Telemedicine Interventions for Glaucoma

(SIGHT Trial)

Recruiting at 1 trial location

Overseen By Phalatha McHaney-Connor

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of Michigan

Disqualifiers: Vision changes, Eye pain, Pregnancy, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 2 Jurisdictions This treatment is already approved in other countries

Compensation: Varies

Number of Visits: Unknown

622 Participants Needed

Trial Summary

What is the purpose of this trial?

This is a multiple site, randomized study that will assess the effects of personalized eHealth education and motivational-interviewing-based counseling on patient adherence to physician follow-up appointments.

Do I need to stop my current medications for this trial?

The trial protocol does not specify whether you need to stop your current medications.

What data supports the idea that Telemedicine Interventions for Glaucoma is an effective treatment?

The available research shows that Telemedicine Interventions for Glaucoma, which include motivational interviewing (MI), can improve patient satisfaction with communication from healthcare staff. One study found that after training staff in MI techniques, patient satisfaction increased. However, the same study noted that the intervention did not improve patients' confidence in using eye drops or their overall health engagement. Another study highlighted that about half of glaucoma patients do not follow their medication plans, and interventions like MI-based counseling have been successful in other chronic conditions. This suggests that while MI can enhance certain aspects of patient experience, more research is needed to determine its full effectiveness in improving medication adherence for glaucoma. ^{1 2 3 4 5}

What safety data exists for telemedicine interventions for glaucoma?

The studies reviewed focus on the feasibility and impact of motivational interviewing (MI) and related interventions for glaucoma, rather than directly addressing safety data. The interventions, such as MI training for para-professionals and personalized behavior change programs, are generally considered safe as they involve counseling and education to improve patient adherence and satisfaction. However, specific safety data for these interventions is not detailed in the provided research abstracts. ^{1 2 3 5 6}

Is the treatment in the trial 'Telemedicine Interventions for Glaucoma' a promising treatment?

Yes, the treatment is promising because it uses motivational interviewing, a counseling style that helps patients stick to their medication plans. This approach has been shown to improve patient satisfaction and communication with healthcare staff, which can lead to better adherence to treatment. ^{1 2 3 4 7}

Research Team

Paula Anne Newman-Casey, MD

Principal Investigator

University of Michigan

Eligibility Criteria

This trial is for adults over 18 with glaucoma. It's not suitable for those experiencing sudden vision changes, significant eye pain, pregnant women, prisoners, or individuals with cognitive impairments.

Exclusion Criteria

I have difficulty with memory or thinking clearly.

Prisoners

I am experiencing severe eye pain.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention

Participants receive either personalized eHealth education and motivational interviewing or standard education and care navigation

6 months

Follow-up

Participants are monitored for adherence to follow-up care with an ophthalmologist

Up to 18 months

Treatment Details

Interventions

• Personalized eHealth Education & Motivational Interviewing

Trial Overview The study is testing whether personalized eHealth education and motivational interviews can help patients stick to their follow-up appointments with doctors. This research involves multiple sites and randomly assigns participants to different groups.

Participant Groups

Group I: Personalized eHealth Education & Motivational Interviewing Experimental Treatment 1 Intervention

Personalized eHealth Glaucoma Education \& Motivational Interviewing

Group II: Standard Education Active Control 1 Intervention

Participant will receive standard glaucoma education.

Who Is Running the Clinical Trial?

University of Michigan

Lead Sponsor

Trials

1,891

Recruited

6,458,000+

Centers for Disease Control and Prevention

Collaborator

Trials

902

Recruited

25,020,000+

Findings from Research

A glaucoma educator trained in motivational interviewing (MI) was successfully integrated into a busy ophthalmology practice, demonstrating feasibility in improving patient adherence to glaucoma treatment.

Patients who participated in the MI program showed improvements in both motivation and adherence to their medication, suggesting that this approach could be effectively implemented in other clinics to enhance treatment outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Feasibility of motivational interviewing delivered by a glaucoma educator to improve medication adherence. Cook, PF., Bremer, RW., Ayala, AJ., et al.[2022]

A brief, glaucoma-specific motivational interviewing training program for ophthalmic para-professionals was found to be feasible and led to improved patient satisfaction with staff communication, as evidenced by a significant increase in satisfaction scores (p = 0.04).

While para-professionals improved their skills in motivational interviewing, the training did not enhance patients' self-efficacy in eye drop instillation or overall health activation, highlighting the need for dedicated time in clinics to effectively implement these counseling techniques.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Glaucoma-Specific Brief Motivational Interviewing Training Program for Ophthalmology Para-professionals: Assessment of Feasibility and Initial Patient Impact. Newman-Casey, PA., Killeen, O., Miller, S., et al.[2023]

This pilot study aims to improve medication adherence in glaucoma patients by using a combination of reminder systems and motivational interviewing, enrolling 57 participants who have shown poor adherence to their medications.

Over a 2-year period, the intervention includes a 3-month reminder phase followed by a 6-month counseling program, with the primary goal of increasing adherence and assessing its impact on clinical outcomes like intraocular pressure.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Personalized behavior change program for glaucoma patients with poor adherence: a pilot interventional cohort study with a pre-post design. Newman-Casey, PA., Niziol, LM., Mackenzie, CK., et al.[2022]

The SEE personalized glaucoma coaching program was well-received by 39 participants, with 95% expressing positive views, highlighting the effectiveness of personalized education and motivational support in improving medication adherence.

Key components that contributed to better adherence included interactions with a glaucoma coach, personalized education, and electronic reminders, with those showing greater improvement in adherence feeling a stronger need to improve and trusting their adherence scores more.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Patient Experience during the Support, Educate, Empower Glaucoma Coaching Program to Improve Medication Adherence: A Pilot Study. Hollenhorst, CN., Elliott, V., Heisler, M., et al.[2021]

In a randomized controlled trial involving 276 glaucoma patients in Nigeria, adapted motivational interviewing (MI) led to a 52% uptake of surgery or laser treatment, compared to 45% in the usual care group, indicating a slight increase in treatment acceptance.

Although the increase in treatment uptake with MI was not statistically significant, the overall acceptance rate of 52% is notably higher than in other studies, suggesting that MI may still have a positive impact on patient engagement in treatment decisions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Can Adapted Motivational Interviewing Improve Uptake of Surgical or Laser Treatment for Glaucoma in Nigeria: Randomized Controlled Trial. Abdull, MM., McCambridge, J., Evans, J., et al.[2018]

The electronic intervention using QR codes significantly increased awareness and discussions about glaucoma risk among first-degree relatives (FDRs) of patients, with 95% of FDRs engaging in conversations after receiving the standard message.

Following the intervention, 59% of FDRs scheduled glaucoma screening appointments, indicating that the method effectively encouraged proactive health behavior regarding glaucoma screening.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Empowering Family Glaucoma Risk Communication Using QR-Code-Mediated Online Intervention. Hallaj, S., Shah, SJ., Cehelyk, EK., et al.[2023]

In a study of 201 patients with glaucoma, reminder calls significantly improved medication adherence compared to usual care, as measured by electronic monitoring and self-reports.

Motivational interviewing (MI) did not show a significant effect on adherence but resulted in higher patient satisfaction compared to reminder calls, suggesting that while MI is beneficial for satisfaction, reminder calls may be a more effective and cost-efficient strategy for improving adherence in patients with already high baseline adherence.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Motivational interviewing or reminders for glaucoma medication adherence: Results of a multi-site randomised controlled trial. Cook, PF., Schmiege, SJ., Mansberger, SL., et al.[2018]

References

1. New Zealand pubmed.ncbi.nlm.nih.gov

Feasibility of motivational interviewing delivered by a glaucoma educator to improve medication adherence. [2022]

2. England pubmed.ncbi.nlm.nih.gov

A Glaucoma-Specific Brief Motivational Interviewing Training Program for Ophthalmology Para-professionals: Assessment of Feasibility and Initial Patient Impact. [2023]

3. England pubmed.ncbi.nlm.nih.gov

Personalized behavior change program for glaucoma patients with poor adherence: a pilot interventional cohort study with a pre-post design. [2022]

4. United States pubmed.ncbi.nlm.nih.gov

Patient Experience during the Support, Educate, Empower Glaucoma Coaching Program to Improve Medication Adherence: A Pilot Study. [2021]

5. United States pubmed.ncbi.nlm.nih.gov

Can Adapted Motivational Interviewing Improve Uptake of Surgical or Laser Treatment for Glaucoma in Nigeria: Randomized Controlled Trial. [2018]

6. United States pubmed.ncbi.nlm.nih.gov

Empowering Family Glaucoma Risk Communication Using QR-Code-Mediated Online Intervention. [2023]

7. England pubmed.ncbi.nlm.nih.gov

Motivational interviewing or reminders for glaucoma medication adherence: Results of a multi-site randomised controlled trial. [2018]