Motivational interviewing or reminders for glaucoma medication adherence: Results of a multi-site randomised controlled trial. Issue 2 (1st February 2017)

• Record Type: Journal Article
• Authors: Cook, Paul F.; Schmiege, Sarah J.; Mansberger, Steven L.; Sheppler, Christina; Kammer, Jeffrey; Fitzgerald, Timothy; Kahook, Malik Y.
• Is Part Of: Psychology & health. Volume 32:Issue 2(2017)
• Page Start: 145
• Page End: 165
• Publication Date: 2017-02-01
• Subjects: adherence -- glaucoma -- motivational interviewing -- reminder -- treatment satisfaction; Clinical health psychology -- Periodicals; Attitude to Health -- Periodicals; Public Opinion -- Periodicals; Psychology -- Periodicals; 150
• DOI: 10.1080/08870446.2016.1244537
• Languages: English
• ISSNs: 0887-0446

Abstract

Abstract : Objective: Nonadherence reduces glaucoma treatment efficacy. Motivational interviewing (MI) is a well-studied adherence intervention, but has not been tested in glaucoma. Reminder interventions also may improve adherence. Design: 201 patients with glaucoma or ocular hypertension were urn-randomised to receive MI delivered by an ophthalmic technician (OT), usual care or a minimal behavioural intervention (reminder calls). Main Outcome Measures: Outcomes included electronic monitoring with Medication Event Monitoring System (MEMS) bottles, two self-report adherence measures, patient satisfaction and clinical outcomes. Multilevel modelling was used to test differences in MEMS results by group over time; ANCOVA was used to compare groups on other measures. Results: Reminder calls increased adherence compared to usual care based on MEMS, p = .005, and self-report, p = .04. MI had a nonsignificant effect but produced higher satisfaction than reminder calls, p = .007. Treatment fidelity was high on most measures, with observable differences in behaviour between groups. All groups had high baseline adherence that limited opportunities for change. Conclusion: Reminder calls, but not MI, led to better adherence than usual care. Although a large literature supports MI, reminder calls might be a cost-effective intervention for patients with high baseline adherence. Replication is needed with less adherent participants.