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

Area of Science:

• Ophthalmology
• Behavioral Science
• Public Health

Background:

• Medication adherence in primary open-angle glaucoma (POAG) is crucial for preventing vision loss.
• Previous interventions for POAG medication adherence have shown inconsistent results.
• Limited integration of health behavior theory and patient preferences may explain intervention variability.

Purpose of the Study:

• To develop a taxonomy of behavior change techniques (BCTs) for improving medication adherence in POAG.
• To evaluate the effectiveness and patient-perceived usefulness of various BCTs in POAG management.

Main Methods:

• Systematic literature review of interventions for POAG medication adherence.
• Inclusion criteria: electronic monitoring of adherence for ≥3 months.
• Evaluation of BCTs based on health behavior theory and patient/provider surveys.

Main Results:

• Twelve studies were reviewed, identifying BCTs such as knowledge shaping, prompts, and behavioral rehearsal.
• Knowledge shaping, prompts, health coaching, and motivational interviewing significantly improved medication adherence.
• These techniques were also perceived as most useful for daily POAG management by patients and providers.

Conclusions:

• A taxonomy of BCTs can guide the development of more effective POAG medication adherence interventions.
• Integrating evidence-based BCTs, particularly those focused on education and motivation, is key to improving patient adherence.
• Future interventions should prioritize patient preferences and theoretical underpinnings for enhanced efficacy.