Treating Psychosocial Distress in Glaucoma

Purpose

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.

Conditions

  • Glaucoma, Primary Open Angle
  • Distress, Emotional
  • Anxiety
  • Depression

Eligibility

Eligible Ages
Over 18 Years
Eligible Sex
All
Accepts Healthy Volunteers
No

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.

Study Design

Phase
N/A
Study Type
Interventional
Allocation
N/A
Intervention Model
Single Group Assignment
Primary Purpose
Other
Masking
None (Open Label)

Arm Groups

ArmDescriptionAssigned Intervention
Experimental
VISION-ACT: Acceptance commitment therapy via a mobile-application 		The arm will pilot a behavioral intervention to treat psychosocial distress in patients with glaucoma using acceptance commitment therapy (ACT) delivered via a mobile-application, called VISION-ACT. The intervention will be developed and refined using qualitative feedback from glaucoma patients and healthcare stakeholders.
  • Behavioral: Acceptance commitment therapy
    The baseline intervention will use ACT, a psychological intervention based on modern behavioral psychology, including relational frame theory, that uses acceptance and mindfulness strategies, along with commitment and behavior-change strategies to increase psychological flexibility. The proposed intervention will be delivered over a 6-week period, with each week including content related to one of the six tenets of ACT: cognitive defusion, acceptance, contact with the present moment, the observing self, values, and committed action. Each week will include educational material, skills work, and homework. The intervention will be delivered via a mobile application.

Recruiting Locations

More Details

Status
Recruiting
Sponsor
Duke University

Study Contact

Samuel Berchuck, PhD
(919) 613-4975
sib2@duke.edu

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