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N. Priyev, D. Klein, A. Madu; Assessing Glaucoma Compliance, Comprehension, and Patient Learning Preferences at a South Bronx Eye Clinic. Invest. Ophthalmol. Vis. Sci. 2008;49(13):5454.
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One of the National Safety Goals for Hospitals is to accurately reconcile medications across the continuum of care. This objective is paramount to effective glaucoma management where visual outcome is heavily dependent on patient compliance. We evaluate the extent of glaucoma patients’ compliance to medications, understanding of disease, and learning preferences.
45 glaucoma patients on at least 1 glaucoma medication were interviewed at an urban ophthalmology clinic. They were asked about their age, duration of illness, type and dosage of medications as well as knowledge of glaucoma and learning preferences. Responses were compared with clinic charts.
The mean age was 65.3± 9.97 years. 22 (49%) patients were taking medications inconsistent with prescription on chart. Of those, 5 were taking discontinued medications. 14 patients did not take at least one medication for an appropriate number of times per day. 9 patients neglected at least one of their medications. 1 patient was taking her glaucoma medications "PRN." 62% (8/13) of the Spanish-speaking patients and 42% (14/32) of the English speaking patients were non-adherent (p=0.13). Most patients (42/45) did not know what glaucoma was. Only three patients mentioned the connection between glaucoma and uncontrolled intraocular pressure. Most patients, however, knew that glaucoma could lead to decreased vision or blindness (31/45). A significant number of patients thought that there was a connection between diabetes/hypertension and glaucoma. Most patients preferred to have pamphlets distributed in the clinic so they could read them while waiting to be seen. A few of the patients preferred a doctor’s explanation of their disease.
In this population, self reported use of medications differed significantly from the prescribed regimen. Patients were most non adherent to frequency of drug administration. Strategies to improve compliance should include knowledge of glaucoma. An informed patient may be more inclined to take medications as directed. These results underscore the mandate to improve patient safety by accurate reconciliation of medication. We have produced a glaucoma medication/dosing booklet in English and Spanish. A follow up study is necessary to document changes in compliance behavior consistent with being more informed.
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