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Heidi Cate, Debi Bhattacharya, Allan Clark, Richard Fordham, Richard Holland, David Broadway, Norwich Glaucoma Adherence Study Group; Non-adherence in glaucoma and its association with satisfaction of glaucoma and medication information. Invest. Ophthalmol. Vis. Sci. 2013;54(15):2623.
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Medication non-adherence can lead to visual field loss, unnecessary additional prescribing and/or intervention. Patient satisfaction with medicines information is associated with improved adherence, however, the relationship between adherence and glaucoma information provision is unclear. The study aimed to determine if patients treated with travoprost were more adherent if satisfied with both medication-related and glaucoma information.
Patients newly prescribed travoprost were given a Travalert Dosing Aid® from which 8 months of daily adherence data were collected. The mean % adherence rate for each month was calculated and month 7 and 8 mean % adherence combined. Participants received either standard care (control) or additional medication and glaucoma related information by trained glaucoma support assistants (GSAs) (intervention). Satisfaction with received information (SIMS) was measured at 2 and 8 months for both groups. At 2 months, the intervention group also rated the glaucoma information received from the GSAs.
208 patients (106 control and 102 intervention) were included. There was no significant difference in adherence between the groups at any time point or at month 7 and 8 combined (p=0.703). There was no correlation between adherence and SIMS score at month 8 for the total cohort (r=-0.015 p=0.883). However, SIMS scores were higher in the intervention group (p<0.001) at months 2 and 8 (Table). More than 80% (n=70) of intervention patients considered the GSA service improved their knowledge of glaucoma (87%), confidence with therapy (85%), and drop administration (87%). There was a positive correlation between satisfaction with glaucoma information received from the GSAs and adherence in the intervention group (r=0.243 p=0.022).
The mean control adherence rate was higher than expected, which may have contributed to the absence of a demonstrable difference between the two groups. However, intervention participants demonstrated raised satisfaction levels with GSA delivered glaucoma and medication-related information relative to standard care. Although this study did not appear to improve adherence, a GSA service did improve patient satisfaction with medication and glaucoma-related information which may have the potential to improve adherence.
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