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Abstract #108374 Published in IGR 23-4
Patient-centered Outcomes After a Medication Adherence Intervention: A Pilot Study
Cho J; Song M; Niziol LM; Heisler M; Resnicow K; Musch DC; Lee P; Darnley-Fisch D; Newman-Casey PAJournal of Glaucoma 2023; 32: 891-899
PRECIS: Self-determination theory (SDT) guided behavioral interventions are effective in improving several patient-centered metrics, including their glaucoma-related distress. However, whether improvement in patient-centered metrics can drive an improvement in medication-taking behavior remains to be seen. OBJECTIVE: The 7-month Support, Educate, Empower (SEE) personalized glaucoma coaching program was previously shown to improve glaucoma medication adherence by 21-percentage points. This study's goal was to assess the impact of the SEE program on Self Determination Theory (SDT) metrics and other patient-centered outcome measures.Participants & METHODS: Glaucoma patients (≥40 y old, taking ≥1 medication) self-reporting poor medication adherence were recruited at the University of Michigan. Eight surveys (with 10 subscales) were completed before and after the 7-month SEE program. Three surveys assessed changes in SDT (Treatment Self-regulation Questionnaire, Healthcare-Climate Questionnaire, Perceived Competence) while the other assessed participants' Glaucoma Knowledge, Glaucoma Medication Self efficacy, Glaucoma-related distress, Perceived benefits, confidence asking and getting questions answered. RESULTS: Thirty-nine participants completed the SEE program. Significant improvements were in 7 subscales, including all three SDT tenets of competence (mean change =0.9, standard deviation =±1.2, adjusted P=0.0002), autonomy (0.5, ±0.9, 0.044), and relatedness (P=0.002). Glaucoma-related distress (-2.0, ±3.2, 0.004), confidence asking questions (1.1, ±2.0, 0.008), and confidence getting questions answered (1.0, ±2.0, 0.009) also improved. Glaucoma-related distress was correlated with perceived competence (r=-0.56, adjusted P=0.005) and an increase in perceived competence was associated with a decrease in glaucoma-related distress (β=-0.43, 95% CI -0.67 - -0.20, adjusted P=0.007). CONCLUSION: The SEE program improved participants' autonomous motivation, perceived support, perceived competence, glaucoma-related distress, and competence. These results point to the promising potential of SDT-guided behavioral interventions in improving patient-centered metrics.
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