Patient perception associated with adherence to glaucoma medication
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Self-reports of better near activities function correlated with an increased adherence to medication in patients with glaucoma, according to research published in the Journal of Glaucoma.
“Glaucoma remains a leading cause of blindness in the United States despite the availability of effective treatments. One significant contributor to this is that less than 50% of patients take medications as physicians recommend,” Juno Cho, MA, department of ophthalmology and vision sciences at the University of Michigan, and colleagues wrote. “There are many reported reasons for why patients poorly adhere to their glaucoma medication. ... Regardless of the reason, poor adherence to glaucoma medication is a pervasive problem whose solutions require an understanding of how the patients’ experience living with glaucoma is related to their medication-taking behavior.”
To investigate the association between patient’s vision perception and adherence to glaucoma medication, researchers analyzed 95 patients with glaucoma (49.5% female, mean age 63.8 years) enrolled in the Support, Educate, Empower program. Patients completed the 25-item National Eye Institute Visual Function Questionnaire (NEI VFQ-25) to assess vision-related quality of life (VRQOL); researchers used Pearson’s correlation coefficient (r) and linear regression to assess the association between VRQOL and medication adherence.
Study results showed the mean adherence to glaucoma medication was 73.8%, and mean NEI VFQ-25 composite score was 81.6; medication adherence correlated positively with better functioning in the domains of ocular pain (r= 0.2; P= .048), near activities (r= 0.29; P= .004) and role difficulties (r= 0.22; P= .036). Linear regression further reported a 10-unit increase in near activities functioning and a 2.2% increase in baseline adherence (95% CI, 1%-5.4%; P= .0056).
“The results from our study suggest that VRQOL and specifically the patient’s perception of their near vision function could be an important patient-centered outcome measure that may serve as an important target in interventions meant to improve glaucoma medication adherence,” Cho and colleagues concluded. “Deploying interventions that teach patients selective secondary control coping skills may help improve perception of their visual function and may help improve glaucoma self-management.”
Perspective
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No matter how good you are at educating and encouraging your patients, studies suggest that many don’t take their medication as prescribed, and this negatively impacts our ability to slow glaucoma-related vision loss. We can better address this problem by improving our understanding of how patients experience this disease.
Cho and colleagues investigated the association between VRQOL and glaucoma medication adherence in their prospective, noncontrolled cohort study. Their primary finding is interesting: better perceived near activities function was associated with a modest (2.2%) increase in glaucoma medication adherence.
Adherence to glaucoma medications is a complex problem, and every patient will have a unique set of factors that undermine treatment. Fully engaging and educating patients in all aspects of glaucoma care is the most powerful way to improve adherence. It’s heartening to learn that traditional optometric skills can also make a difference. So please don’t forget to listen to your patient’s near complaints. Those new occupational progressives might improve glaucoma control.
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