Glaucoma medication non-compliance in Hebron, Palestine
Abstract
Background: The purpose of this study was to determine patient characteristics, estimate the extent of compliance of glaucoma patients with medication, the technique of drop instillation, and follow-up clinic visits.
Material and methods: We interviewed all glaucoma patients attending their regular follow-up visits, over three months, at St. John Eye Hospital, Hebron, Palestine. A questionnaire with 34 questions was used to fill patient responses. The questions dealt with patient characteristics: glaucoma treatments, and their awareness and attitudes towards different components of non-compliance with medical treatment. We also observed the patient’s practice of instilling placebo eye drops.
Results: We interviewed 44 patients: 33 females (75%) and 11 males (25%). Patients using more than one drop constituted 63% of patients. 82% of patients affirmed “Not missing doses last week”, and 52% stated that they “Never stopped taking drops in the past”, while only 36% of files showed drop compliance. 91% of patients claimed to make follow-up visits on time, while documented follow-up compliance was 64%.
Conclusion: This study revealed a poor agreement between subjective compliance and file records among Palestinian patients with glaucoma visiting our clinic. We need to educate our glaucoma patients about the disease and its complications, drop administration technique, compliance with drop administration, and clinic visits.
Keywords: glaucomanon-compliancemedication compliancefollow-up visit complianceHebron
References
- Kingman S. Glaucoma is second leading cause of blindness globally. Bull World Health Organ. 2004; 82(11): 887–888.
- Quigley HA, Broman AT. The number of people with glaucoma worldwide in 2010 and 2020. Br J Ophthalmol. 2006; 90(3): 262–267.
- Olthoff C, Schouten J, van de Borne B, et al. Noncompliance with Ocular Hypotensive Treatment in Patients with Glaucoma or Ocular HypertensionAn Evidence-Based Review. Ophthalmology. 2005; 112(6): 953–961.e7.
- Kass MA, Meltzer DW, Gordon M, et al. Compliance with topical pilocarpine treatment. Am J Ophthalmol. 1986; 101(5): 515–523.
- Brown MM, Brown GC, Spaeth GL. Improper topical self-administration of ocular medication among patients with glaucoma. Can J Ophthalmol. 1984; 19(1): 2–5.
- Konstas AG, Maskaleris G, Gratsonidis S, et al. Compliance and viewpoint of glaucoma patients in Greece. Eye (Lond). 2000; 14 Pt 5: 752–756.
- Masoud M, Sharabi-Nov A, Pikkel J. Noncompliance with Ocular Hypertensive Treatment in Patients with Primary Open Angle Glaucoma among the Arab Population in Israel: A Cross-Sectional Descriptive Study. J Ophthalmol. 2013; 2013: 405130.
- Spooner JJ, Bullano MF, Ikeda LI, et al. Rates of discontinuation and change of glaucoma therapy in a managed care setting. AmJ Manag Care. 2002; 8(10 ): Suppl–S262.
- Gurwitz JH, Yeomans SM, Glynn RJ, et al. Patient noncompliance in the managed care setting. The case of medical therapy for glaucoma. Med Care. 1998; 36(3): 357–369.
- Khandekar R, Shama MES, Mohammed AJ. Noncompliance with medical treatment among glaucoma patients in Oman — a cross-sectional descriptive study. Ophthalmic Epidemiol. 2005; 12(5): 303–309.
- Kholdebarin R, Campbell RJ, Jin YP, et al. Multicenter study of compliance and drop administration in glaucoma. Can J Ophthalmol. 2008; 43(4): 454–461.
- Djafari F, Lesk MR, Harasymowycz PJ, et al. Determinants of adherence to glaucoma medical therapy in a long-term patient population. J Glaucoma. 2009; 18(3): 238–243.
- Bloch S, Rosenthal AR, Friedman L, et al. Patient compliance in glaucoma. Br J Ophthalmol. 1977; 61(8): 531–534.
- Aziz AM, Ibrahim MI. Medication noncompliance — a thriving problem. Med J Malaysia. 1999; 54(2): 192–199.
- Lau JTF, Lee V, Fan D, et al. Knowledge about cataract, glaucoma, and age related macular degeneration in the Hong Kong Chinese population. Br J Ophthalmol. 2002; 86(10): 1080–1084.
- Patel SC, Spaeth GL. Compliance in patients prescribed eyedrops for glaucoma. Ophthalmic Surg. 1995; 26(3): 233–236.
- Taylor SA, Galbraith SM, Mills RP. Causes of non-compliance with drug regimens in glaucoma patients: a qualitative study. J Ocul Pharmacol Ther. 2002; 18(5): 401–409.
- AAO PPP. AAO PPP. Summary benchmarks for preferred practice pattern® guidelines. Oct 2018. Glaucoma Summary Benchmarks 2018.
- Lori Baker-Schena. Patient adherence. AAO EyeNet Mag 2017; 51–55. https://www.aao.org/eyenet/article/patient-adherence.