A 2-hour Information Session and Patient Recall has Minimal Impact on Glaucoma-treatment Persistence in a Mature Practice

Abstract

Purpose: To study the impact of a 2-hour information session and 3 patients' phone calls on patient persistence with glaucoma medication.Patients and Methods: All patients with glaucoma treatment, part of a 27-year old solo glaucoma practice, were invited to attend the information session. Patients who attended the session (n=342) were contacted by phone 1, 4, 10 months later and regular use of drops was stressed. Patients were unaware of the study. We compared the persistence of the patients before and after attending the session, and their persistence to that of patients who did not attend (n=1187). Persistence with glaucoma medication was assessed by examination of data (2002 to 2007) from a provincial medical and drug insurance database.Results: Patients attending the session had glaucoma for 10 years. They had a better persistence than those who did not attend (P<0.05). Their persistence remained the same 1 year after attending the session but tended to be improved in the first 180 days (P<0.076). During the study period, there was a 4% increase in overall persistence (P<0.05). This could be due to an increase in prostaglandins prescriptions and changes in b-blockers formulation.Conclusions: The information session and patient's recalls had a limited impact on patient persistence. This could be due to the selection of a population already persistent (78.9%). The results could have been different in less persistent patients and new patients. It could be different in another practice setting.

Systematic review of educational interventions to improve glaucoma medication adherence: an update in 2015

“…Blondeau and colleagues 33 measured persistence with glaucoma medication for two years before and one year after a group education session. The sessions consisted of a power point presentation about glaucoma by a glaucoma nurse.…”

“…33 All of the other observational studies used various measures of self-report, and the only validated instrument was used by Lunnela's group. 25 …”

“…The quality of the observational studies was more variable. Two studies received an Ottowa-Newcastle score of 5/5, Blondeau's study 33 of a glaucoma nurse-led group education session and Cook's study 28 of motivational interviewing delivered by a trained glaucoma technician. Two studies received Ottowa-Newcastle scores of 4/5, in which they lost one point because their length of follow-up after their intervention was less than six months, but the studies were otherwise very well-designed.…”

“…Four studies used pharmacy refill data 17,23,24,33 to objectively measure adherence, and those studies were able to capture a broader picture of patients' adherence to their medications than those using electronic monitoring of a single medication. The study by Gray and colleagues 17 took place in the UK while the studies by Glanz 23 and Muir 24 took place in the US and the study by Blondeau 33 took place in Canada.…”

“…The study by Gray and colleagues 17 took place in the UK while the studies by Glanz 23 and Muir 24 took place in the US and the study by Blondeau 33 took place in Canada. The caveat to using prescription refill data as a measure of adherence is that unless the data is from a single-payer closed-pharmacy system such as in the UK 17 or Canada, 33 it is difficult to be certain that all refills are being captured from the large number of potential pharmacies at which a patient may have filled a script. Thus using prescription refill data from local pharmacies to measure adherence, such as in the I-SIGHT study, 23 will decrease the signal to noise ratio of the measurement, leading to a less accurate classification of adherence status.…”