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G. F. Schwartz, K. Plake, M. A. Mychaskiw; Evaluating Adherence and Readiness for Behavior Change in Patients Prescribed Ocular Hypotensive Therapy. Invest. Ophthalmol. Vis. Sci. 2008;49(13):4983. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To compare responses in two patient populations to a questionnaire developed to identify those prescribed ocular hypotensive (OH) medication whose adherence may need improvement and who may be ready to change .
The content/face validity of a 62-item, self-administered questionnaire based on the Transtheoretical Model of Change was confirmed by 9 glaucoma specialists. Questions related to demographics, visual function, health and medications, and use of/problems with OH therapies. The instrument was given anonymously to 202 patients prescribed ≥1 OH medication and with no history of trabeculectomy - 102 from a tertiary metropolitan glaucoma referral practice (Group 1), 100 from a more rural multispecialty ophthalmology practice (Group 2).
Those in Group 1 were younger (<60 years: 36.3% vs 21.5%), less likely to be Caucasian (65.3% vs 81.4%), and better educated (≤high school/GED: 20.1% vs 54.7%); P<0.05 for all 3 between-group differences. In both groups, >80% had glaucoma, >60% were diagnosed >3 years previously, and >70% expected to take eyedrops for the rest of their lives. The majority (Groups 1, 2: 86.6%, 92.6%) reported administering eyedrops every day, although more in Group 2 reported administering eyedrops at the same time every day (78.6%, 91.6%; P<0.05). Groups were similar with regard to mean number of adherence problems (0.92±1.08, 1.07±2.52) and mean adherence scores (23.98±1.29, 23.77±2.54). Common barriers to adherence were forgetting when the regular schedule changed (14.7%, 10.3%), forgetting when traveling (13.7%, 19.6%), and falling asleep (19.6%, 15.5%). In Group 1, the number of adherence problems was correlated with adherence score (r=-0.611, P<0.0001) and number of side effects (r=0.349, P<0.0001).
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