Browsing by Author "Awan, Nabeel"

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    A Comparison of Objectively- and Subjectively-Measured Adherence in Glaucoma Patients of African Descent
    (Office of the Vice Chancellor for Research, 2015-04-17) Awan, Nabeel; Sutaria, Ankita; Bigatti, Silvia M.; Sirk, Emily; Hosty, Elizabeth; Payton, Chloe; Grow, Shelbi; Sutton, Bradley; Torbit, Julie; Racette, Lyne
    Purpose. Adherence to medical treatment of glaucoma is challenging. People of African descent (AD) have higher prevalence of open-angle glaucoma (OAG) and have been shown to have worse adherence. The goal of this prospective, observational study was to compare objectively- and subjectively-measured adherence in patients of African descent and to determine their relationship with self-efficacy. Methods. Twenty-one patients of AD diagnosed with OAG in the past five years were included in this study. Patients used a once-daily topical prostaglandin analog eye drop and self-administered their medication. Subjective adherence was assessed through self-report. Adherence was objectively measured using MEMS bottles. The cap of these bottles records the number of times the bottle is opened. Self-efficacy was assessed using the 10-item Glaucoma Medication Self-Efficacy scale and the 6-item Eye Drop Technique Self-Efficacy scale. MEMS adherence percentages were compared to self-reported adherence using a paired sample two-tailed t-test. To assess the relationship between objectively measured adherence and self-efficacy, patients were divided into 3 groups (n=7 each): high, medium and low adherence groups. The Chi-square test was used to determine whether differences in self-efficacy between the groups were present for each question on the two self-efficacy scales. Results. Subjectiveadherence (mean ± standard deviation) (97.34% ± 5.61) was significantly higher than objective adherence (66.34% ± 26.68) (p= 0.01). Of the 21 patients, 17 self-reported higher adherence levels than MEMS adherence levels. 4 patients with the highest levels of objectively measured adherence were the only patients to correctly estimate their adherence by self-report. Only one question was significantly associated with objective adherence: patients with high adherence were significantly more confident about taking their glaucoma medications when they do not experience symptoms (p = 0.04). Conclusions. Results showed that patients with higher adherence are more confident about using their eye drops in the absence of symptoms.
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    Improving Adherence in African American Patients through Motivational Interviewing
    (Office of the Vice Chancellor for Research, 2015-04-17) Grow, Shelbi; Awan, Nabeel; Botros, Mark; Idowu, Eniola
    Glaucoma is a chronic disease of the eye and African Americans are more susceptible to the disease compared to other races. The medical treatment of glaucoma requires that patients instill eye drops each day for the rest of their lives. Adherence to this regimen be challenging and has been reported to be worse in patients of African American descent (AD), a segment of the population that is disproportionately affected by the disease. Motivational Interviewing (MI) is a goal-oriented, patient-centered counseling style for eliciting behavior change by helping patients to explore and resolve ambivalence. MI can improve adherence and has been shown to be more effective in minority populations. The purpose of the pilot study was to determine whether MI might improve adherence in glaucoma patients of AD. Thirteen patients of African American descent (AD) who received a clinical diagnosis of open-angle glaucoma were included in the study. Patients were included in the study if they used once-a-day prostaglandin analog eye drops and administered their own medication. Adherence was measured using Medical Event Monitoring System (MEMS) bottles. The cap of these bottles electronically records the date and time at which the bottle is opened. At the initial visit patients were instructed to place the eye medication bottle in the MEMS bottle and to continue to use their medication as they normally would. At the second visit (week 3), baseline adherence was assessed. Patients with adherence levels below 75% (n=9) received MI and those with adherence levels over 75% served as controls (n=4). At the last visit (week 9), patients returned and the final adherence was assessed. Baseline and final adherence were compared in each group using a t-test. In the group who received MI, final adherence (67.9% ± 7.68) was significantly higher than baseline adherence (55.95% ± 22.16) (p=0.03). In the control group, no significant difference between baseline adherence (81.38% ± 5.52) and final adherence (82% ± 17.33) (p=0.46) was observed. These preliminary results suggest that motivational interviewing may be effective in improving adherence in patients of AD with glaucoma.