Impact of psychometric measures on adherence patterns to ocular hypotensive therapy in patients with primary open-angle glaucoma

Abstract

Purpose : We previously reported that resilience was positively associated with medication adherence in patients with primary open-angle glaucoma (POAG) during the COVID-19 pandemic (Racette et al., 2022). The aim of this study was to assess resilience during the pandemic as well as the relationship between medication adherence, patient loneliness and patient activation.

Methods : In this prospective cohort study, POAG patients who were prescribed hypotensive eyedrops were selected from an ongoing longitudinal National Institute of Health-funded study initiated before the onset of the COVID-19 pandemic. Patient loneliness, activation, and resilience were assessed using the University of California Los Angeles Loneliness Scale, Patient Activation Measure (PAM), and Connor-Davidson Resilience Scale, respectively. Mean adherence was assessed electronically over two six-month periods (before and after the onset of the pandemic), using Medication Event Monitoring System. Multivariate analysis of variance was performed using change in the adherence between two timepoints as the independent variable and PAM and UCLA loneliness scales as fixed effects.

Results : A total of 47 patients were included in this analysis. Mean ± SD age was 70.65 ± 7.94 years and 51% of patients were male. The odds of a decline in medication adherence were associated with the odds of a decline in resilience (OR = 1.66). Mean adherence before the pandemic was positively associated with resilience (r = 0.289, p = 0.049). However, there were no significant associations between mean adherence and resilience after the onset of the pandemic (r = 0.037, p = 0.806). A negative correlation was observed between mean adherence and loneliness (r = - 0.323, p = 0.027) but there was no correlation between mean adherence and patient activation scores. Resilience was positively correlated with patient activation (r = 0.467, p <0.001) and negatively correlated with loneliness (r = - 0.426, p = 0.003). From multivariate analysis, it was found that both loneliness [F_15,1 = 5946.500, p = .010] and patient activation [F_15,1 = 15727.312, p = .006] had a significant effect on adherence.

Conclusions : Medication adherence was associated with resilience and loneliness during the pandemic. Psychometric assessments can assist in the identification and support of patients at risk for worsening adherence.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.