The University of North Carolina at Chapel Hill has received a grant worth nearly $1.6 million over four years from the Agency for Healthcare Research and Quality to help reduce vision problems in African-Americans caused by glaucoma.
Glaucoma is the leading cause of irreversible blindness for African-Americans; they are five times more likely to get glaucoma than white Americans and six times more likely to go blind from it. Glaucoma is a condition that can damage the optic nerve leading to loss of vision. It is caused by abnormally high pressure inside the eye.
Betsy Sleath, the George H. Cocolas Distinguished Professor and chair of the Division of Pharmaceutical Outcomes and Policy at the UNC Eshelman School of Pharmacy, is the principal investigator on the grant. She is also a senior research fellow at the Cecil G. Sheps Center for Health Services Research at UNC-Chapel Hill.
"We want to empower glaucoma patients to be more actively involved during their visits by asking their doctors more questions about glaucoma and its treatment," Sleath said. "We hypothesize that doing this will in turn lead to doctors educating patients more, which could lead to improved outcomes for patients."
Sleath's team will enroll 380 glaucoma patients who say they take their medications as directed less than 80 percent of the time. The patients will come from three ophthalmology clinics: UNC Hospitals in Chapel Hill, North Carolina; the Department of Veterans Affairs Medical Center in Durham, North Carolina; and the private practice of Alan Robin, M.D., in Baltimore, Maryland.
Patients will be randomly placed in an intervention or control group. Those in the intervention group will watch a short video on the importance of being actively involved during their doctor visits and given a list of questions about glaucoma so they can check off the ones they want to ask their doctor. The intervention is being developed with the input of African-American patients with glaucoma.
In addition, patients will be audio-recorded during their doctor's visits and will use the Medication Event Monitoring System, a device which records the date and time that a medication bottle is opened and closed to measure their medication adherence. Patients will be followed for one year.
"We hypothesize that African-American patients with glaucoma in the intervention group will have significantly improved communication with their ophthalmologists, and this improved communication will improve glaucoma medication self-efficacy, adherence and intraocular pressure," Sleath said.
The study aims to contribute to the Healthy People 2020 goal of reducing glaucoma-related visual impairment. Healthy People 2020 is a federal government initiative to improve the health of Americans over a decade.