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G. F. Schwartz, K. Plake, M. A. Mychaskiw; Assessing Behavior and Readiness for Behavior Change in Patients Taking Ocular Hypotensive Therapy. Invest. Ophthalmol. Vis. Sci. 2007;48(13):2401.
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Nonadherence and poor persistence with ocular hypotensive (OH) medications are common. An instrument was developed to identify patients whose behavior may need to be improved and who may be ready to change.
The content and face validities of the 62-item survey, which was based on the Transtheoretical Model of Change, were confirmed by 9 glaucoma specialists. The self-administered survey includes patient demographics, patient evaluations of health and medications, use of and difficulties taking OH medications, and visual function. The questionnaire was administered anonymously in a glaucoma referral practice to consecutive patients prescribed ≥1 OH medication with no history of trabeculectomy.
In all, 102 patients were surveyed of whom 63.6% were ≥60 year old, 84.3% had glaucoma, 63.7% were diagnosed >3 years before, 45.1% were taking 1 OH medication, and 16.7% were taking >2 medications. The vast majority (86.6%) reported administering eyedrops every day, 12.4% were taking action to meet this goal, and 1% were contemplating such action; 78.6% reported administering eyedrops at the same time every day and the remainder were taking or preparing/contemplating such action (17.3% and 4.0%, respectively). Adherence score (23.98±1.29, possible/actual range 0-25/20-25) and number of adherence problems (0.92±1.08, range 0-5) were negatively correlated (r=-0.611, P<0.0001), while number of adherence problems and number of side effects were positively correlated (0.84±1.26, range 0-6; r=0.349, P<0.0001).
Identifying patients’ behaviors and barriers to medication adherence and persistence will allow appropriate interventions to be designed.
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