Development of a patient-centred toolkit for improving glaucoma medication adherence: a motivational interviewing approach

Background: Non-adherence to medication is reported among patients with glaucoma. The use of cognitive-based behaviour methods such as motivational interviewing (MI) is a promising approach to resolving non-adherence to medication among such patients. Objective: This study aimed to develop a patient-centred MI manual for improving glaucoma medication adherence. Methods: This study employed a descriptive methodological design conducted in three phases, namely, content development, validation, and training. Barriers and motivators of non-adherence to glaucoma medication were generated from a qualitative study. Scale level content validity index (SCVI) and intraclass correlation coefficients among the validators were calculated. The extent of collaboration between the interviewers and the interviewees and the fidelity of the MI process were analysed. P-values less than 0.05 were adjudged statistically significant. Results: Barriers to glaucoma medication adherence included inadequate knowledge about glaucoma, lack of motivation, cost of medication, forgetfulness, and difficulty with drop administration. The SCVI and the intraclass correlation coefficient were 0.9 and 0.92 (p = 0.0001; 95% CI [0.68, 0.99]) respectively. The correlation coefficient for the extent of the collaboration between the interviewers and the interviewees was 0.931 (p = 0.001). The practitioner’s mean score ± SD was 3.7 ± 0.2. Conclusion: A patient-centred MI manual developed through a multidisciplinary approach with a good validity index and excellent inter rater reliability can be beneficial in facilitating behavioural change to improve glaucoma medication adherence.