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Establishing Consensus on the Appropriate Tool for Measuring Adherence to Glaucoma Medication in a Sub-Saharan
Benjamin Abaidoo1,2,3, Khathutshelo Percy Mashige3, Pirindhavellie Govender-Poonsamy3
1Ophthalmology Unit, Department of Surgery University of Ghana Medical School Accra Ghana.
Public Health Challenges
|April 10, 2026
Summary
The Glaucoma Treatment Compliance Assessment Tool-Short form (GTCAT-S) is the most effective tool for measuring glaucoma medication adherence. Experts reached a consensus, showing high reliability and agreement for this validated tool.
Area of Science:
- Ophthalmology
- Pharmacology
- Health Services Research
Background:
- Assessing medication adherence is crucial, yet specific tools for glaucoma medication adherence lack clear guidance.
- Existing methods for measuring adherence offer limited direction for glaucoma patients.
Purpose of the Study:
- To establish expert consensus on the optimal tool for measuring glaucoma medication adherence using the Delphi technique.
- Identify the most appropriate instrument for assessing adherence to glaucoma medications.
Main Methods:
- A two-round Delphi study involved 16 experts from various fields.
- Three validated adherence measurement tools were assessed for glaucoma medication.
- Consensus, agreement, and inter-rater reliability were evaluated using Kendall's Coefficient of Concordance, SCVI, and ICC.
Main Results:
- High consensus levels (81.0% and 89.0%) were achieved across Delphi rounds.
- The Glaucoma Treatment Compliance Assessment Tool-Short form (GTCAT-S) emerged as the preferred tool.
- GTCAT-S demonstrated strong agreement (SCVI=0.91) and excellent inter-rater reliability (ICC=0.94).
Conclusions:
- The GTCAT-S is the most suitable tool for measuring non-adherence to glaucoma medication.
- High SCVI and ICC values for GTCAT-S indicate robust measurement consistency and expert agreement.
- This study provides essential guidance for selecting an appropriate tool for glaucoma medication adherence assessment.
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