Glaucoma Patient Perspectives on Effective Coaching for Self-Management.

Precis: In semi-structured exit interviews, participants in a personalized glaucoma coaching program reported improved self-efficacy in managing their disease. Coaching was frequently cited as catalyst to enhancing medication adherence, emphasizing its role in team-based care.

Purpose: To assess patients' experience with coaching to motivate improved adherence to glaucoma self-management.

Methods and materials: Participants in the Support, Educate, Empower (SEE) personalized glaucoma coaching program completed exit interviews after participating in a six-month coaching program. Interviews were audio-recorded and transcribed verbatim. Transcripts were analyzed using interpretivist grounded theory. Thematic saturation was reached after coding 30 interviews; 32 were included. Themes were identified, a codebook was generated, and two researchers coded the transcripts (NLC, DTD) and a third adjudicated any disagreements (EF). Main outcomes measures were defined as themes and the number of participants who expressed a theme.

Results: Of the 32 participants interviewed in this study, 59% (n=19) identified as male, 41% (n=13) identified as female, 50% (n=16) identified as Black, 34% (n=11) identified as White, 6% (n=2) identified as Asian. Major themes surrounding coaching included how coaching promoted change in eye drop use, knowledge learned from the coach, feeling accountable to the coach, the coach being accessible, how coaches demonstrated empathy, how the coach collaborated to help people develop a sense of control and efficacy over glaucoma self-management, and how coaches built rapport. Additional themes were program satisfaction, fear of vision loss as a motivator to improve glaucoma self-management, and constructive feedback for the program.

Conclusion: This qualitative assessment of the SEE personalized glaucoma coaching program demonstrated that high-quality coaching and rapport building may help patients with previously low medication adherence feel more motivated and in control of their glaucoma.