Feasibility of motivational interviewing delivered by a glaucoma educator to improve medication adherence
Paul F Cook1, Robert W Bremer2, AJ Ayala4, Malik Y Kahook31College of Nursing, 2Department of Psychiatry, 3Department of Ophthalmology, School of Medicine, University of Colorado Denver, Aurora, CO, USA; 4Rocky Mountain Lions Eye Institute, University of Colorado Hospital, Aurora, CO, USAIntroductio...
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| Autores principales: | , , , |
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| Formato: | article |
| Lenguaje: | EN |
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Dove Medical Press
2010
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| Materias: | |
| Acceso en línea: | https://doaj.org/article/e986ca5095fe4d5e903e7035824bb97b |
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| Sumario: | Paul F Cook1, Robert W Bremer2, AJ Ayala4, Malik Y Kahook31College of Nursing, 2Department of Psychiatry, 3Department of Ophthalmology, School of Medicine, University of Colorado Denver, Aurora, CO, USA; 4Rocky Mountain Lions Eye Institute, University of Colorado Hospital, Aurora, CO, USAIntroduction: Adherence to glaucoma treatment is poor, potentially reducing therapeutic effects. A glaucoma educator was trained to use motivational interviewing (MI), a patient-centered counseling style, to improve adherence. This study was designed to evaluate whether MI was feasible in a busy ophthalmology practice.Methods: Feasibility was assessed using five criteria from the National Institutes of Health Behavior Change consortium: fidelity of intervention components to MI theory; success of the training process; delivery of MI-consistent interventions by the glaucoma educator; patient receipt of the intervention based on enrollment, attrition, and satisfaction; and patient enactment of changes in motivation and adherence over the course of the intervention.Results: A treatment manual was designed by a multidisciplinary team with expertise in health psychology, public health, and ophthalmology. The glaucoma educator received 6 hours of training including role-play exercises, self-study, and individual supervision. His MI-related knowledge and skills increased following training, and he delivered exclusively MI-consistent interventions in 66% of patient encounters. 86% (12/14) of eligible patients agreed to be randomized into glaucoma educator support or a control condition. All 8 patients assigned to the glaucoma educator completed at least 2 of 6 planned contacts, and 50% (4/8) completed all 6 contacts. Patients assigned to the glaucoma educator improved over time in both motivation and adherence.Conclusion: The introduction of a glaucoma educator was feasible in a busy ophthalmology practice. Patients improved their adherence while participating in the glaucoma educator program, although this study was not designed to show a causal effect. The use of a glaucoma educator to improve glaucoma patients’ medication adherence may be feasible at other ophthalmology clinics, and can be implemented with a standardized training approach. Pilot data show the intervention can be implemented with fidelity, is acceptable to patients and providers, and has the potential to improve adherence.Keywords: adherence, counseling, glaucoma, medication, training |
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