Patient and Neighborhood Factors Influencing Glaucoma Medication Adherence

This study identified patient-level factors as key barriers and facilitators to glaucoma medication adherence, varying by sex and neighborhood disadvantage (ADI), suggesting that targeted interventions could improve glaucoma medication adherence outcomes.

To identify the barriers and facilitators to glaucoma medication adherence for participants in the Support, Educate, Empower Personalized Glaucoma Coaching Program pilot study and assess any differences by demographics.

This was a mixed-methods study of participants who reported glaucoma medication adherence of ≤80.00%. Patient (age, sex, and race) and neighborhood [Area Deprivation Index (ADI)] factors were obtained, and participants completed a semistructured interview. Patient interviews were transcribed and analyzed using the modified Penchansky and Thomas framework to assess barriers and facilitators to glaucoma medication adherence, and participant numbers were computed for each theme.

Of the 44 participants, 52% were 65 years or older, 45% were female, 45.5% were Black, and 34% lived in high-ADI neighborhoods. The most cited theme by participants for barriers and facilitators to medication adherence was patient-level factors (52% and 48%, respectively). Difficulty with the medication schedule was a leading barrier (48%), while the location of eye drops in the home (25%) was a leading facilitator. Patient-level barriers and facilitators differed by sex and ADI.

Patient-level barriers and facilitators to glaucoma medication adherence were most frequently mentioned. Patient-level facilitators differed by sex and ADI; patient and neighborhood factors should be considered when assessing glaucoma medication adherence, as it may differ by these factors. In this cohort of glaucoma patients with poor medication adherence, patient-level factors served as more significant barriers compared with those related to health care in the US. Consequently, targeted interventions addressing these individual barriers could potentially improve medication adherence outcomes.