Purchase this article with an account.
Nabeel Awan, Ankita Sutaria, Silvia Bigatti, Emily Sirk, Elizabeth Hosty, Chloe Payton, Shelbi Grow, Bradley Sutton, Julie Torbit, Lyne Racette; A comparison of objectively- and subjectively-measured adherence in glaucoma patients of African descent. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):5020.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Adherence to the medical treatment of glaucoma is challenging for patients. People of African descent (AD) have a higher prevalence of primary open-angle glaucoma and have been shown to have worse adherence. The aim of this prospective, observational study was to compare objectively- and subjectively-measured adherence in patients of African descent and to determine their relationship with self-efficacy.
Twenty-one patients of AD diagnosed with open-angle glaucoma in the past five years were included in this study. All patients used a once-daily topical prostaglandin analog eye drop and self-administered their medication. Subjective adherence was assessed through self-report. Adherence was objectively measured using Medical Event Monitoring System (MEMS) bottles. The cap of these bottles electronically records the number of times the bottle is opened. Self-efficacy was assessed using the 10-item Glaucoma Medication Self-Efficacy scale and the 6-item Eye Drop Technique Self-Efficacy scale. MEMS adherence percentages were compared to self-reported adherence using a paired sample two-tailed t-test. To assess the relationship between objectively measured adherence and self-efficacy, patients were divided into 3 groups (n=7 each): high, medium and low adherence groups. The Chi-square test was used to determine whether differences in self-efficacy between the groups were present for each question on the two self-efficacy scales.
Subjective adherence (mean ± standard deviation) (97.34% ± 5.61) was significantly higher than objective adherence (66.34% ± 26.68) (p= 0.01). Of the 21 patients included in the study, 17 self-reported higher adherence levels than MEMS adherence levels. The 4 patients with the highest levels of objectively measured adherence were the only patients to correctly estimate their adherence by self-report. Only one question was significantly associated with objective adherence. Patients with high adherence were significantly more confident that they were taking their glaucoma medications when they do not experience symptoms (p = 0.04).
Overall, the patients of African descent enrolled in this study overestimated their adherence levels. The results showed that patients with higher adherence are more confident about using their eye drops in the absence of symptoms.
This PDF is available to Subscribers Only