To assess the Support, Educate, Empower (SEE) personalized glaucoma coaching program impact on 1) eye drop instillation technique and 2) eye drop instillation self-efficacy.
A prospective pre-post pilot study.
Patients with a diagnosis of glaucoma or ocular hypertension taking ≥ 1 glaucoma medication, ≥40 years old, spoke English, self-administered their eye drops, and ≤80% adherent to their glaucoma medication by electronic monitoring.
Eye drop administration was video recorded before the first SEE in-person coaching session, which included teaching eye drop instillation techniques using a motivational interviewing-based approach. At the third and final in-person counseling session six months later, eye drop administration was video recorded. Participants’ self-efficacy was assessed using the validated Eye Drop Technique Self-Efficacy Scale (EDTSES) survey at baseline and one month after completion program. Pre- and post-intervention videos were assessed by an observer masked to time point. Pre to post intervention comparisons were made using McNemar’s and paired t-tests.
The main outcome was change in participants’ eye drop instillation technique as measured by 1) accuracy of an eye drop landing on the eye, 2) ability to instill an eye drop on the first attempt, and 3) contaminating the bottle by contact with ocular surface, eyelashes, and skin. The secondary outcome measure was pre- to post- change in the EDTSES (6 items, each assessed on a 3-point Likert scale, with higher scores indicating better self-efficacy).
Thirty-nine subjects completed the SEE intervention, 38 with pre and post EDTSES scores and 31 with video recordings. Six out of 31 participants instilling drops outside the eye pre-intervention improved their technique post-intervention, while 2 participants worsened (p=0.157). From pre- to post-intervention, participants demonstrated significant improvement in not touching the ocular surface (p=0.046), the eyelashes (p=0.020), or the skin (p=0.025) with the bottle tip. There was a significant increase in eye drop instillation self-efficacy from an average score of 2.6 (SD=0.3) to 2.8 (SD=0.2) on the EDTSES (p=0.007).
The SEE Program significantly decreased eye drop bottle contamination and increased eye drop instillation self-efficacy.

Copyright © 2020. Published by Elsevier Inc.