Treating Psychosocial Distress in Glaucoma

Duke University28 enrolled

Overview

In this study, using three phases, the investigators will use an iterative development approach to refine a behavioral intervention for managing concomitant psychosocial distress in glaucoma. Phase 1: The investigators will begin by developing a baseline intervention using strategies from Acceptance and Commitment Therapy (ACT), and delivered using a mobile application. Phase 2: The investigators will refine the baseline intervention for glaucoma patients using qualitative interviews conducted with primary open-angle glaucoma (POAG) patients with psychosocial distress (N=20), and health professionals (N=5). Phase 3: Finally, the investigators will measure acceptability and feasibility of the refined intervention through a single-armed pilot study (N=25). The investigators hypothesize that the refined intervention will yield an acceptable and feasible intervention in a POAG patient population, setting the stage for a future efficacy study.

Study Type

INTERVENTIONAL

Allocation

Purpose

OTHER

Masking

NONE

Enrollment

Conditions

Glaucoma, Primary Open Angle Distress, Emotional Anxiety

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria * diagnosed with mild, moderate, or severe chronic glaucoma (e.g., POAG), * had a visual field within the past year at the main Duke Eye Center, * been prescribed pressure lowering eye drop medication, * at least mild distress (based on PHQ-4), * 18 years old, * able to understand, speak, and read English, and * be able to provide informed consent. Exclusion Criteria * diagnosed with borderline glaucoma or as a glaucoma suspect, * had a glaucoma surgery in past month (e.g., trabeculectomy, glaucoma drainage device/tube), * visual acuity of worse than 20/70 in the better seeing eye, * diagnosed with a major medical conditions (e.g., cancer, or another visual disorder, like macular degeneration), * diagnosed with a psychiatric conditions (e.g., schizophrenia, bipolar disorder), and * reported or suspected cognitive impairment indicated by provider or chart review.

Outcomes

Primary Outcomes

Change in psychosocial distress

Measured using the Hospital Anxiety and Depression Scale (HADS). The scale ranges from 0-42 with higher values indicating higher distress.