Evaluation of Factors Affecting the Compliance and Treatment Adherence in Glaucoma Patients

Purpose: To evaluate the compliance rates and identify the obstacles to compliance among glaucoma cases. Material and Method: This descriptive and cross-sectional study included 186 glaucoma patients, who were applied structured interviews in order to determine their demographic and clinical parameters. Patient compliance was analyzed based on three criteria: 5 or more doses missed in the last month, correct or incorrect knowledge of treatment, and proper or improper eye drop instillation. By analyzing the distribution of demographic and clinical parameters in these criteria groups, we tried to clarify the obstacles to correct medication use. Results: 54 patients (29.9%) reported missing more than 5 drops in the last month and 75 (40.3%) patients were unable to describe their medication regimen accurately. With regard to drop administration, 45 cases (24.2%) demonstrated improper technique. The most common parameters observed in cases with higher missing rates were: forgetfulness, insufficient knowledge about glaucoma, low cup/disc ratio, using higher number of anti-glaucoma medications, negative family history for glaucoma. Inadequate knowledge about treatment regimen was associated with shorter duration of glaucoma, insufficient knowledge about glaucoma, low education level and higher number of anti-glaucoma medications. Factors associated with improper administration technique were older age, presence of deformity of upper extremity, and shorter duration of glaucoma. Discussion: The high rates of noncompliance among glaucoma patients demand a systematic approach. In newly diagnosed patients and in patients with poor glaucoma control, the factors associated with low patient compliance should be evaluated. Physicians should take a more active role in educating patients and their caretakers about glaucoma and its treatment, and should instruct them on the proper drop administration technique. Therapy should be personalized for each patient. These measures, which may increase the compliance, would prevent frequent changes in patient's therapeutic regimen or surgery.