Original articleIntentional and Unintentional Nonadherence to Ocular Hypotensive Treatment in Patients with Glaucoma
Section snippets
Study Design
This was a hospital-based, cross-sectional study of patients receiving ophthalmic care at a public tertiary ophthalmic hospital. Consecutive patients were recruited from specialist glaucoma clinics and, on providing informed consent, volunteered to participate in an interviewer-administered survey. Ethical approval was obtained from the Royal Victorian Eye and Ear Hospital's Human Research and Ethics Committee, and the study was conducted in accordance with the Declaration of Helsinki.
Participant Inclusion and Exclusion Criteria
Sample Characteristics and Self-Reported Adherence
The sample was aged between 17 and 91 years, with a mean of 67.7 years (standard deviation [SD], 13.56 years). Among participants, 61.1% were male. Participants had been using eye drops for glaucoma for an average of 8.67 years (range, <1–43 years). A total of 72 (55%) participants reported to be fully adherent. Of the 59 (45%) who reported nonadherence, 39 (66.1%) reported unintentional nonadherence only. Ten participants (16.9%) reported intentional nonadherence, and 10 participants (16.9%)
Discussion
This study revealed that both intentional and unintentional nonadherence is a problem for glaucoma patients. Although unintentional nonadherence is most common, one third of nonadherers report intentional nonadherence, and nonadherers may exhibit both intentional and unintentional nonadherence. Overall, nonadherence was more likely in younger patients and those without other chronic health problems requiring medication. Adherers held a stronger belief in the necessity for eye drops than
References (28)
- et al.
Primary open-angle glaucoma
Lancet
(2004) - et al.
Understanding different beliefs held by adherers, unintentional nonadherers, and intentional nonadherers: application of the Necessity-Concerns Framework
J Psychosom Res
(2008) - et al.
Patients' beliefs about prescribed medicines and their role in adherence to treatment in chronic physical illness
J Psychosom Res
(1999) - et al.
The Brief Illness Perception Questionnaire
J Psychosom Res
(2006) - et al.
Beliefs about medicines predict refill adherence to inhaled corticosteriods
J Psychosom Res
(2008) - et al.
Risk factors for noncompliance with glaucoma follow-up visits in a residents' eye clinic
Ophthalmology
(1998) Number of people with glaucoma worldwide
Br J Ophthalmol
(1996)Glaucoma
Timolol treatment prevents or delays glaucomatous visual field loss in individuals with ocular hypertension: a five-year, randomized, double-masked, clinical trial
Trans Am Ophthalmol Soc
(1989)- et al.
Factors for glaucoma progression and the effect of treatment: the Early Manifest Glaucoma Trial
Arch Ophthalmol
(2003)
Patient adherence and medical treatment outcomes: a meta-analysis
Med Care
Compliance and persistency in glaucoma follow-up treatment
Curr Opin Ophthalmol
Noncompliance with ocular hypotensive treatment in patients with glaucoma or ocular hypertension: an evidence-based review
Ophthalmology
Medication adherence in glaucoma: approaches for optimizing patient compliance
Curr Opin Ophthalmol
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Manuscript no. 2009-675.
Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.