The Support, Educate, Empower (SEE) Personalized Glaucoma Coaching Trial Results

Document Type

Conference Proceeding

Publication Date

6-1-2025

Publication Title

Invest Ophthalmol Vis Sci

Keywords

eye drops, adult, Caucasian, coaching, conference abstract, controlled study, counselor, Diabetes Distress Scale, distress syndrome, drug therapy, female, Finland, glaucoma, human, intraocular pressure, major clinical study, male, medication compliance, motivational interviewing, multicenter study, patient compliance, randomized controlled trial, tonometer

Abstract

Purpose : Test the effect of the Support, Educate, Empower (SEE) personalized glaucomacoaching program in a sample of medically-treated glaucoma participants with poor self-reported adherence on the following outcomes: 1) the primary outcome, medicationadherence; 2) the secondary outcome, glaucoma-related distress (GRD); 3) the exploratoryoutcome, intraocular pressure (IOP).Methods : Patients with glaucoma taking ≥1 eyedrop medications and self-reportingadherence ≤85% were recruited from two sites (University of Michigan [UM] and HenryFord Health System [HFHS]). Eligible participants were randomized 1:1 to the SEEintervention or usual care. The SEE intervention included motivational interviewing-basedcoaching alongside personalized glaucoma education at three in-person sessions from atrained non-physician counselor, four between-visit phone calls to discuss adherencescore, and automated medication reminders. All participants were followed for 6 monthsduring which medication adherence was monitored electronically (AdhereTech, New York,NY), and GRD (Modified Diabetes Distress Scale) and IOP (iCare tonometer; Tiolat Oy,Helsinki, Finland) were measured at study enrollment and exit. Medication adherence wascalculated as the percentage of doses taken by doses prescribed over the 6-month studyperiod. Outcomes were compared between SEE intervention and usual care groups with 2-sample t- and Wilcoxon tests.Results : 235 participants were enrolled (107 UM, 128 HFHS) and randomized (117 SEEintervention, 118 control). Participants were 67±11 (mean±standard deviation) years old,53% female, 30% White and 61% Black, and 63% reported income <$60k, 24% $61-$120k,and 13% >$120k. Electronically monitored adherence was significantly better in SEEintervention participants than usual care (77.6%±19.7 vs 58.0%±25.2, respectively,p<0.0001), as was change in GRD (-0.58±0.87 vs -0.23±0.74, p=0.003), and IOP in the eyewith worse mean deviation trended towards improvement (-1.01±4.54 vs 0.15±3.72,p=0.12) while IOP in the eye with better mean deviation showed no difference (-0.36±3.43vs -0.14±4.91, p=0.49).Conclusions : The SEE personalized glaucoma coaching program was a multi-facetedintervention that improved medication adherence and glaucoma related distress inglaucoma patients with poor self-reported adherence. There was a trend towards animprovement in IOP control.

Volume

66

Issue

8

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