Abstract
Purpose: :
To investigate the influence of personality traits on adherence to QD IOP lowering medication.
Methods: :
Adherence to QD travoprost was measured with the Travalert® monitoring device on 60 consecutive medically controlled glaucoma patients who had been using travoprost for at least 1 month without drop-related complaints. Following a training on the use of the device topical medication was continued and Travalert® with inactivated alarm function was used for 3 months. Health status, social circumstances, personality traits and anxietas (measured with STAI-S and -T, EPQ, shortened hopeless inventory validated for Hungarian population) were registered. Adherence was defined with instillation of travoprost at 9 p.m. (±2 hours). The ratio of the non-adherent days was used for analysis.
Results: :
58 patients (age: 67.3±14.1 years) used the device. Psychoticism, extroversion and neuroticism did not exceed the normal values (U test, p>0.05). Social desirability (15.05±4.08 points) was significantly higher that the standard (10.13±3.91 points) (U-test, p<0.0001). Non-adherence for the total period was 23.0%. It was 21.2%±29.3% and 26.5 %±31.3% for the first and last 10 days, respectively (Wilcoxon sinked rank test, p=0.027). Life circumstances, education, profession, frequency of visits, glaucoma related QL measures, visual functions, length of glaucoma treatment, number of eye drops and systemic medications, confidence in glaucoma treatment did not influence adherence (Spearman’s correlation, Kruskal-Wallis test p>0.05). Test positivity on the shortened hopeless scale (n=7, 12.1%) confirmed with mild to moderate depression level on the Shortened Beck Depression Inventory was not associated with increased or more frequent non-adherence (Wilcoxon rank sum test, p=0.071, Chi square test, p=0.527).
Conclusions: :
Despite objectively measured adherence to QD PG analogue medication was relatively good, it decreased already in the third month after the initial training. Increased social desirability indicates that self-reported adherence is a biased measure. Objective monitoring of adherence showed that in contrast to previous studies using subjective assessment of adherence, mild to moderate depression was not associated with increased non-adherence.
Keywords: clinical (human) or epidemiologic studies: health care delivery/economics/manpower • clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials • clinical (human) or epidemiologic studies: outcomes/complications