Abstract
Background: Many factors influence glaucoma medication adherence. A better understanding of the relationships between knowledge, attitude and patients’ practice problems in using glaucoma medications may reveal opportunities for intervention that could improve patients’ clinical outcomes. The challenge of non-adherence to glaucoma follow-up and treatment plans remains a significant global healthcare concern. Non-adherence to medication is a challenge to effective treatment of many chronic diseases, including glaucoma and remains so even with the implementation of strategies aimed at improving adherence. In South Africa, the information-motivation and behavioural skills model (IMBSM) of glaucoma adherence constructs might be useful in describing and predicting adherence behaviours that have not been articulated to people with glaucoma.Aim: The study applied the IMBSM in strengthening eye care follow-up amongst glaucoma patients in the Limpopo province of South Africa.Setting: The study was conducted at a selected hospital in the Vhembe District, Limpopo province, South Africa.Methods: A cross-sectional quantitative descriptive study via questionnaire was conducted on patients who were taking intraocular pressure-lowering medications and subject to follow up at a glaucoma clinic. A total of 429 eligible patients were purposefully selected for data collection using structured questionnaires. Oral informed consent was obtained from all respondents before they completed the questionnaires.Results: Only 55% of the total sample reported a glaucoma non-adherence rate of less than or equal to 95% compared with 45% who reported glaucoma adherence rate of more than or equal to 95%. Independent predictors of non-adherence were: inadequate glaucoma knowledge (29%), forgetfulness (26%) and patients’ beliefs (18%).Conclusion: The findings revealed the need for on-going glaucoma educational and informational interventions to address the motivation and adherence behavioural skills of patients to strengthen the current levels of glaucoma adherence behaviour. These findings suggest that the application of the IMBSM might improve glaucoma patients’ adherence.
Highlights
Several studies show that glaucoma is the second leading cause of blindness worldwide, accounting for an approximately 3.12 million cases globally and the leading cause of irreversible blindness.[1,2] The number of glaucoma patients are expected to rise to about 76.0 million in 2020 and to 111.8 million in the year 2040.3 The most common risk factor for glaucoma is raised intraocular pressure (IOP)
Similar findings were reported in Nigeria and South Africa, where the number of female participants without formal education were in the majority.[2,34]
The study identified that glaucoma knowledge is low as it is cited as the most contributing factor for glaucoma medication non-adherence
Summary
Several studies show that glaucoma is the second leading cause of blindness worldwide, accounting for an approximately 3.12 million cases globally and the leading cause of irreversible blindness.[1,2] The number of glaucoma patients are expected to rise to about 76.0 million in 2020 and to 111.8 million in the year 2040.3 The most common risk factor for glaucoma is raised intraocular pressure (IOP). Lowering of IOP is the only proven strategy for preventing the risk of glaucoma progression. Medication is often suboptimal for glaucoma and non-adherence is a significant barrier to effective use of medication. The challenge of non-adherence to glaucoma follow-up and treatment plans remains a significant global healthcare concern. Non-adherence to medication is a challenge to effective treatment of many chronic diseases, including glaucoma and remains so even with the implementation of strategies aimed at improving adherence. In South Africa, the information-motivation and behavioural skills model (IMBSM) of glaucoma adherence constructs might be useful in describing and predicting adherence behaviours that have not been articulated to people with glaucoma
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