SEE Coaching Boosts Glaucoma Medication Adherence | JAMA Ophthalmology

For individuals navigating the challenges of glaucoma, a new approach to medication adherence shows promise. A study published in JAMA Ophthalmology on February 26, 2026, reveals that a “Support, Educate, Empower” (SEE) coaching program significantly improves adherence to prescribed eye drop medications compared to standard written education. This finding is particularly relevant given that inconsistent medication use is a leading contributor to vision loss in glaucoma, a condition affecting millions worldwide.

Understanding Glaucoma and the Adherence Challenge

Glaucoma isn’t a single disease, but rather a group of conditions that damage the optic nerve, often due to increased pressure inside the eye. The National Eye Institute estimates that over 3 million Americans have glaucoma, and this number is projected to rise with an aging population. Even as effective treatments are available – primarily in the form of eye drops to lower intraocular pressure – their success hinges on consistent, long-term use.

However, adherence rates are notoriously low. Many factors contribute to this, including complex medication regimens, side effects, forgetfulness, and a lack of understanding about the disease and the importance of treatment. The SEE program directly addresses these issues through a personalized, multimodal approach.

The SEE Intervention: A Closer Look

The study, conducted at the University of Michigan (UM) and Henry Ford Health System (HFHS) between April 2021 and December 2023, involved 235 participants with glaucoma who reported taking one or more ocular hypotensive eye drop medications but admitted to adherence levels of 85% or lower. Participants were randomly assigned to either the SEE intervention or a control group receiving standard written glaucoma education.

The SEE program is a six-month program built around motivational interviewing, a counseling technique designed to help individuals explore and resolve ambivalence about behavior change. It includes three in-person sessions with a non-physician counselor, four follow-up phone calls, personalized multimedia educational materials, and automated medication reminders. This contrasts sharply with the control group, who received three standard mailings about glaucoma.

The primary outcome measured was medication adherence, electronically monitored using the AdhereTech system, which tracks when doses are taken. Secondary outcomes included changes in glaucoma-related distress, providing a more holistic view of the program’s impact.

Study Findings and What They Signify

The results demonstrated a clear benefit to the SEE intervention. While mean self-reported adherence was 63.9% across all participants, the study showed a statistically significant improvement in electronically monitored adherence within the SEE group compared to the control group. This suggests that the personalized coaching and support provided by the SEE program were effective in helping patients stay on track with their medications.

It’s important to note that the study was non-masked, meaning that participants and counselors knew who was receiving the intervention. This could introduce some bias, as participants in the SEE group might have been more motivated simply knowing they were part of a special program. The study population was limited to patients receiving care at two health systems in Michigan, which may limit the generalizability of the findings to other populations or healthcare settings.

However, the study’s strength lies in its use of electronic monitoring, which provides a more objective measure of adherence than self-report. The finding that the SEE program reduced glaucoma-related distress is as well significant, suggesting that it not only improved medication-taking behavior but also enhanced patients’ overall well-being.

Beyond Adherence: The Importance of Patient Empowerment

The success of the SEE program highlights the critical role of patient empowerment in managing chronic conditions like glaucoma. Simply providing information – as with the standard written education – is often not enough. Patients need ongoing support, motivation, and personalized guidance to overcome the barriers to adherence. The motivational interviewing component of the SEE program is key, as it helps patients identify their own reasons for wanting to adhere to treatment and develop strategies to achieve their goals.

This approach aligns with broader trends in healthcare towards patient-centered care, which emphasizes the importance of shared decision-making and collaborative partnerships between patients and clinicians. The Agency for Healthcare Research and Quality has long advocated for patient-centered care models, recognizing that engaged and informed patients are more likely to achieve positive health outcomes.

What Comes Next: Implementation and Further Research

The findings from this study are encouraging, but further research is needed to determine the long-term effectiveness of the SEE program and to identify the specific components that are most impactful. Future studies could explore the cost-effectiveness of the program and its feasibility for implementation in diverse healthcare settings.

Researchers are also investigating whether similar coaching programs could be beneficial for other chronic conditions where medication adherence is a challenge, such as diabetes and hypertension. The principles of motivational interviewing and personalized support may be broadly applicable to improving health behaviors across a range of conditions.

For individuals with glaucoma, the best course of action remains consistent communication with their ophthalmologist and adherence to prescribed treatment plans. The Glaucoma Research Foundation provides valuable resources and support for patients and their families. As healthcare systems continue to evolve, programs like SEE offer a promising pathway towards improving outcomes and preserving vision for those living with this sight-threatening disease.