RESEARCH PROTOCOL: Glaucoma Treatment Adherence and Persistence - Full Text View

Purpose

The investigators are studying motivational interviewing (MI). MI is a counseling method to help people adopt healthy behaviors. The investigators will test whether MI improves patients' accurate use of glaucoma eye drops. The investigators will train eye clinic staff called glaucoma educators to use MI. Up to 250 patients at 3 clinics will be recruited. All patients will receive their usual eye care. Based on chance, some patients will also be supported by a glaucoma educator. The groups will be compared on medication adherence using micro-electro-mechanical system(MEMS). MEMS are electronic bottle caps that track when a medication bottle is opened. Patients will be aware that their medication use is tracked. The groups will also be compared on treatment value, outcomes, and cost. The investigators will also collect data on variables that may predict medication adherence.

Condition	Intervention
Primary Open Angle Glaucoma	Behavioral: motivational interviewing Behavioral: three phone calls to remind patients to take their eye drops

Study Type:	Interventional
Study Design:	Allocation: Randomized Intervention Model: Parallel Assignment Masking: Single Blind (Caregiver) Primary Purpose: Supportive Care
Official Title:	An Assessment of the Impact of Motivational Interviewing Via Glaucoma Educator on Glaucoma Treatment Adherence and Persistence

Resource links provided by NLM:

Genetics Home Reference related topics: early-onset glaucoma

MedlinePlus related topics: Glaucoma

Drug Information available for: Tetrahydrozoline hydrochloride Boric acid

U.S. FDA Resources

Further study details as provided by University of Colorado, Denver:

Primary Outcome Measures:

Primary Outcomes - MEMS-based Medication Adherence and Persistence: [ Time Frame: 1 month ] [ Designated as safety issue: No ]
Compare adherence and persistence between the intervention and control groups. (Medication Event Monitoring Systems)that record the date and time a pill bottle is opened we are evaluating the percentage of prescribed doses taken during ain one-week intervals, but will augment it by also considering a more fine-grained percentage of prescribed doses taken in required dosing window (defined as within 3 hours before or after the scheduled time) as a second primary outcome measure.

Secondary Outcome Measures:

Counselor-Rated Medication Adherence [ Time Frame: 1 Month ] [ Designated as safety issue: No ]
we will supplement MEMS-based adherence metrics with a counselor rating of adherence completed by the glaucoma educator during each in-person or telephone contact with intervention group participants. The interview also measures patients' perceived reasons for nonadherence, including treatment cost, lack of commitment based on low perceived benefits of treatment, and fear of potential adverse drug events (ADEs)

Enrollment:	201
Study Start Date:	April 2011
Study Completion Date:	January 2013
Primary Completion Date:	January 2013 (Final data collection date for primary outcome measure)

Arms	Assigned Interventions
Experimental: motivational interviewing 3 phone and 3 in person counseling support sessions with glaucoma educator	Behavioral: motivational interviewing counseling intervention
Active Comparator: reminder calls behavioral: three phone calls to remind patients to take their eye drops	Behavioral: three phone calls to remind patients to take their eye drops reminder phone calls
No Intervention: standard care standard care for glaucoma

Eligibility

Ages Eligible for Study:	18 Years and older
Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	Yes

Criteria

Inclusion Criteria:

community-dwelling adults with primary or secondary open-angle glaucoma, and
a current prescription for monotherapy topical glaucoma medication.

Exclusion Criteria:

patient-reported inability to administer eye drops that cannot be addressed successfully through in-person instruction at the clinic,
cognitive impairment at a level that would in the judgment of the referring physician interfere with study participation,
referring physician's determination that glaucoma surgery is likely within the next 6 months,
any active medical, psychological, or substance use disorder that would in the referring physician's judgment significantly interfere with study participation (e.g., comorbid congestive heart failure (CHF) resulting in a recent hospitalization; active psychosis due to uncontrolled bipolar disorder; etc.), or
no visual field test within the past 6 months (data required for the randomization approach described below).

Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT01409421

Locations

United States, Colorado
Lions Eye Institute, UC Denver
Aurora, Colorado, United States, 80045
United States, Oregon
Devers Eye Institute
Portland, Oregon, United States, 97210

Sponsors and Collaborators

University of Colorado, Denver

Merck

Investigators

Principal Investigator:	Malik Kahook, MD	Lions Eye Inst. UC Denver
Principal Investigator:	Paul F Cook, Ph.D	UC Denver, College of Nursing
Principal Investigator:	Jeffery Kammer, MD	Vanderbilt University- Opthamology
Principal Investigator:	Steve Mansberger, MD	Devers Eye Inst. Oregon

More Information

No publications provided

Responsible Party:	University of Colorado, Denver
ClinicalTrials.gov Identifier:	NCT01409421 History of Changes
Other Study ID Numbers:	11-0122, 2517807
Study First Received:	August 2, 2011
Last Updated:	January 15, 2013
Health Authority:	United States: Institutional Review Board

Keywords provided by University of Colorado, Denver:

adherence
glaucoma
motivational interviewing

Additional relevant MeSH terms:

Glaucoma
Glaucoma, Open-Angle
Ocular Hypertension
Eye Diseases
Tetrahydrozoline
Nasal Decongestants
Vasoconstrictor Agents
Cardiovascular Agents

Therapeutic Uses
Pharmacologic Actions
Respiratory System Agents
Sympathomimetics
Autonomic Agents
Peripheral Nervous System Agents
Physiological Effects of Drugs

ClinicalTrials.gov processed this record on May 19, 2013