Browsing by Subject "Motivational Interviewing (MI)"

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    An Assessment of the Fidelity of Two Different Interventions to Improve Adherence to Glaucoma Treatment in Patients of African Descent
    (Office of the Vice Chancellor for Research, 2015-04-17) Idowu, Eniola; Bigatti, Silvia M.; Racette, Lyne
    Glaucoma is a chronic eye disease, which is asymptomatic and can slowly lead to blindness if left untreated. Glaucoma is caused by damage to the optic nerve and can lead to irreversible loss of sight. The overall objective of this MURI study was to determine the impact of two different interventions on compliance to glaucoma medication in patients of African descent with open-angle glaucoma. Two types of intervention were used – Education and Motivational Interviewing (MI). The educational intervention involved sharing knowledge with patients about glaucoma, its causes, and its treatments, to help patients better understand glaucoma and the importance of adhering to the daily medication regimen. The MI intervention involved communicating with the patients and encouraging them to identify strategies that would help them better adhere to their medications. These sessions were video-recorded and the content of each video was transcribed verbatim. The transcripts were then scored to assess the fidelity of each session with the intervention type that was given; this was done to ensure that each patient in the MI group received intervention consistent with MI, and that each patient in the Education group received an intervention free of MI. The standard Motivational Interviewing Treatment Integrity 3.0 coding sheet was used to code the MI and Education sessions. Global ratings were given for empathy, direction, collaboration, evocation and autonomy/support on a scale ranging from 1 (Low) to 5 (High). The following behaviors were counted within each transcript: giving information, MI adherent (asking permission, affirm, emphasize control, support), MI Non-adherent (advise, confront, direct), questions (closed questions, open questions), and reflections (simple, complex). We expect that the MI interventions would have significantly higher scores on MI adherent behaviors and significantly lower on MI-non-adherent behaviors compared to the Education session.
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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.