Meducation: A Randomized Controlled Trial of an Online Educational Video Intervention to Improve Glaucoma Eye Drop Technique and Adherence

摘要

Glaucoma is the second-leading cause of blindness in the United States. Progression of glaucoma can be prevented by reducing intraocular pressure using eye drop medications, but patients tend to have difficulty instilling eye drops correctly. Short educational videos may be helpful to instruct patients on correct eye drop instillation, but only one small study testing an educational video for glaucoma eye drop technique has been performed to date. Therefore, the objective of this dissertation was to determine the effectiveness of an online video intervention in improving self-efficacy, technique, and adherence to eye drops in glaucoma patients.;Ninety-two patients with glaucoma, who self-administered their own eye drops and had less than perfect technique, were enrolled in this pilot randomized controlled trial. They were randomized to watch the MeducationRTM eye drop technique video in the intervention group, or a nutrition video in the control group. Five eye drop technique steps were assessed using objective video recordings at baseline, immediately after the video, and 1 month later. The secondary outcomes were eye drop technique self-efficacy and medication adherence. Linear regression models were used to determine whether the intervention group had better self-efficacy, technique, and adherence than the control group after adjusting for important covariates.;Adjusted for baseline self-efficacy, intervention patients had better eye drop technique self-efficacy than controls immediately after the video (p=0.024) and at 1 month (p=0.015). Adjusted for baseline technique and other covariates, eye drop technique averaged 0.75 steps better in intervention patients than controls immediately after the video (p=0.002) and 0.63 steps better at 1 month (p=0.011). The intervention did not significantly improve adherence. Participants' mean rating of usefulness of the video was 3.40 on a 4-point scale. Patients' most preferred method for having access to the intervention was in the doctor's office exam room, but also desired online options for watching the video.;We concluded that a short educational video can significantly improve glaucoma patients' self-efficacy and eye drop technique. The video should be disseminated in multiple ways: in the exam room when drops are prescribed as well as online.