Department of Ophthalmology & Visual Sciences, University of Michigan Medical School, Ann Arbor, Michigan.
Calvin College, Grand Rapids, Michigan.
Ophthalmol Glaucoma. 2020 Jul-Aug;3(4):238-252. doi: 10.1016/j.ogla.2020.04.016. Epub 2020 May 7.
To understand patients' qualitative experiences with the Support, Educate, Empower (SEE) personalized glaucoma coaching program, provide a richer understanding of the components of the intervention that were useful in eliciting behavior change, and understand how to improve the SEE Program.
A concurrent mixed-methods process analysis.
Thirty-nine patients with a diagnosis of any kind of glaucoma or ocular hypertension who were aged ≥40 years, were taking ≥1 glaucoma medication, spoke English, self-administered their eye drops, and had poor glaucoma medication adherence (defined as taking ≤80% of prescribed medication doses assessed via electronic medication adherence monitors) who completed the 7-month SEE Program.
All participants who completed the study were interviewed in-person using a semistructured interview guide after the intervention. Coders conducted qualitative analysis of transcribed interviews using Grounded Theory. Participants were then stratified into groups based on change in adherence, and thematic differences between groups were examined.
Themes that emerged from interviews categorized by the number of participants who expressed a theme and the number of representative citations.
Participants expressed positive views toward the program overall (95%, n = 37/39). They perceived program components as working together to improve their medication adherence. Interactions with the glaucoma coach (38 participants, 184 citations), motivation to aid personal change (38 participants, 157 citations), personalized glaucoma education (38 participants, 149 citations), electronic reminders, and hearing their adherence score (37 participants, 90 citations) were most commonly cited by participants as helpful program elements contributing to improved adherence. Patients expressed a desire for personalized education to be a standard part of glaucoma care. Participants who demonstrated more improvement in adherence had a more trusting attitude toward the adherence score and a greater magnitude of perceived personal need to improve adherence.
Participants reported a highly positive response to the in-person glaucoma education and motivational interviewing intervention used in conjunction with automated adherence reminders.
了解患者对支持、教育、授权（SEE）个性化青光眼辅导计划的定性体验，更深入地了解干预措施中有助于引发行为改变的组成部分，并了解如何改进 SEE 计划。
同时进行的混合方法过程分析。
39 名被诊断患有任何类型青光眼或高眼压症的患者，年龄≥40 岁，正在服用≥1 种青光眼药物，会讲英语，自行滴眼药水，且青光眼药物依从性差（定义为通过电子药物依从性监测器评估的，仅服用规定药物剂量的≤80%），他们完成了 7 个月的 SEE 计划。
所有完成研究的参与者在干预结束后，使用半结构化访谈指南进行了面对面访谈。编码员使用扎根理论对转录访谈进行了定性分析。然后，根据依从性的变化对参与者进行分组，并检查组间的主题差异。
根据表达主题的参与者人数和代表性引文数量进行分类的访谈中出现的主题。
参与者对整个计划持积极看法（95%，n=37/39）。他们认为计划的组成部分共同作用，提高了他们的药物依从性。与青光眼教练的互动（38 名参与者，184 条引文）、帮助个人改变的动机（38 名参与者，157 条引文）、个性化青光眼教育（38 名参与者，149 条引文）、电子提醒以及听到他们的依从性评分（37 名参与者，90 条引文）是参与者最常提到的有助于提高依从性的有益计划要素。患者希望个性化教育成为青光眼护理的标准组成部分。在依从性方面表现出更大改善的参与者对依从性评分更信任，并且更强烈地认为个人需要提高依从性。
参与者对结合自动化依从性提醒使用的现场青光眼教育和动机访谈干预措施做出了高度积极的反应。
