Adherence to medical treatment in primary open-angle glaucoma in Egypt

Abstract

Purpose The aim of the study was to find the state of adherence to medical treatment and the factors affecting it among Egyptian primary open-angle glaucoma patients. Patients and methods A total of 110 adult patients, previously diagnosed with primary open-angle glaucoma, were administered a questionnaire that included most of the potential causes of nonadherence (defined as missing one or more doses of a previously prescribed topical intraocular pressure (IOP)-reducing eye drop during the last 4 weeks) to glaucoma medication reported in the literature (based on age, sex, education level, illness duration, association of other chronic diseases, medication side effects, instillation difficulties, fear of blindness, concept of missing one dose only, hope of prognosis, number of used drugs, and financial cost) during their usual follow-up visit to the outpatient clinic of the Nile Health Insurance Hospital from November 2009 to May 2010. Results Forty-two (38.8%) patients were found to be nonadherent and 68 (61.8%) patients were adherent (no missed doses in the last 4 weeks). Hope of controlling the disease had a statistically significant positive effect on adherence to treatment, whereas the presence of other chronic illnesses had a positive statistically significant effect on nonadherence. The effect of other factors, such as age, sex, education level, illness duration, medication side effects, instillation difficulties, fear of blindness, concept about missing one dose only, number of used drugs, and financial cost, although affecting the adherence level, were statistically insignificant. Conclusion Despite the recent development of drugs with relatively simpler treatments and fewer side effects, nonadherence to topical hypotensive treatment continues to be a considerable obstacle in the treatment of glaucoma patients. The mood of the patient and awareness about his illness are very important factors that determine the adherence level. Fear of blindness and the hope of a good prognosis are powerful motivating factors.