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Published on: March 12, 2016
[Causes of patients' non-adherence with glaucoma medication dosing: systemic classification based on dosing schedule]
1Department of Ophthalmology, Kanmon Medical Center National Hospital Organization, Japan. kobi@earth.ocn.ne.jp
Purpose:
To study the causes of patients' nonadherence with the instruction of glaucoma medication dosing and to analyze them based on the dosing schedules by means of systemic classification.
Methods:
Four hundred twenty eight patients who had been prescribed glaucoma medication for at least six months were studied. Adherence was ascertained by means of a predetermined questionnaire. Nonadherent patients were interviewed with stratified questionnaires to elicit the causes for the non-adherence, which were analyzed with cluster analysis.
Results:
The total number of non-adherents (more than 3 doses missed per month) was 114 (26.6%). The non-adherence rate in the morning was 18.2% (51/280) and in the evening 24.7% (75/304); there was no significant difference. Structured interviews for the 114 non-adherents elicited 194 unique situational problems (1.7 +/- 0.6/individual), which were grouped into four major categories: 25 medication regimen factors (12.9%), 119 patients' related factors (61.3%), 6 provider-related factors (3.1%) and 44 environmental factors (22.7%). Patients' related factors showed the higher incidence compared with other factors in both dosing time (p<0.01): Sleeping and taking a bath caused 39 patients (20.1%) to miss medication in patients with eye-drops' application in the evening.
Conclusions:
Each dosing time may have its own situational problems, which may be likely to be multidimensional and must considered with each individual patient.
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