Eye Patient Adherence and Compliance Study

Condition(s) studied

Investigational drug(s) / intervention(s)

Eye Droppers: Participants in this arm receive individualized training and support to improve correct and consistent instillation of glaucoma eye drops. The intervention includes in-person or virtual instruction by the Eye Patient Adherence and Compliance Study-Intervention Program (EYE-PACIP) team on proper drop technique, use of assistive devices where needed, and caregiver training when applicable. Patients with significant physical or cognitive limitations may receive additional volunteer or home-care support. In long-term care settings, coordination with facility staff ensures adherence support. Reinforcement is provided through demonstration, return-demonstration, and follow-up monitoring of technique and adherence.

Eye Educate: Participants receive structured glaucoma education aimed at improving disease understanding, treatment awareness, and motivation for adherence. Education is delivered through one-on-one or group sessions at the clinic and includes standardized materials (pamphlets, videos, and resources from recognized ophthalmology organizations). Content covers disease chronicity, importance of lifelong treatment, risks of non-adherence, and medication side effects. Pre- and post-intervention assessments are used to evaluate knowledge improvement.

Eye Coordinate: This arm provides adherence support through structured reminder systems designed to reduce forgetfulness. Interventions include mobile phone alarms, calendar reminders, and physical reminder cards to track medication use. Weekly follow-up calls are conducted during the first month, followed by scheduled check-ins at 3, 6, and 12 months. Patients also report missed doses through logs or reminder tools, which are reviewed during follow-up to reinforce adherence behaviours.

Eye Help: Participants receive assistance to overcome transportation-related barriers to clinic attendance. The intervention includes coordination with community transportation services (e.g., volunteer drivers, community transport programs) and linkage to available support services. For patients in long-term care or retirement homes, mobile or outreach-based support may be arranged to facilitate continuity of follow-up care. The goal is to improve clinic attendance and reduce missed appointments.

Eye Refer: Participants receive enhanced access to ophthalmic assessment through mobile or outreach-based clinical support. A trained ophthalmic technician conducts home or facility-based assessments, including intraocular pressure measurement, optic nerve imaging, and portable visual field testing. Findings are reviewed by an ophthalmologist to guide timely management decisions. The intervention also includes strengthened referral coordination to reduce delays in specialist care and improve continuity between primary and specialist services.

Study summary

This study looks at ways to help people with glaucoma take their eye drops regularly and attend their clinic appointments. Each participant will be asked about the main challenges they face, such as forgetfulness, difficulty using drops, lack of transportation, or limited understanding of their condition. Based on their biggest challenge, participants will receive one type of support that is already part of usual care, such as education, reminders, help with applying drops, or assistance getting to appointments. The investigators will follow participants over time to see if this support improves how well they follow their treatment and their quality of life.

Eligibility

Primary outcome measure(s)

• Change in Glaucoma Treatment Compliance Assessment Tool (GTCAT) Score from Baseline to 12 Months — Baseline and 12 months
  Medication adherence will be assessed using the 27-statement Glaucoma Treatment Compliance Assessment Tool-Short Form (GTCAT-S). The GTCAT-S assesses behavioural factors associated with glaucoma medication adherence, including knowledge, susceptibility, cues to action, self-efficacy, and treatment barriers. A derived adherence score ranges from 0 to 27, with higher scores indicating greater adherence to glaucoma treatment. The primary outcome will be the within-participant change in GTCAT-S score from baseline to 12 months, calculated as the 12-month score minus the baseline score. A positive change indicates improvement in medication adherence.

Trial sites (1)

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