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.
Aim 1: Develop a scalable, personalized educational intervention and test its usability in focus groups.
Aim 2: Pilot the personalized educational intervention
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.