Impact of a Brief Educational Intervention on Glaucoma Persistence: A Randomized Controlled Clinical Trial

Abstract

Purpose: To determine whether two sessions of a glaucoma educational intervention resulted in better persistence to glaucoma eye drop therapy compared to normal care.Methods: A total of 165 patients newly diagnosed with glaucoma who required eye drop therapy were recruited into a randomized clinical trial from the glaucoma clinic at Maisonneuve-Rosemont Hospital in Montreal, Canada. Patients were randomized to either an immediate intervention or normal care. The intervention consisted of two 60–90 minute sessions of education on glaucoma and its management, given in a small group format by a non-practicing ophthalmologist. Persistence to glaucoma medication was examined for 1 year by the use of Hospital medical records and by pharmacy claims records from the Régie de l’assurance maladie du Québec (Quebec Health Insurance Program). A questionnaire was administered, and medication possession ratio calculated. The primary outcome was persistence, defined as having medication available at least 75% of the time. Secondary outcomes included eye drop instillation technique and perception of the importance of eye drop therapy.Results: The intervention group achieved better persistence to eye drop therapy, as 77% of controls and 89% of people receiving the intervention were persistent (p = 0.049). The intervention also resulted in better eye drop instillation technique (p < 0.001) and greater perception of the importance of eye drop therapy (p < 0.001).Conclusions: Brief instructional sessions offered to newly diagnosed glaucoma patients can result in better persistence rates over 1-year follow-up. Strategies to permanently offer these types of initiatives should be considered.