Exploring the influence of patient-provider communication on intraocular pressure in glaucoma patients

PATIENT EDUCATION AND COUNSELING

卷:98

Article

Carpenter, Delesha M.¹  Tudor, Gail E.²  Sayner, Robyn³  Muir, Kelly W.^4,5  Robin, Alan L.^6,7,8  Blalock, Susan J.⁹  Hartnett, Mary Elizabeth¹⁰  Giangiacomo, Annette L.¹¹  Sleath, Betsy L.⁹ 

[1] Univ North Carolina Chapel Hill, Eshelman Sch Pharm, Asheville, NC USA

[2] Husson Univ, Dept Math & Stat, Bangor, ME USA

[3] Stanford Univ, Sch Med, Stanford, CA 94305 USA

[4] Duke Univ, Sch Med, Durham, NC 27706 USA

[5] Durham VA Med Ctr, Durham, NC USA

[6] Johns Hopkins Univ, Wilmer Inst, Baltimore, MD USA

[7] Johns Hopkins Univ, Sch Publ Hlth, Baltimore, MD USA

[8] Univ Maryland, Baltimore, MD 21201 USA

[9] Univ N Carolina, Eshelman Sch Pharm, Chapel Hill, NC USA

[10] Univ Utah, John A Moran Eye Ctr, Salt Lake City, UT USA

[11] Emory Univ, Sch Med, Atlanta, GA USA

关键词: Glaucoma;    Patient-provider communication;    Medication adherence;    Eye drop technique;    Mediation analysis;   

DOI  :  10.1016/j.pec.2015.07.001

来源: Elsevier

【 摘 要 】

Objective: We examined whether six patient-provider communication behaviors directly affected the intraocular pressure (IOP) of glaucoma patients or whether patient medication adherence and eye drop technique mediated the relationship between self-efficacy, communication, and IOP. Methods: During an 8-month, longitudinal study of 279 glaucoma patients and 15 providers, two office visits were videotape-recorded, transcribed, and coded for six patient-provider communication behaviors. Medication adherence was measured electronically and IOP was extracted from medical records. We ran generalized estimating equations to examine the direct effects of communication on IOP and used bootstrapping to test whether medication adherence and eye drop technique mediated the effect of communication on IOP. Results: Provider education about medication adherence (B = -0.50, p < 0.05) and inclusion of patient input into the treatment plan (B = -0.35, p < 0.05) predicted improved IOP. There was no evidence of significant mediation. Conclusion: The positive effects of provider education and provider inclusion of patient input in the treatment plan were not mediated by adherence and eye drop technique. Practice Implications: Providers should educate glaucoma patients about the importance of medication adherence and include patient input into their treatment plan. (C) 2015 Elsevier Ireland Ltd. All rights reserved.

【 授权许可】

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