Project Overview +

Glaucoma is the second leading cause of blindness in the United States and is the leading cause of irreversible blindness among African-Americans. Treatment, when consistently implemented, can prevent blindness, and yet at least 30% and as high as 80% of glaucoma patients do not adhere to their glaucoma medications or return for their follow-up appointments. This lack of adherence results in worse outcomes, with higher rates of visual field progression.

Educational interventions to improve patient adherence have shown some promise, and there is significant potential to expand upon these successes, as well as to address the obstacles that have burdened the educational approaches implemented to date. The past interventions that have been most successful are those that engage patients in a process that explores their personal barriers to adherence and tailors interventions accordingly.

This research program utilizes not only health behavior theory, but also principles from behavioral economics to create a personalized computer-based glaucoma education program that can be taught by non-physician educators to motivate improved self-management in glaucoma patients.

Related Media +

Related Media:

Aims +

Aim 1: Develop a scalable, personalized educational intervention and test its usability in focus groups.

Aim 2: Pilot the personalized educational intervention

Participants +

Sixty glaucoma patients with poor medication adherence will be recruited from the both general ophthalmology clinics and the glaucoma clinic at the University of Michigan. We oversample African-American patients for a total of 20 African-American subjects.

Intervention +

Phase 1: We develop the personalized, tailored, computer-based educational modules using the Michigan Tailoring System software and principles of health behavior theory and behavioral economics. We then conduct usability studies with patients, ophthalmic technicians, ophthalmologists and caregivers and improve the program.

Phase 2: We conduct a pilot randomized controlled trial to determine performance parameter estimates including the effect size and standard errors to adequately power a future trial.

At the completion of the project, we will have created a scalable, personalized educational intervention to improve glaucoma medication adherence based in health behavior theory and behavioral economic theory that can be administered by glaucoma educators.

eyeGuide: Personalized Tablet-based Glaucoma Education

09/01/2013 - 08/31/2016


National Eye Institute

Principal Investigator:

Paula Newman-Casey, MD, MS