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Glaucoma patient expression of medication problems and nonadherence
Catherine Slota1, Robyn Sayner, Michelle Vitko
1*PhD †PharmD ‡BA §PhD, MSPH ∥MD Division of Pharmaceutical Outcomes and Policy, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (CS, RS, MV, DMC, SJB, BS); Department of Ophthalmology, University of Maryland, Baltimore, Maryland (ALR); Department of Ophthalmology University of Michigan, Ann Arbor, Michigan (ALR); Department of International Health, Bloomberg School of Public Health, Baltimore, Maryland (ALR); Department of Ophthalmology, School of Medicine, Johns Hopkins University, Baltimore, Maryland (ALR); Department of Ophthalmology, School of Medicine, Duke University, Durham, North Carolina (KWM); Durham VA Medical Center, Health Services Research and Development, Durham, North Carolina (KWM); Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center University of Utah, Salt Lake City, Utah (MEH); and Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (BS).
Glaucoma patients with lower health literacy are less likely to report medication side effects and administration difficulties. Healthcare providers should proactively assess these issues to improve patient adherence to glaucoma therapy.
Area of Science:
- Ophthalmology
- Patient Adherence
- Health Literacy
Background:
- Glaucoma therapy adherence is crucial for managing intraocular pressure and preventing vision loss.
- Patient-reported outcomes regarding medication side effects and administration are vital for effective treatment.
- Understanding demographic influences on patient self-reporting can optimize clinical communication and care.
Purpose of the Study:
- To investigate the association between patient demographic factors and the self-reporting of medication side effects.
- To determine if demographic characteristics influence the expression of difficulties with glaucoma eye drop instillation.
- To examine the relationship between patient demographics and nonadherence to prescribed glaucoma therapy.
Main Methods:
- A study involving 279 English-speaking adult glaucoma patients from six ophthalmology clinics.
- Videotaping of patient medical visits, followed by immediate post-visit interviews by research assistants.
- Verbatim transcription and coding of visit recordings to identify expressed problems, analyzed using generalized estimating equations.
Main Results:
- Lower health literacy was significantly associated with reduced reporting of side effects (OR, 0.47) and administration issues (OR, 0.26).
- Patients reporting problems during interviews were more likely to express them to their ophthalmologist (side effects OR, 1.86; administration OR, 3.13).
- Expressed medication problems correlated with a higher likelihood of expressing nonadherence (side effects OR, 2.03; administration OR, 2.89).
Conclusions:
- Glaucoma patients with lower health literacy may underreport medication side effects and administration challenges.
- Healthcare providers need to actively inquire about medication-related problems to identify and address potential adherence barriers.
- Addressing expressed medication issues is critical, as patients reporting problems are more likely to exhibit nonadherence.
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