Clinician gives pearls for breaking down glaucoma adherence barriers

SALT LAKE CITY — Communication between doctor and patient, simplification of dosing, working as a team to develop a reminder and recognizing challenges patient may have with the health care system are some of the glaucoma management pearls one clinician gave in a lecture here.

The number one barrier glaucoma patients gave for why they did not adhere to their medication regimen was, "I forgot how and when I had to use the eye drops," PRIMARY CARE OPTOMETRY NEWS Editorial Board member Leo Semes, OD, FAAO, said in a presentation at Specialty Day during Optometry's Meeting here.

"When we think about barriers, we should think about solutions," he said at the symposium, which was sponsored by the Optometric Glaucoma Society.

Dr. Semes recommends a four-step adherence assessment interview developed by Steven R. Hahn, MD, to evaluate a patient's compliance to medication.

First, ask a nonthreatening, open-ended question about medication use such as, "Are you having any trouble with taking your drops?" Second, acknowledge difficulties patients have taking medications. Third, make sure the patient understands the importance of adherence and its effect on the treatment regimen. Finally, ask a direct question about adherence, such as asking how many times the patient has missed a dose in the last 3 months.

Once it has been established that there is a problem with compliance, Dr. Semes gave other practical tips for ensuring compliance, such as presuming patients need to be told everything twice, tailor your approach to each situation and aggressively address high-risk situations.