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21-06-2012 | Legal medicine | Article

Trial participation may improve glaucoma treatment adherence


Free abstract

MedWire News: Participation in a telephone-based communication intervention study improves patient adherence to glaucoma treatment and appointment keeping, show US study results.

However, while patients who were randomly assigned to the intervention arm of the study showed significant improvements in adherence, so did patients assigned to the control or "usual care" arm, say the researchers.

This suggests that "motivated patients participating in an ongoing clinical trial may improve their adherence, even without tailored messages," writes the team in Archives of Ophthalmology.

Nevertheless, Karen Glanz (University of Pennsylvania, Philadelphia) and co-authors believe that new technologies such as interactive voice recognition and electronic reminder devices may play a supportive role in the effort to improve adherence in patients with glaucoma.

Nonadherence to glaucoma medication ranges from 5% to 80%, they explain.

Their 12-month study included 312 patients with glaucoma who, according to self-reports from the preceding year, did not take their medication, refill their medication, and/or keep their eye-clinic appointments.

A total of 150 (96%) participants randomly assigned to the intervention group, which involved 12 educational telephone calls followed up with individually tailored printed materials, had 12-month follow-up data available, as did 152 (98%) of those in the control group.

Using this data, Glanz and colleagues observed that adherence increased significantly during the study in all areas, for both groups. In particular, self-reported medication adherence increased from 10.2% to 30.2% in the intervention group, and from 13.5% to 27.0% in the control group.

Furthermore, in two-thirds of the adherence outcomes measured, the intervention group improved by 4‑10 percentage-points more compared with the control group; however, this was statistically nonsignificant.

The communication intervention was well received by patients, note the researchers, with 85% rating the telephone calls as easy to understand and 78‑85% saying they were interesting, personally relevant, and helpful. Responses to the printed materials were also positive.

"Glaucoma patient care should include reminders about consistent use of medication and the importance of keeping appointments," they conclude.

By Sarah Guy

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