What happens when patients with chronic conditions don’t take their medicines? In the case of glaucoma—they lose their sight. According to Paul Cook, PhD, assistant professor in the CU College of Nursing, approximately half of Americans currently take medications for chronic conditions, and half of those stop treatment in the first year. Thanks to $800,000 in funding from a pharmaceutical manufacturer and in partnership with co-primary investigator Malik Kahook, MD, faculty with the CU School of Medicine, Dr. Cook’s team is training glaucoma educators to support patients' medication adherence.
“Only 42 percent of patients use their glaucoma drops. Even after some patients go blind in one eye, adherence only goes up to 58 percent,” says Dr. Cook. “We bring a psychological counseling background to the care team to help patients understand their motivation for treatment and overcome barriers. This interdisciplinary approach provides better care for the patent as a whole person, not just a diagnosis.”
Dr. Cook's team uses motivational interviewing (MI), a research-tested counseling approach for health promotion. Dr. Cook has used MI in other studies to improve adherence to medications, dental care recommendations, and self-management of chronic diseases. He trains interprofessional groups of health care providers to use MI through grants like the glaucoma study, and professional development workshops offered by the College of Nursing.
The multi-site randomized controlled trial of MI for glaucoma adherence is in process at the Rocky Mountain Lions Eye Institute on the Anschutz Medical Campus, Vanderbilt University in Nashville, and Devers Eye Institute in Portland. Researchers expect the study to determine the benefit of psychologically based counseling delivered by a glaucoma educator, improving adherence, treatment satisfaction and clinical outcomes for patients.
Finding innovative health care solutions to improving patient care starts with quality research. The University of Colorado College of Nursing has diverse programs of research that seek to understand and improve health care with patients in mind.