventions aiming to improve medication adherence in primary open-angle glaucoma (POAG) have yielded equivocal findings. This equivocacy has been attributed to several factors, including limited incorporation of health behavior theory and patient preference into intervention design. In this study, we performed a literature review of interventions aiming to improve medication adherence in POAG to develop a taxonomy of behavior change techniques (BCTs). Eligible studies measured medication adherence using electronic monitors for a minimum of 3 months. For each study, we evaluated the effectiveness of the BCTs, their basis in health behavior theory, and their usefulness in day-to-day management of POAG by surveying a sample of patients and providers. Twelve studies were included. BCTs included knowledge shaping (education), prompts (reminders), behavioral rehearsal (eye drop instillation training), and pharmacological support (combination monotherapy vs. polytherapy). Knowledge shaping, prompts, health coaching, and motivational interviewing led to an improvement in medication adherence and were perceived as being most useful in day-to-day management of POAG. Taxonomies of BCTs can help researchers to improve the design and effectiveness of interventions for improving medication adherence in POAG.