Delesha M Carpenter1, Gail E Tudor2, Robyn Sayner3, Kelly W Muir4, Alan L Robin5, Susan J Blalock6, Mary Elizabeth Hartnett7, Annette L Giangiacomo8, Betsy L Sleath6. 1. Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Asheville, USA. Electronic address: dmcarpenter@unc.edu. 2. Department of Mathematics and Statistics, Husson University, Bangor, USA. 3. School of Medicine, Stanford University, Stanford, CA, USA. 4. School of Medicine, Duke University, & Durham VA Medical Center, Durham, USA. 5. Wilmer Institute and Bloomberg School of Public Health; Johns Hopkins University, & University of Maryland, Baltimore, MD, USA. 6. Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, USA. 7. John A. Moran Eye Center, University of Utah, Salt Lake City, USA. 8. School of Medicine, Emory University, Atlanta, USA.
Abstract
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.
OBJECTIVE: We examined whether six patient-provider communication behaviors directly affected the intraocular pressure (IOP) of glaucomapatients 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 glaucomapatients 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 glaucomapatients about the importance of medication adherence and include patient input into their treatment plan.
Authors: Betsy Sleath; Susan Blalock; David Covert; Jennifer L Stone; Asheley Cockrell Skinner; Kelly Muir; Alan L Robin Journal: Ophthalmology Date: 2011-12 Impact factor: 12.079
Authors: Betsy Sleath; Susan J Blalock; Delesha M Carpenter; Robyn Sayner; Kelly W Muir; Catherine Slota; Scott D Lawrence; Annette L Giangiacomo; Mary Elizabeth Hartnett; Gail Tudor; Jason A Goldsmith; Alan L Robin Journal: Ophthalmology Date: 2014-12-24 Impact factor: 12.079
Authors: Yesha S Shah; Michael Cheng; Aleksandra Mihailovic; Eva Fenwick; Ecosse Lamoureux; Pradeep Y Ramulu Journal: Ophthalmology Date: 2021-10-28 Impact factor: 14.277