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Study identifies noncompliance, risk factors in glaucoma patients
In a study to evaluate patient adherence with once-daily glaucoma medications, researchers found that 17.2% of patients were deemed nonadherent, based on electronic monitoring.
Boland and colleagues also reported in JAMA Ophthalmology that they identified possible risk factors for nonadherence.
The researchers conducted a prospective cohort study and evaluated 491 patients who were being treated for glaucoma with once-daily prostaglandin eye drops. Participants were required to use a specific medication bottle with an electronic cap to record their adherence, as detailed in the study.
Patients also took tests and answered questions about their mental health, overall health and feelings about medication adherence, according to the study.
Results showed that 407 participants completed the 3-month evaluation. According to the study, 82.8% were deemed adherent based on taking their medication correctly at least 75% of the time. The other 17.2% were deemed nonadherent.
Researchers reported that the participants in the nonadherent group were more likely to be younger, of African descent, have less education and have worse scores regarding their mental health. Additionally, the nonadherent patients were more likely to be unable to name their medications and to admit to missing doses.
"As in previous studies, we found poor correlation between self-reported adherence and adherence measured objectively," the authors concluded. "Some information can still be gleaned from the adherence-related questions, however, since the nonadherent group was statistically more likely to admit to missing drops at both the baseline and 3-month points. At baseline, they reported a lower overall adherence rate for the past month, were less likely to agree that they follow physicians’ orders, were more likely to agree that eye drops cause problems and were less likely to agree that remembering eye drops is ‘easy.’ At the 3-month visit, they were also more likely to agree that they forget eye drops on some days.
“Given that most patients are taking their eye drops as prescribed, identifying patients at risk of nonadherence is a critical step,” they continued. “The results from the patient questions and demographic factors may, therefore, be useful in creating risk calculators that could find those patients most in need of intervention."
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JAMA Ophthalmol. 2014; doi: 10.1001/jamaophthalmol.2014.856.