Survey examines glaucoma medication noncompliance, improper administration

More than half of glaucoma patients do not use their medications properly because of either noncompliance or improper administration techniques, according to results from a multicenter survey of Canadian patients with the disease.

Yvonne M. Buys, MD, FRCSC, and colleagues used a standardized questionnaire to estimate the prevalence and predictors of noncompliance and improper medication administration techniques for 500 patients with glaucoma at 10 eye care centers in Canada.

Noncompliance was defined as omitting at least one drop of medication weekly or failing to accurately explain a dosing regimen. In addition, the investigators evaluated the eye drop administration techniques of 473 of these patients.

Of the 500 patients, 25.6% said they missed at least one drop of medication per week, and 4.2% could not accurately describe their medication regimen, the authors said. The percentage of noncompliance for the entire cohort was 27.9%.

The authors reported that 6.8% of patients missed their intended eye when administering drops, and 28.8% of patients contaminated the bottle tip; overall, 33.8% of patients demonstrated improper administration techniques, according to the study.

Forgetfulness and being away from drops were the most frequent patient-reported causes for noncompliance.

The investigators found statistically significant associations between patient-reported noncompliance and formal education limited to elementary school (P = .004), as well as treatment duration of less than 5 years (P = .03).

Factors associated with improper administration techniques were age of 60 years and older (P = .005) and formal education limited to elementary school (P = .04), according to the study.

"Glaucoma patients should be educated on the importance of compliance and instructed on proper drop administration," the study authors said in the August issue of Canadian Journal of Ophthalmology.