Abstract
Purpose :
Poor medication adherence has been associated with greater visual field severity. However, little is known about how environmental factors affect medication adherence in glaucoma patients. The purpose of this study is to explore how environmental factors, including environmental light, clutter, and contrast affect medication adherence.
Methods :
We conducted a cross-sectional analysis of data from the Safety And Functionality Eye Research (SAFER) study. We evaluated adults diagnosed with glaucoma using at least one eye drop. Medication adherence to eye drops was assessed through Medication Events Monitoring System (MEMS) devices. Adherence was defined as the ratio of missed doses to prescribed doses during the period of MEMS usage (mean=7.1; SD=1.3). Measurements for light, clutter and contrast were taken at the areas where participants stored their eye drop medications in the home. Clutter and contrast were then categorized as none/mild, moderate/severe. Multivariable models utilizing generalized estimating equations (GEE) were employed to explore the effect of environmental factors on medication adherence (dependent variable), accounting for multiplicity of eyedrops per patient. Models were adjusted for age, gender, race, education, comorbidities, polypharmacy, and number of eye drops.
Results :
61 participants were included in the study. Mean (SD) age was 73.7 (8.6) years, and a majority were White (62.3%), and male (54%). The average mean deviation in the better eye was -7.1 dB (7.3). One third (34.4%) had at least 1 missed dose over 7 days. Most participants placed their eye drops in the bedroom (38.5%). In GEE models, light, clutter, and contrast were not associated with medication adherence (p>0.05). However, the location of the eye drop storage was associated with adherence such with storage in the kitchen (β=-8.5% [95% CI: -16.2, -0.8], p=0.03) or office (β=-11.6% [95% CI: -21.7, -1.6], p=0.02) associated with less missed doses compared to bedroom storage. Adherence did not significantly differ between eye drops placed in the living room or bathroom compared to the bedroom (p>0.05).
Conclusions :
Location of eye drop storage may influence medication adherence in adults with glaucoma.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.