Active clinical trials for "Glaucoma"

OBJECTIVE Our objective was to determine whether two group educational sessions plus one-on-one eye drop instillation training would improve adherence to glaucoma therapy as measured by pharmacy claims data in a cohort of newly diagnosed patients. Our hypothesis was that adherence would be improved in the intervention group and that patients would better understand their disease and how to manage it. METHODS Study Design and Population: A randomized controlled clinical trial was conducted in newly diagnosed glaucoma patients at Maisonneuve-Rosemont Hospital in Montreal, Canada. Half of the participants were randomized to receive the intervention and half were randomized to receive a delayed intervention at the conclusion of the study. Inclusion criteria included a diagnosis of glaucoma requiring intraocular pressure lowering eye drop therapy and prescription drug insurance through the Régie de l'Assurance Maladie du Québec (RAMQ) (the Quebec Health Insurance Program) throughout the course of the study. There were three sources of data for this study: a questionnaire, the medical record, and RAMQ prescription drug claims data. Follow-up was for one year. Recruitment and Randomization: From July, 2007 until December, 2011, a researcher approached eligible patients to determine their interest in participating in the study. Interested participants signed the informed consent form and were randomized. Participants in the intervention group were given an appointment to come back to the Hospital for the group intervention. Participants in the control group were given an appointment to receive the group intervention at the end of the study. Intervention: Small groups of about 10 people were gathered for two 60-90 minute educational sessions on glaucoma in a classroom at Maisonneuve-Rosemont Hospital. During a break, each patient received one-on-one teaching on how to properly instill drops without touching the eye or using unnecessary drops. Questionnaire and Assessment of Eye Drop Technique: A single questionnaire was given at the end of the study to all participants. The intervention group completed the questionnaire after the intervention while the control group completed the questionnaire before the intervention. Questions were included on demographics, systemic comorbidities, ocular medications, eye drop practices and difficulties, and glaucoma knowledge. The instructor rated the ability of the participant to put eye drops in the eye taking into account the number of drops that were used and whether contact with the lid or conjunctiva occurred (good, fair, bad). We created a composite score on the perception of the importance of glaucoma eye drop therapy using the following four questions: 1) do you think glaucoma is a serious disease, 2) do you believe that your treatment will be effective, 3) do you think your drops can lower the pressure in your eyes, 4) do you think your drops can help to preserve vision. Answers of no or do not know were given 0 points and answers of yes were given 1 point. Scores were summed and the composite score ranged from 0 to 4. Medical Chart Review: At the end of the follow-up period, information was obtained on: the prescribed eye drop therapy for each patient per eye, whether the patient had undergone glaucoma filtering surgery, whether the patient had died or was no longer being followed, the most recent visual field mean deviation in the better eye using the Humphrey Visual Field Analyzer 24-2 SITA Standard Program. Pharmaceutical Claims and Calculation of Medication Possession Ratio: The Medication Possession Ratio (MPR) was calculated as the sum of days of prescription supply divided by the number of days in which a prescription was required. Each person gave consent to contact the RAMQ to obtain pharmaceutical claims for all glaucoma medications. Data were collected on the date of purchase, and the name, dose, and class of the medicine. Data on the number of days of medication available per bottle were taken from the Rylander and Friedman studies with the minimum value used. For the numerator of the MPR, we calculated how many days of medication were available using RAMQ data. For the denominator of the MPR, we calculated the number of days that medication was prescribed in the medical chart. We took into account whether drops were needed for one or two eyes. If a participant was on multiple medications, we calculated a single mean MPR for all medications. We then dichotomized the MPR so that those having medication less than 75% of the days were defined as non-adherent, as we did previously in Djafari et al. SIGNIFICANCE Adherence can be a problem in glaucoma because patients must often take daily eye drops despite not noticing any benefit to their vision and despite frequent side effects. Low cost interventions that help to improve adherence are needed.

The purpose of this study is to study the effect on intraocular pressure in glaucoma patients using the TravAlert dosing aid with or without the Eyot drop guider and with or without additional patient education.

The purpose of this study is to develop new ways of assisting patients with glaucoma and their eye doctors in using the recommendations from practice guidelines.

To evaluate the IOP-lowering efficacy of bimatoprost 0.03% in patients found to be low-responders to latanoprost therapy.

The positive effects of exercise on ocular health are known, but modern lifestyles have made it difficult to incorporate physical activity into the daily lives of the Chinese population. Recent studies suggest that exercise plays an important role in lowering intraocular pressure (IOP) by protecting retinal ganglion cells (RGCs) in glaucoma patients as well as other potential neuroprotective benefits. Increasing the amount of physical activity within the Chinese glaucoma population may have marked effects on health outcomes and coincides with the Chinese government's efforts to make exercise an urgent public health priority. There is a need for innovative, cost-effective, and proven interventions to promote exercise behavior change and social media platforms may be able to fill this niche. WeChat is China's largest and most frequently used social media and messaging application with an estimated 570 million users. The platform has been found to be a useful tool in healthcare settings to promote weight-loss, health literacy, and patient adherence in Chinese populations. This study is a 5-weeks randomized control trial with three total study visits. 80 patients from an academic glaucoma clinic in Wenzhou Medical College will be randomized into two groups. The intervention group will be enrolled into an Official WeChat Group and receive periodic reminders to exercise, health education materials, and motivational incentives. The control group will receive weekly reminders and leaflets at the first clinic visit. Patients' daily step data will be monitored using an Accelerometer WGT3X-BT. The intervention duration will include an initial clinic visit, a one-week follow-up after wearing the accelerometer, and then a subsequent one-month follow-up visit after wearing the accelerometer. At the one-week visit the patient will be randomized and at the subsequent one-month visit there will be a close-out discussion about the study. In addition to collecting step data at clinic visits, investigators will also measure patients' visual field tests, optical coherence tomography angiography (angio-OCT), and intraocular pressure (IOP) using Goldmann Tonometry. The investigators' hypothesis is that using an Official WeChat Patient Group will be a robust and effective stimulus to increase physical exercise.

The goal is to conduct a 5-year prospective, randomized controlled trial to test an innovative, community-based intervention using posterior and anterior fundus photography of the optic nerve and macula and intraocular eye pressure measurements to improve access and utilization of eye care to detect, treat, and manage high-risk patients with previously undiagnosed glaucoma and other eye diseases. Research shows that subject failure to attend follow-up eye care appointments diminishes any previous benefits of community screenings for glaucoma. Greater adherence to follow-up visits can reduce glaucomatous blindness.

The purpose of this study is to identify whether or not injection of a study drug (ethacrynic acid) using the investigational Retroject device is able to lower eye pressures in patients with advanced glaucoma. 20 patients with advanced glaucoma with visual acuity less than 20/200 and intraocular pressures (IOP) >20mmHg on maximum medical therapy will be asked to participate in the study. The first five patients will have the Retroject device placed over their eye for 30 seconds and then removed. Assuming no issues, then it will be placed on the eye for one minute. The second group of patients (3 total) will have the Retroject device placed on the eye and then an injection of ethacrynic acid into the episcleral vein. The third group of patients (12 total) will have the Retroject device placed on the eye and then will be randomized in a 2:1 ratio to receive either an ethacrynic acid injection or a balanced salt solution injection. All 20 patients will then return for intraocular pressure measurements on days 1, 2, 3, and 7 as well as 6 weeks after injection. In addition, the patients will undergo pre and post intervention corneal endothelial assessments (endothelial cell count, shape analysis, and pachymetry). Potential safety issues are unlikely and include bleeding, infection, pain, ototoxicity, or temporary or permanent loss of vision.

The study will be conducted to examine the feasibility of using a Health Coach for improving the ophthalmic care of glaucoma patients. Patients taking glaucoma medications will have a coaching intervention and adherence to glaucoma drops will be monitored using a dose-recording device. The dosing data will be analyzed to examine the effect on adherence and qualitative interviews at the conclusion of the study will be used to examine which elements of the coaching experience were most helpful in the glaucoma patient population.

This study will compare the glaucoma day-ward patients' efficacy with inpatients by evaluating the glaucoma knowledge and psychology , and will analysis the reasons of the differences. Half of participants will receive treatment in day-ward, while the other half will receive treatment in hospital.

This is a research project about services provided to African American patients with glaucoma. The goal of the project is to improve communication between providers and African-American patients about glaucoma.