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Introduction Adherence to glaucoma medications is essential for successful treatment of the disease but is complex and difficult for many of our patients. Health coaching has been used successfully in the treatment of other chronic diseases. This pilot study explores the use of health coaching for glaucoma care. Methods A mixed methods study design was used to assess the health coaching intervention for glaucoma patients. The health coaching intervention consisted of four to six health coaching sessions with a certified health coach via telephone. Quantitative measures included demographic and health information, adherence to glaucoma medications (using the visual analog adherence scale and medication event monitoring system), and an exit survey rating the experience. Qualitative measures included a precoaching health questionnaire, notes made by the coach during the intervention, and an exit interview with the subjects at the end of the study. Results Four glaucoma patients participated in the study; all derived benefits from the health coaching. Study subjects demonstrated increased glaucoma drop adherence in response to the coaching intervention, in both visual analog scale and medication event monitoring system. Study subjects’ qualitative feedback reflected a perceived improvement in both eye and general health self-care. The subjects stated that they would recommend health coaching to friends or family members. Conclusion Health coaching was helpful to the glaucoma patients in this study; it has the potential to improve glaucoma care and overall health.

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Methods Study participantsGlaucoma patients were recruited for participation in a prospective pilot study to use Health Coaching in the care of glaucoma. The study protocol was approved by the Duke University Institutional Review Board; study participants were in the study for a total of six months, starting with an initial visit when demographic information was collected, followed by the health coaching intervention, ending with an exit interview. Four glaucoma patients completed the pilot study.

In the 18th century smallpox was a scourge that infected 60% and killed 10% of England's population. On May 14, 1796 a young English doctor persuaded a local farmer to allow his 8 yr‐old son, James Phipps, to be infected, first with cowpox, then with smallpox. The boy did develop cowpox but was resistant to smallpox. The boy was the first to be “vaccinated” until 1979, when the World Health Organization declared smallpox eradicated. There are several misconceptions about this story.Edward Jenner was not the first to use cowpox to prevent smallpox. Other doctors in England were doing the same, but Jenner brought attention to this procedure. He self‐published his results after his original paper was rejected.His experiments seem unethical. Actually, his procedures were not unusual for his times. Even today his work would pose an interesting risk/benefit dilemma. Jenner remained friends with James, who was a pall bearer at his funeral.Jenner theorized the virus started with an infected horse hoof disease. Later it was discovered that the virus passes from rodent to cat to cow to milkmaid.Jenner was a small country doctor, astute but with little education. Jenner, from a prestigious family, apprenticed with a local doctor at the age of 13 for seven years. He then trained in medicine at St. George's Hospital in London. After 2 years he returned home to became a gentleman doctor and well‐known naturalist. Lack of medical diploma was not unusual, with only two official medical schools in England.Smallpox is eradicated. The virus does exist today, in frozen vials stored in Atlanta and Moscow. The virus is preserved to develop vaccines in case the virus reappears or is unleased by terrorists.