June 2020
Volume 61, Issue 7
ARVO Annual Meeting Abstract  |   June 2020
Comparative Assessment of Patient and Provider Perspectives on the Impact of Sociobehavioral Factors on Glaucoma Treatment Adherence
Author Affiliations & Notes
  • Shervonne Poleon
    Optometry and Vision Science, University of Alabama at Birmingham, Birmingham, Alabama, United States
  • Lyne Racette
    Ophthalmology and Visual Sciences, University of Alabama, Birmimgham, Alabama, United States
  • Matthew Fifolt
    Public Health, University of Alabama, Birmingham, Alabama, United States
  • Yu-Mei Schoenberger-Godwin
    Preventive Medicine, University of Alabama at Birmimgham, Birmingham, Alabama, United States
  • Michael D Twa
    College of Optometry, University of Houston, Houston, Texas, United States
  • Footnotes
    Commercial Relationships   Shervonne Poleon, None; Lyne Racette, None; Matthew Fifolt, None; Yu-Mei Schoenberger-Godwin, None; Michael Twa, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2020, Vol.61, 69. doi:
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      Shervonne Poleon, Lyne Racette, Matthew Fifolt, Yu-Mei Schoenberger-Godwin, Michael D Twa; Comparative Assessment of Patient and Provider Perspectives on the Impact of Sociobehavioral Factors on Glaucoma Treatment Adherence. Invest. Ophthalmol. Vis. Sci. 2020;61(7):69.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose : Despite the documented effect of ocular hypotensives on delaying glaucoma progression, adherence remains suboptimal. Socioeconomic factors such as education and income are established determinants of adherence, however, predictive models based on these variables have exhibited limited fidelity (Newman-Casey, 2015). This suggests that sociobehavioral factors such as emotional support may also play a critical role in modifying behavior. We aim to assess the impact of sociobehavioral factors on adherence, and hypothesize that these factors will be differentially weighted between glaucoma patients and providers.

Methods : An ideally sized, two-round Delphi panel was used to elicit consensus on principal modifiers of adherence. Panelists represented two respondent groups: optometrists, ophthalmologists, and glaucoma specialists (N=8), and patients over 40 who have used topical hypotensive eye drops for two years or more (N=10). In Round 1, 50 statements that assessed treatment barriers, facilitators, motivators, beliefs, and needs were scored using an ‘agree-disagree’ Likert scale. Where 80% or more of respondents agreed that statements were important, consensus was met and statements advanced to Round 2 where they were ranked from most to least applicable. Differences between patient and provider scores were quantified for all statements using the Mann-Whitney U test.

Results : Of the 10 statements that reached consensus, memory aides, perceived treatment efficacy, and worry about blindness were identified as key factors with no significant differences between patients and providers (all p-values > 0.05). Statistically significant group differences were observed for some of the 40 statements that did not reach consensus; emotional support, helping relationships, and social interactions were prioritized by patients, while providers prioritized use of daily routines, regimen complexity, instillation skill, and cost as key modifiers of adherence (all p-values <.05).

Conclusions : Consensus between patients and providers was achieved for some factors such as worry. However, areas of non-consensus highlighted differential weighting of sociobehavioral factors by patients and providers-supporting our hypothesis. This juxtaposition of patient and provider perspectives can reveal important, yet under-explored sociobehavioral targets for modifying adherence in glaucoma.

This is a 2020 ARVO Annual Meeting abstract.


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