glaucoma medication noncompliance
TRANSCRIPT
Purpose
To determine patient characteristics
Estimate the magnitude of noncompliance with glaucoma treatment
Estimate the determinants of noncompliance with glaucoma treatment
Methods
An interview was conducted with all glaucoma patients attending their regular follow-up visit over a 3-month period
A questionnaire was filled.
Noncompliance definition
Missing at least 1 drop per week and / or
Irregularity of doctor visits (< twice per year) and / or
Inability to accurately describe one’s medication routine
Visual Field
Mild Moderate severe Not done0%
5%
10%
15%
20%
25%
30%
35%32%
10%
24%
34%
Mean Deviation (MD): Mild (< - 6 dB); Moderate (- 6 to -12 dB); Severe (> - 12 dB)
Cost of Drops
High cost
Low cost
Not an issue
0%
10%
20%
30%
40%
50%
60%
70%
80%
90% 85%
2%
12%
up to 100
100-200 200-30028%
29%
30%
31%
32% 32% 32%
29%
Who administers the drops
AuntChild Se
lf
Siblin
g
Spouse
0%
10%
20%
30%
40%
50%
60%
2%
27%
57%
5% 5%
Most common Difficulties/problems in taking drops
Cause S/E Hard to pay Drops fall on cheek
0%
10%
20%
30%
40%
50%
60%
70%
80%
54%
76%
44%
Take drops last week?
Never missed Days
Never missed Doses
Never missed Drops
78%
80%
82%
84%
86%
88%
90%
92%
85%
90%
83%
Documented !
Filtration 2000, on Rx since
Not using drops as prescribed
Puts >1 drop in eye
Uses drops as sees fit
Using different drops each visit
Using drops according to fasting hours
Using drops BE (Given drops for LE)
Using drops BE (LE IOP always high)
Using drops in wrong eye
Using drops LE (Given drops for BE)
Claims drops lasts 4 months
Claims some drops NA
Denies has glaucoma
Does not recognize drops
Make visits Noncomplianton-time
No
Som
etim
es
Yes. A
lway
s0%
10%20%30%40%50%60%70%80%90%
7% 12%
80%
0%
5%
10%
15%
20%
25%22%
Observed drop recognition
Recognize dropsDoes not recognize drops
0%10%20%30%40%50%60%70%80%90% 84%
16%
Technique:Observation Contamination
Missing
eye
No on
e with
pat
ient
On ta
rget
0%
20%
40%
60%
80%
7% 10%
83%
No Yes0%
10%
20%
30%
40%
50%
60%
70%
37%
63%
Close punctum Wait 3 min
0%10%20%30%40%50%60%70%80%90%
88%
3%10%
No Yes0%
10%
20%
30%
40%
50%
60%
70%
80%
80%
20%