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:	Paul F Cook, Robert W Bremer, AJ Ayala, et al
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2010
Materias:	Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/e986ca5095fe4d5e903e7035824bb97b
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spelling	oai:doaj.org-article:e986ca5095fe4d5e903e7035824bb97b2021-12-02T04:04:05ZFeasibility of motivational interviewing delivered by a glaucoma educator to improve medication adherence1177-54671177-5483https://doaj.org/article/e986ca5095fe4d5e903e7035824bb97b2010-09-01T00:00:00Zhttp://www.dovepress.com/feasibility-of-motivational-interviewing-delivered-by-a-glaucoma-educa-a5340https://doaj.org/toc/1177-5467https://doaj.org/toc/1177-5483Paul 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&rsquo; 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 Paul F CookRobert W BremerAJ Ayalaet alDove Medical PressarticleOphthalmologyRE1-994ENClinical Ophthalmology, Vol 2010, Iss default, Pp 1091-1101 (2010)
institution	DOAJ
collection	DOAJ
language	EN
topic	Ophthalmology RE1-994
spellingShingle	Ophthalmology RE1-994 Paul F Cook Robert W Bremer AJ Ayala et al Feasibility of motivational interviewing delivered by a glaucoma educator to improve medication adherence
description	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&rsquo; 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
format	article
author	Paul F Cook Robert W Bremer AJ Ayala et al
author_facet	Paul F Cook Robert W Bremer AJ Ayala et al
author_sort	Paul F Cook
title	Feasibility of motivational interviewing delivered by a glaucoma educator to improve medication adherence
title_short	Feasibility of motivational interviewing delivered by a glaucoma educator to improve medication adherence
title_full	Feasibility of motivational interviewing delivered by a glaucoma educator to improve medication adherence
title_fullStr	Feasibility of motivational interviewing delivered by a glaucoma educator to improve medication adherence
title_full_unstemmed	Feasibility of motivational interviewing delivered by a glaucoma educator to improve medication adherence
title_sort	feasibility of motivational interviewing delivered by a glaucoma educator to improve medication adherence
publisher	Dove Medical Press
publishDate	2010
url	https://doaj.org/article/e986ca5095fe4d5e903e7035824bb97b
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Feasibility of motivational interviewing delivered by a glaucoma educator to improve medication adherence

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