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Adherence and Persistence: The Challenges for Glaucoma Medical Therapy
Simon E Skalicky1, Ivan Goldberg
1From the *Addenbrooke's Hospital, Cambridge, United Kingdom; †Faculty of Medicine, University of Sydney, Sydney New South Wales, Australia; and ‡Discipline of Ophthalmology, University of Sydney, Sydney, New South Wales, Australia.
Summary
Suboptimal adherence to ocular hypotensive medications is a significant issue for glaucoma patients. Strategies like electronic monitoring and patient-clinician communication can improve medication adherence and persistence.
Area of Science:
- Ophthalmology
- Patient Adherence Research
Background:
- Suboptimal adherence and persistence to ocular hypotensive medications are prevalent challenges in glaucoma management.
- This issue impacts a wide range of glaucoma patients globally, irrespective of demographics.
- Healthcare providers often struggle to accurately identify patients with poor adherence in clinical practice.
Purpose of the Study:
- To review strategies for systematically assessing adherence and persistence to ocular hypotensive medications.
- To explore the determinants of adherence behavior in glaucoma patients.
- To identify interventions for improving medication adherence and persistence.
Main Methods:
- Review of existing strategies for adherence assessment, including electronic monitoring.
- Analysis of factors influencing adherence behavior (provider, environmental, medication, patient).
- Evaluation of interventions aimed at improving adherence, such as education, counseling, and reminders.
Main Results:
- Electronic monitoring offers valuable insights into patient adherence patterns.
- Adherence is influenced by a complex interplay of patient, provider, environmental, and medication-related factors.
- Combined interventions, including education, counseling, and reminders, show promise for improving adherence.
Conclusions:
- Systematic assessment of adherence is crucial for effective glaucoma management.
- Addressing multifactorial determinants of adherence is key to improving patient outcomes.
- A collaborative clinician-patient relationship is vital for identifying and overcoming adherence barriers.
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