A Change in the Causes Precluding Adherence of Glaucoma Medication Regimen: Systemic Analysis over 12 Months

Purpose: To study the change in the causes that precluded adherence to glaucoma medication regimen by repeating the importance of the treatment for 1 year and to analyze them by means of systemic classification. Methods: Participants in this study were 230 patients who had been prescribed anti- glaucoma medication for at least six months. Adherence was examined at baseline and at 12 month, and its changes were studied. Adherence was ascertained by means of a predetermined questionnaire. Patients with poor adherence were interviewed with stratified questionnaires to elicit the causes precluding the adherence, which were analyzed with cluster analysis. Results: Two hundred three patients (88.3%) finished this study. Of these, 69 patients reported having poor adherence at baseline and 60 at 12 months (p=0.3). Structured interviews elicited 115 (0.6±0.9/individual) and 79 (0.4±0.7/individual) unique situational problems, respectively (p=0.0128), which were grouped into four separate and major categories:14 and 5 medication regimen-related factors (p=0.0345), 70 and 54 patients-related factors (p=0.1), and 10 and 6 provider-related factors (p=0.3) at baseline and at 12 months, respectively. There were 21 environmental factors at baseline which reduced to 8 after 1 year, and 10 new ones added to them, resulting in a total of 18 (p=0.6). Conclusions: All situational problems showed a significant reduction after explaining the importance of glaucoma medication. The causes precluding adherence to topical medication regimen may be likely to be multi-dimensional and should be considered in association with each individual patient.