Personalized behavior change program for glaucoma patients with poor adherence: a pilot interventional cohort study with a pre-post design

Abstract

Participants who have issues with medication adherence may have problems because of underlying psychological distress. [...]we will use the patient health questionnaire (PHQ-9), a validated measure used clinically to assess for depression [77], during the 3-, 10-, and 12-month study visits so that all participants are screened for depression annually and if a participant is identified as having depressive symptoms they will be referred to appropriate care (see protocol, Additional file 4). Baseline adherence for the 3-month interval before any intervention will be investigated for the Hawthorne effect. Because simply monitoring a patient can cause them to temporarily change their behavior, even in the absence of actual intervention [81], we will plot adherence over time for each patient during the first 3 months of monitoring. [...]the effect of the intervention on glaucoma medication adherence will be tested. Because all participants receive the intervention, this will be a test of slope of medication adherence over time (Ymedication adherence ~ Xtime). [...]the effect of the intervention on a mediator will be tested (Ymediator ~ Xtime).