Supplement 1.
Content of a group-based educational program for patients with glaucoma to improve adherence with eye drops
| Manchester group-based education program (Numbers indicate learning outcome) | How learning outcome will be met | Duration (minutes) |
|---|---|---|
| Session 1 | ||
| For group to chat informally prior to start of the session | Provide patients with tea, coffee, and biscuits – informal chat Serve tea/coffee throughout the sessions, so patients can help themselves |
Prior to start of session proper |
| 1. To understand the diagnosis/understand difficulties with giving a diagnosis | In groups of 3–4, discuss: | 20 |
| • Why are you here today? | ||
| 2. To understand glaucoma | • How did you get referred to the eye hospital? | |
| 9. To put the condition into perspective – to know how to manage their risk | • What happened after you were referred? | |
| • What do you know about your condition? | ||
| • What do you want to know? | ||
| • What problems (if any) did you encounter in the last month related to either diagnosis or drops? | ||
| 1. To understand the diagnosis/understand difficulties with giving a diagnosis | The professional facilitators will use the examples, identified by patients from the "patient discussion" above to illustrate the following: | 30 |
| 2. To understand glaucoma | • How the eye works | |
| 9. To put the condition into perspective – to know how to manage their risk | • What is glaucoma? (including eye pressure) | |
| • Difficulties of giving a diagnosis | ||
| • Different types of diagnosis | ||
| • How might glaucoma affect my eye sight? | ||
| • What to expect at an eye clinic appointment (explain tests such as field test, link to eye drops – what have they been prescribed/have drops been changed?) | ||
| 3. To understand the implications of eye drops | Linked from previous segment "what to expect at eye clinic appointment"): | 45 |
| 4. To understand the side effects of eye drops and tablets | • Practice instilling eye drops (practical workshop) – use of aids to help instill eye drops | |
| 5. To feel confident to instill eye drops | • Professional facilitator will use examples from previous discussion to : | |
| • explain how eye drops work to control glaucoma | ||
| • explain if eye drops interfere with other medicines | ||
| • side effects of drops | ||
| • Practical issues – eg, should they be kept in fridge/what if I work nights?/do they have to be put in same time each night? | ||
| • Start to discuss behavior of using drops/beliefs about drops/medicines in general | ||
| 8. To understand their own reasons for nonadherence | Participants are supported to develop their own understanding of adherence and how they might maintain/improve it. This is done via group and individual discussions using a "questionnaire" to facilitate discussion | 20 |
| 10. Referring them to other sources of information and support | Professional facilitators hand out information (leaflets) Have list of information sources Book appointment for individual chat with health professional |
5 |
| Facilitator to ask more formal questions of group to assess if learning outcomes have been met In group discuss how useful the course has been for them, good points, points to improve, what would they change? |
15 | |
| Session 2 | ||
| Tea and coffee prior to start of session | ||
| 8. To understand their own reasons for nonadherence | Group activities – feedback on adherence behavior – how have their plans to maintain/improve adherence worked? | 30 |
| 6. To be able to ask questions of the doctors/nurses/optometrists involved in their care | Practical advice re how to find out information they need in a consultation | 40 |
| 7. To be able to challenge the system | Tips "n" tricks + group discussion | |
| • Write down questions you have before you go in to consultation | ||
| • Take somebody in to consultation with you so they remember if you don’t + opportunity to have individual chat with a health professional for advice | ||
| 9. To put the condition into perspective – to know how to manage their risk | Professional and patient facilitators moderate discussions on: DVLA regulations for patients with glaucoma lifestyle and glaucoma |
20 |
| Evaluation | Group discussion Action plan – what are they going to do differently as a result of attending the group-based education sessions? Discuss how useful the course has been for them Good points, bad points, what would they change? |
10 |
Abbreviation: DVLA, Driver and Vehicle licensing Authority.