Challenges Contributing to Loss to Follow-up as Experienced by Glaucoma Patients in the Vhembe District of Limpopo Province, South Africa

Abstract

Background: Glaucoma is a group of chronic diseases of the optic nerve that, if not managed effectively, could lead to blindness of many people worldwide. Non-adherence to medical treatments typically lead to burdensome consequences such as progressive visual loss and disabilities. Fortunately, literature reveals that with timed appropriate treatment, such blindness can be prevented. Thus, patients’ adherence to follow-up plays an important role in maintaining vision. However, glaucoma patients in Vhembe District still miss their follow-up appointments. Objective: This study sought to explore factors contributing to loss to follow-up as experienced by glaucoma patients in South Africa. Methods: Qualitative, explorative, and descriptive research designs, using qualitative methodology, were adopted. The population consisted of glaucoma patients who had been on antiglaucoma medications for three years and above. The purposive sampling method was used to select 18 participants for the study. Data were collected using a semi-structured interview using an interview guide. Participants were between the ages of 24 and 80 years. Tesch’s eight steps of qualitative data analysis were used. Measures to ensure trustworthiness and ethical issues were observed. Results: The study findings revealed that some of the patients did not understand glaucoma disease and the importance of follow-up. Financial constraints, traditional/religious belief, shortage of medications, and negative staff attitude were the most cited barriers contributing to loss to follow-up. Conclusion: Follow up adherence amongst glaucoma patients was negatively influenced by low disease knowledge. Therefore an improvement in patient education, transportation services, and clinic efficiency may strengthen follow-up visits.