Adherence with Medical Therapy for Primary Open-Angle Glaucoma in Kenya - A Pilot Study

Area of Science:

• Ophthalmology
• Public Health

Background:

• Adherence to topical glaucoma therapy presents significant challenges, especially within the African healthcare context.
• Previous adherence assessments in this region have relied heavily on self-reporting, potentially overestimating compliance.

Purpose of the Study:

• To pilot an objective method for assessing medication adherence in patients with newly diagnosed open-angle glaucoma in an African setting.
• To evaluate the feasibility and preliminary findings of using weighed medication bottles to track adherence.

Main Methods:

• A pilot study involved 11 patients newly diagnosed with open-angle glaucoma who received Lumigan 0.01% in weighed bottles.
• Adherence was assessed over one year by weighing returned bottles monthly to estimate the number of drops used.
• A brief compliance questionnaire was administered alongside objective measurements.

Main Results:

• 45% of participants (5 out of 11) did not complete the full year of topical therapy.
• For the 6 patients who completed the year with monthly bottle returns and controlled intraocular pressure (IOP), the mean usage was 1.74 drops per eye per day.
• These adherent patients reported good self-perception of their compliance.

Conclusions:

• Objective adherence measures, alongside self-reports, suggest that topical medication may not be the optimal first-line treatment for glaucoma in this specific environment.
• The study highlights that patients consistently attending for repeat prescriptions and follow-up appointments demonstrate a higher likelihood of adherence.