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Stefanie Frech, Manuela Ritzke, Anja Wollny, Amin Gamael, Attila Altiner, Rudolf F Guthoff, Christian Helbig; Adherence patterns of glaucoma patients - a qualitative study based on narrative interviewing technique. Invest. Ophthalmol. Vis. Sci. 2019;60(9):4463. doi: https://doi.org/.
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Primary open-angle glaucoma (POAG), an initially asymptomatic chronic disease causing irreversible nerve fiber damage, progresses slowly without any notable sign of vision loss in early stages. The standard, non-invasive treatment is the topical administration of eye drops, harboring the known problem of patients not being adherent. It is important to understand the patients course of action, motives and personal life situations to increase the awareness of the importance of a regular medication. The study was performed to determine action levels, which depict adherence with the aim to understand and to name patient-related patterns of adherence.
For this study, 25 glaucoma patients were interviewed using the narrative interviewing technique. The interviews were recorded, pseudonymized, transcribed, and analyzed by an interdisciplinary team of physicians, and social- and natural scientists. Analysis was performed using methods of qualitative empirical social research, namely the inductive content analysis and the documentary method with comparative analysis and typification.
First results revealed different levels of action and adherence patterns as part of the medication management strategies of patients. Some followed a strict routine as part of daily life. For others, applying the drops became a ritual which helped them to remember taking the drops in combination with other activities. Both patterns, routine and ritual, provided security. For some, taking drops was a challenging task, which was primarily performed because of the physicians order. Also, forms of care and medication management taken over by family members were identified. Some patients showed a high sense of affliction, the fear of going blind or to redevelop acute symptoms, thus being intrinsically motivated to take the drops.
Different patterns of adherence were identified, which were dependent on the biography, the living conditions or the knowledge about the disease. Interpreting eye drop medication as a routine, a ritual or a challenge was helpful for passive and uninformed patients, while active patients, being aware of the consequences of not taking the drops were motivated and driven by intrinsic factors. These identified patterns, as well as further identified patterns, will help to promote medication management of non-adherent patients to prevent loss of visual function.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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