April 17, 2009
Betsy Sleath, PhD, a professor at the UNC Eshelman School of Pharmacy, has received a four-year, $2.65 million grant from the National Eye Institute to study how the communication between glaucoma patients and their doctors affects how well the patients take their medication and the effectiveness of the treatment.
There is currently no cure for glaucoma, but it is possible to treat the disease with medication or surgery and prevent further loss of vision. However, about half the patients who start on glaucoma medications stop taking them within six months even though they should take the medications for the rest of their lives. Glaucoma affects more than 2 million Americans and is responsible for causing approximately 10 percent of all cases of blindness in the United States.
“The findings from this study can be used to educate providers and patients about how to optimize communication during glaucoma visits to assure improved patient outcomes,” Sleath says. “If we find that certain aspects of provider-patient communication during medical visits are related to medication adherence and persistence and intraocular pressure, then we can design intervention studies to test strategies for improving communication between providers and glaucoma patients.”
Sleath is also a research fellow at the Cecil G. Sheps Center for Health Services Research. Susan Blalock, PhD, who is also an associate professor at the School, is a major collaborator on the grant.
The study will follow thirty ophthalmologists at six clinics, their ophthalmic technicians, and 420 new patients who are diagnosed with or suspected to have glaucoma. Researchers will videotape a patient’s first two visits to collect data on factors such as the extent to which the provider does an individualized assessment of the patient’s views of glaucoma and its treatment, how much the provider involves the patient in setting treatment goals, and whether the provider shows the patient how to properly administer the medication. The patient is interviewed immediately after each of the first two visits and again six months after the second visit to collect data on medication adherence and persistence and intraocular pressure.
A pilot study conducted by Sleath and Alan Robin, MD, of Johns Hopkins University found that 15 percent of the patients in the study said no one gave them information about their glaucoma medications, and 20 percent said no one showed them how to use their medications.
The research team for the study includes Sleath; Blalock; Mary Elizabeth Harnett, MD, a professor of ophthalmology at UNC-Chapel Hill; Brenda DeVellis, PhD, a professor of health behavior and health education in the UNC Gillings School of Global Public Health; and Annette Giangiacomo, MD, an assistant professor at Emory University. The research team also includes collaborators from Duke University, Johns Hopkins University, and ophthalmology practices from around the state.