Improving adherence to glaucoma medication: a randomised controlled trial of a patient-centred intervention (The Norwich Adherence Glaucoma Study)

BMC Ophthalmology

Research Article

David C Broadway¹  Heidi Cate¹  Richard Fordham²  Allan Clark²  Richard Holland²  Debi Bhattacharya³ 

[1] Norfolk & Norwich University Hospital NHS Trust, Glaucoma Research Unit, Level 2, West Block, NR4 7UY, Colney Lane, Norwich, UK;School of Pharmacy, University of East Anglia, NR4 7TJ, Norwich, UK;Norwich Medical School, University of East Anglia, NR4 7TJ, Norwich, UK;School of Pharmacy, University of East Anglia, NR4 7TJ, Norwich, UK;

关键词: Glaucoma;    National Health Service;    Ocular Hypertension;    Primary Open Angle Glaucoma;    Theoretical Domain Framework;   

DOI  :  10.1186/1471-2415-14-32

 received in 2013-12-13, accepted in 2014-03-17,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundImproving adherence to ocular hypertension (OH)/glaucoma therapy is highly likely to prevent or reduce progression of optic nerve damage. The present study used a behaviour change counselling intervention to determine whether education and support was beneficial and cost-effective in improving adherence with glaucoma therapy.MethodsA randomised controlled trial with a 13-month recruitment and 8-month follow-up period was conducted. Patients with OH/glaucoma attending a glaucoma clinic and starting treatment with travoprost were approached. Participants were randomised into two groups and adherence was measured over 8 months, using an electronic monitoring device (Travalert® dosing aid, TDA). The control group received standard clinical care, and the intervention group received a novel glaucoma education and motivational support package using behaviour change counselling. Cost-effectiveness framework analysis was used to estimate any potential cost benefit of improving adherence.ResultsTwo hundred and eight patients were recruited (102 intervention, 106 control). No significant difference in mean adherence over the monitoring period was identified with 77.2% (CI, 73.0, 81.4) for the control group and 74.8% (CI, 69.7, 79.9) for the intervention group (p = 0.47). Similarly, there was no significant difference in percentage intraocular pressure reduction; 27.6% (CI, 23.5, 31.7) for the control group and 25.3% (CI, 21.06, 29.54) for the intervention group (p = 0.45). Participants in the intervention group were more satisfied with information about glaucoma medication with a mean score of 14.47/17 (CI, 13.85, 15.0) compared with control group which was 8.51 (CI, 7.72, 9.30). The mean intervention cost per patient was GB£10.35 (

【 授权许可】

CC BY   
© Cate et al.; licensee BioMed Central Ltd. 2014