# Improving Glaucoma Medication Adherence

> **NIH VA I01** · DURHAM VA MEDICAL CENTER · 2020 · —

## Abstract

Anticipated Impact on Veteran's Healthcare: Over 1 million Veterans live with uncorrectable visual
impairment that is severe enough to reduce quality of life and independence. We propose to test an
intervention designed to improve glaucoma medication adherence with the ultimate goal of reducing glaucoma-
related blindness in Veterans.
Project Background: Glaucoma is a leading cause of irreversible blindness among Veterans and across the
US. The number of Americans with glaucoma is rising due to the aging population, yet there is still no cure for
the disease. The only treatment that has been proven to reduce the risk of vision loss from glaucoma is
lowering the intraocular pressure. The most common treatment to lower intraocular pressure is the prescription
of glaucoma eye drops. Although multiple clinical trials have shown that intraocular pressure can be lowered by
the daily use of glaucoma eye drops and glaucoma–related vision loss can be reduced, adherence to the
prescribed glaucoma regimen is often poor. Patients with medical comorbidities are at higher risk for glaucoma
medication nonadherence, which is worrisome for the visual outcomes of Veterans because, on average,
Veterans are more likely to have more numerous medical co-morbidities than their non-Veteran age-matched
peers.
Project Objectives: There is a critical need for an evidence-based intervention that improves glaucoma
medication adherence at reasonable cost and with clinically relevant outcomes. The objective of this
application is to conduct a randomized, controlled trial to evaluate a novel intervention designed to improve
glaucoma medication adherence in Veterans and ultimately reduce glaucoma-related blindness. We will
accomplish this through the following specific aims.
Specific Aim 1: Evaluate the impact of a novel intervention to improve glaucoma medication adherence
through a randomized controlled trial.
Specific Aim 2: Evaluate the impact of the intervention on intensification of glaucoma therapy among
Veterans with glaucoma.
Specific Aim 3: Evaluate the incremental cost-effectiveness and budget and workflow impacts of the
intervention compared to control.
Project Methods: We propose to randomize 200 Veterans with medically-treated glaucoma and up to 200
companions to 1 of 2 arms, providing 80% power to detect a 10% difference in the proportion of prescribed
glaucoma medication doses taken between the 2 arms in the 6 months following the intervention as measured
by electronic monitors. The intervention is multifaceted but simple in design in order to facilitate
implementation in a busy clinical setting. An ophthalmic technician will provide clear education about
glaucoma, addresses specific barriers to adherence identified by the Veteran in a validated survey of glaucoma
medication self-efficacy, and will coach patients on eye drop administration techniques, and recommend eye
drop aids if functional limitations are identified. The technician will provide an individualiz...

## Key facts

- **NIH application ID:** 9768207
- **Project number:** 5I01HX001893-03
- **Recipient organization:** DURHAM VA MEDICAL CENTER
- **Principal Investigator:** Kelly Muir
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2020
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2017-03-01 → 2021-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9768207

## Citation

> US National Institutes of Health, RePORTER application 9768207, Improving Glaucoma Medication Adherence (5I01HX001893-03). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9768207. Licensed CC0.

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