Muir Kelly W, Rosdahl Jullia A, Hein Aaron M, Woolson Sandra, Olsen Maren K, Kirshner Miriam, Sexton Malina, Bosworth Hayden B
Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina; Durham Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Health Care System, Durham, North Carolina.
Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina.
Ophthalmol Glaucoma. 2022 Jan-Feb;5(1):40-46. doi: 10.1016/j.ogla.2021.04.006. Epub 2021 Apr 20.
To test the effectiveness of an intervention designed to improve glaucoma medication adherence.
Randomized, controlled trial at a Veterans Affairs (VA) eye clinic.
Veterans with medically treated glaucoma who reported poor adherence and their companions if applicable.
Participants, and their companions if applicable, were randomized to receive an intervention to improve medication adherence that included glaucoma education, personalized disease management suggestions, and a reminder aid, or the control arm that received education regarding general eye health.
The average proportion of prescribed glaucoma medication doses taken on schedule over the 6 months after randomization according to an electronic monitor between participants in the 2 arms.
The mean proportion of prescribed doses taken on schedule was higher in the intervention group compared with controls (0.85 vs. 0.62, P < 0.0001). The difference in proportions between the 2 groups did not vary in regressions models adjusted for companion status, frequency of dosing, and race. The longitudinal model indicated that the intervention group had significantly higher adherence during the first month after randomization and continued to stay higher through 6 months (month by treatment interaction, P = 0.003).
A multifaceted intervention can help improve glaucoma medication adherence.
测试一项旨在提高青光眼药物治疗依从性的干预措施的有效性。
在一家退伍军人事务(VA)眼科诊所进行的随机对照试验。
接受药物治疗的青光眼退伍军人,若适用,还包括他们的同伴。
参与者及其同伴(若适用)被随机分配接受一项旨在提高药物治疗依从性的干预措施,该措施包括青光眼教育、个性化疾病管理建议和提醒辅助工具,或接受关于一般眼部健康的教育的对照组。
根据电子监测器,两组参与者在随机分组后6个月内按时服用的青光眼规定药物剂量的平均比例。
干预组按时服用规定剂量的平均比例高于对照组(0.85对0.62,P<0.0001)。在根据同伴状态、给药频率和种族进行调整的回归模型中,两组之间的比例差异没有变化。纵向模型表明,干预组在随机分组后的第一个月依从性显著更高,并在6个月内持续保持较高水平(治疗与月份交互作用,P=0.003)。
多方面干预有助于提高青光眼药物治疗依从性。