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B.L. Sleath, A. Robin, D. Covert, J. Byrd; Patient–Reported Problems in Using Glaucoma Medications and Adherence to Therapy . Invest. Ophthalmol. Vis. Sci. 2005;46(13):2468.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: We investigated self–reported adherence by assessing patient reported problems in using medications for glaucoma. Methods: Patients on 2 or more glaucoma medications in 3 different practices completed a self–administered survey regarding problems with their glaucoma medications in 13 different areas. We assessed patient adherence to glaucoma medications during the past week using the Brief Medication Questionnaire. We calculated an average percent adherence to glaucoma medications. We dichotomized adherence into those patients who reported being 100% adherent and those who were less adherent. Results: 296 patients participated. 46% were White and 39% were African American. 47% were female. Patient age ranged from 20 to 95 years (mean=68, SD=13). 75% had prescription drug insurance. Patients reported paying between 0 and $356 dollars per month out–of–pocket for their glaucoma medications (mean=$41.34, SD=$50.91). 76% used 2 glaucoma medications, 19% used 3, and 5% used 4 or more. Patients reported an average of 2.5 problems (SD=2.4) using their glaucoma medications (range 0–11). The most frequent problems included: (a) drop administration (59%), (b) difficulty paying for medications (44%), (c) hard to read the print on the container (17%), (d) side effects (15%), and (d) difficulty remembering to take the medications (11%). Less education was related to difficulty paying for medications (t–test=–2.24, p=0.026). Older patients reported more problems opening bottles (t–test=3.11, p=0.004). Patients on more glaucoma medications were significantly more likely to report difficulties with remembering to take their medications, getting their refills on time, squeezing the bottle, getting the seal off, and opening the container. 14% of patients reported not taking all prescribed doses of their glaucoma medications during the past week. None of the patient demographics were significantly related to non–adherence. Some factors significantly associated with patient non–adherence: having difficulty squeezing the bottle (Fisher’s exact test, p=0.009) and having trouble remembering to take the medications (Fisher’s exact test, p=0.02). Finally, it is important to note that nearly one–fourth of the patients waited less than three minutes when instilling multiple glaucoma medications and waiting more than 3 minutes was positively associated with increasing education (t–test= 2.37, p=0.019). Conclusions: Non–adherence to glaucoma medical therapy is a significant problem with patients and this was consistent across the 3 practices.
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