Improving Compliance via Education, Reminders, and Evaluating Physician-Patient Concerns in Glaucoma
PURPOSE: To improve glaucoma treatment compliance via education, medication reminders, and understanding of patient and physician concerns. DESIGN: Prospective Comparative Case Series SUBJECTS: 194 consecutive eligible patients diagnosed with primary open angle glaucoma or ocular hypertension at a single academic center (92 male and 102 female) and 16 glaucoma specialists volunteered their responses. METHODS: All 194 eligible patients were interviewed regarding glaucoma knowledge, medication usage, concerns, and fears. They were counseled, given educational handouts, and reinterviewed after 4 weeks. All 16 glaucoma specialists were also surveyed regarding their concerns for their patients. MAIN OUTCOME MEASURE: Patient's knowledge of the basic premise of glaucoma, compliance to their medications, including concerns and fears of glaucoma in both patients and physicians. RESULTS: In this study, patients aged ≥ 65 years were more compliant than those < 65 years (76% vs 50%, p<0.05). In follow-up interviews of 125 (64%) patients, I found significant increase in glaucoma knowledge from 53% to 67% (p<0.05) and compliance from 77% to 94% (p<0.05). In addition, patients' major fear was becoming dependent on others (p<0.05), while physicians were more concerned about patients' ability to administer eyedrops and understanding of instructions (p<0.05). CONCLUSION: I found that patients aged ≥ 65 were more compliant. Our intervention improved patient compliance by 17 % and represents a potential model for glaucoma management. In addition, the disparity between patient and physician fears suggest that communication barriers must be addressed to improve patient care.
Medication Adherence, Ophthalmic Solutions, Patient Compliance, Glaucoma, Health Knowledge, Attitudes, Practice
University of Texas Southwestern Medical Center
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