Multicenter study of compliance and drop administration in glaucoma

doi:10.3129/i08-076

Canadian Journal of Ophthalmology

Volume 43, Issue 4, August 2008, Pages 454-461

https://doi.org/10.3129/i08-076 Get rights and content

Abstract

Background: Poor compliance with medication is a major concern in the management of glaucoma. Improper administration technique can lead to contamination and inaccurate dosing. This study estimates the prevalence and predictors of noncompliance and improper administration technique among Canadian glaucoma patients.

Methods: Data were collected using a standardized questionnaire. Noncompliance was defined as missing at least 1 drop of medication per week and (or) the inability to accurately describe the medication regimen. Patients were asked to indicate the most common reason for missing medication. Study personnel assessed drop administration technique as patients were applying eye drops. Physicians provided information, including measures of disease stability, regarding the patient℉s glaucoma. Predictors were assessed using odds ratios from a logistic regression model.

Results: 500 patients from 10 centers across Canada participated in the study. Of these, 25.6% reported missing at least 1 drop of medication per week, and 4.2% were unable to accurately describe their medication regimen. The overall proportion of noncompliance was 27.9%. With regard to drop administration, 6.8% missed their eye and 28.8% contaminated the bottle tip; overall, 33.8% demonstrated improper technique. The most common reasons given for missing eye drops were “forgetfulness” and “being away from drops.” Formal education limited to elementary school and treatment duration of <5 years increased patient-reported noncompliance. Factors associated with improper administration technique were age 60 years and older and formal education limited to elementary school.

Interpretation: Over 50% of the patients surveyed were either noncompliant or demonstrated improper administration technique. Glaucoma patients should be educated on the importance of compliance and instructed on proper drop administration.

Résumé

Contexte: La faible observance thérapeutique soulève une vive inquiétude pour la gestion du glaucome. Les mauvaises techniques d℉instillation peuvent entraîner la contamination et des erreurs de dosage. La présente étude estime la prévalence de l℉inobservance, les indicateurs prévisionnels et les techniques inappropriées d℉instillation chez les patients atteints du glaucome au Canada.

Méthodes: Les données ont été colligées par questionnaire standardisé où l℉inobservance a été définie comme étant le manque d℉au moins une goutte de médication par semaine et (ou) l℉incapacité de décrire avec exactitude le régime médicamenteux. Les patients furent invités à indiquer les raisons les plus fréquentes pour lesquelles ils sautaient un traitement. Le personnel de l℉étude a évalué les techniques d℉instillation oculaire. Les médecins ont fourni l℉information sur le glaucome des patients, y compris les mesures de stabilité de la maladie. Les indicateurs prévisionnels ont été évalués selon les rapports de cotes selon un modèle de régression logistique.

Résultats: 500 patients de 10 centres à travers le Canada ont participé à l℉étude. Parmi eux, 25,6 % ont rapporté avoir omis au moins 1 instillation par semaine et 4,2 % n℉ont pu décrire exactement le régime médicamenteux. En somme, le taux d℉inobservance était de 27,9 %. En ce qui concerne l℉instillation des gouttes, 6,8 % ont raté l℉œil et 28,8 % ont contaminé le rebord de la bouteille et, en général, 33,8 % n℉utilisaient pas la technique appropriée. La raison la plus fréquente pour avoir omis une instillation était «l℉oubli» et «pas de médicament à portée de la main». Le taux d℉inobservance était plus élevé chez les patients qui avaient fait le cours primaire seulement et suivaient le traitement depuis de <5 ans. Les facteurs associés avec une technique d’instillation inappropriée étaient l’âge, 60 ans et plus, et la scolarisation de niveau primaire seulement.

Interprétation: Plus de 50 % des patients de l’étude n’observaient pas la thérapie ou utilisaient une technique d’instillation inadéquate. Les patients glaucomateux devraient être informés de l’importance de suivre la thérapie et on devrait leur enseigner la technique appropriée d’instillation.

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¹: Poster presentation at the Canadian Ophthalmological Society Annual Meeting in Whistler, B.C., June 11–14, 2008

²: This article has been peer-reviewed.

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Multicenter study of compliance and drop administration in glaucoma1,2

Abstract

Résumé

Ophthalmology

Am J Ophthalmol

Am J Ophthalmol

J Pharm Sci

The number of people with glaucoma worldwide in 2010 and 2020

Br J Ophthalmol

Factors for progression and glaucoma treatment: the Early Manifest Glaucoma Trial

Curr Opin Ophthalmol

The Ocular Hypertension Treatment Study: a randomized trial determines that topical ocular hypotensive medication delays or prevents the onset of primary open-angle glaucoma

Arch Ophthalmol

The Advanced Glaucoma Intervention Study (AGIS): 7. The relationship between control of intraocular pressure and visual field deterioration

Am J Ophthalmol

Early Manifest Glaucoma Trial Group. Reduction of intraocular pressure and glaucoma progression: results from the Early Manifest Glaucoma Trial

Arch Ophthalmol

Noncompliance with ocular hypotensive treatment in patients with glaucoma or ocular hypertension: an evidence-based review

Ophthalmology

Improper topical self-administration of ocular medication among patients with glaucoma

Can J Ophthalmol

Compliance and viewpoint of glaucoma patients in Greece

Eye

Microbial contamination of medications used to treat glaucoma

Br J Ophthalmol

Administration technique and compliance in topical drug therapy of glaucoma

Effect of written instructions on accuracy of self-reporting medication regimen in glaucoma patients

J Glaucoma

Side effects of topical treatment in pigmentary glaucoma

Acta Ophthalmologica