Exploring the influence of patient-provider communication on intraocular pressure in glaucoma patients.

Abstract

OBJECTIVE: We examined whether six patient-provider communication behaviors directly affected the intraocular pressure (IOP) of glaucoma patients or whether patient medication adherence and eye drop technique mediated the relationship between self-efficacy, communication, and IOP. METHODS: During an 8-month, longitudinal study of 279 glaucoma patients and 15 providers, two office visits were videotape-recorded, transcribed, and coded for six patient-provider communication behaviors. Medication adherence was measured electronically and IOP was extracted from medical records. We ran generalized estimating equations to examine the direct effects of communication on IOP and used bootstrapping to test whether medication adherence and eye drop technique mediated the effect of communication on IOP. RESULTS: Provider education about medication adherence (B=-0.50, p<0.05) and inclusion of patient input into the treatment plan (B=-0.35, p<0.05) predicted improved IOP. There was no evidence of significant mediation. CONCLUSION: The positive effects of provider education and provider inclusion of patient input in the treatment plan were not mediated by adherence and eye drop technique. PRACTICE IMPLICATIONS: Providers should educate glaucoma patients about the importance of medication adherence and include patient input into their treatment plan.