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JC Tsai, SE Ramos, CA McClure, JW Pichert, DG Schlundt; Medication Adherence Barriers In Patients With Glaucoma . Invest. Ophthalmol. Vis. Sci. 2002;43(13):277.
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Purpose: To systematically identify and describe the obstacles to medication adherence (compliance) for patients with glaucoma (i.e. develop a taxonomy of barriers). Methods: Structured interviews were conducted with 49 patients with a diagnosis of glaucoma. Subjects' responses were recorded verbatim on an interview form as well as recorded on audiotapes for later reference. Situational obstacles to medication adherence were elicited. Using hierarchical cluster analysis, the situational descriptions were stratified, grouped, and analyzed by frequency distribution. Results: Seventy-two (72) unique obstacles to adherence were reported. These were then grouped into four (4) distinct and separate categories. Situational and environmental factors accounted for the greatest number of obstacles (41 of 72; 57%) and involved major life events (e.g. illness, hospitalization, etc.), travel/away from home, competing activities, and change in the daily routine. Difficulties associated with the medication regimen (e.g. cost, complexity, and side-effects of the drugs) accounted for 18 of 72 situational barriers (25%). Individual patient factors (10 of 72; 14%), and provider factors (2 of 72; 3%) were less commonly cited. Conclusion: Significant barriers to regimen adherence for patients with glaucoma exist in addition to those cited by previous ophthalmic studies. A systematic classification (i.e. taxonomy) of these barriers was formulated to assist in optimizing patient education and problem solving regarding prescribed therapeutic regimens.
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