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Predictors of Adherence to Glaucoma Treatment in a Multisite Study

  • Original Article
  • Published:
Annals of Behavioral Medicine

Abstract

Background

Poor adherence hinders glaucoma treatment. Studies have identified demographic and clinical predictors of adherence but fewer psychological variables.

Purpose

We examined predictors from four health behavior theories and past research.

Methods

In the baseline phase of a three-site adherence study, before any intervention, 201 participants used electronic Medication Event Monitoring System (MEMS) bottles to monitor eyedrop use for 2 months, and completed questionnaires including self-reported adherence.

Results

MEMS showed 79 % adherence and self-report 94 % (0.5–1.5 missed weekly doses), but they correlated only r s  = 0.31. Self-efficacy, motivation, dose frequency, and nonminority race/ethnicity predicted 35 % of variance in MEMS. Cues to action, self-efficacy, and intention predicted 20 % of variance in self-reported adherence.

Conclusions

Self-efficacy, motivation, intention, cues to action, dose frequency, and race/ethnicity each independently predicted adherence. Predictors from all theories were supported in bivariate analyses, but additional study is needed. Researchers and clinicians should consider psychological predictors of adherence. (ClinicalTrials.gov ID# NCT01409421.)

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Acknowledgments

This research was supported by a grant from Merck & Co., Inc., with additional research infrastructure support from the Colorado Clinical and Translational Science Institute, NIH grant #1UL1RR025780-01. The sponsor’s representative participated in design of the study and review of the manuscript, and Dr. Fitzgerald’s contributions are gratefully recognized with co-authorship credit. The authors wish to acknowledge Laurra Aagaard, Gordon Barker, Sandy Owings, Mary Preston, Scott Ruark, Christopher Shelvock, and Christina Sheppler for their contributions to this study.

Authors’ Statement of Conflict of Interest and Adherence to Ethical Standards

Authors Paul F Cook, Sarah J. Schmiege, Steven Mansberger, Jeffrey Kammer, Timothy Fitzgerald, and Malik Y. Kahook declare that they have no conflict of interest. All procedures, including the informed consent process, were conducted in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. This study was reviewed for human subjects and confidentiality (HIPAA) compliance and approved by the Colorado Multiple Institutional Review Board.

Author information

Authors and Affiliations

  1. University of Colorado College of Nursing, University of Colorado, Campus Box C288-04, Aurora, CO, 80045, USA

    Paul F. Cook PhD & Sarah J. Schmiege PhD

  2. Devers Eye Institute, Portland, OR, 97210, USA

    Steven L. Mansberger MD

  3. Vanderbilt Eye Institute, Nashville, TN, 37232, USA

    Jeffrey Kammer MD

  4. Merck & Co., Inc., White House Station, NJ, USA

    Timothy Fitzgerald MA, PhD

  5. University of Colorado School of Medicine, University of Colorado, Aurora, CO, 80045, USA

    Malik Y. Kahook MD

Authors
  1. Paul F. Cook PhD
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  2. Sarah J. Schmiege PhD
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  3. Steven L. Mansberger MD
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  6. Malik Y. Kahook MD
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Corresponding author

Correspondence to Paul F. Cook PhD.

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Cook, P.F., Schmiege, S.J., Mansberger, S.L. et al. Predictors of Adherence to Glaucoma Treatment in a Multisite Study. ann. behav. med. 49, 29–39 (2015). https://doi.org/10.1007/s12160-014-9641-8

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  • DOI: https://doi.org/10.1007/s12160-014-9641-8

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