A Cross-sectional Study on Adherence to Topical Glaucoma Medication and its Determinants among Patients Attending Glaucoma Clinics of a Tertiary Care Institute of Ahmedabad City, Gujarat, India

Abstract

Aim and background:Glaucoma is a leading cause of blindness in India, and treatment adherence is essential to prevent vision loss. However, studies have shown that treatment adherence rates among glaucoma patients in India are low. It is important to identify the factors determining treatment adherence in order to improve compliance with the treatment, thereby preventing worsening vision. The current study was conducted with an objective to assess the treatment adherence among glaucoma patients using the Morisky Medication Adherence Scale (MMAS-8) and to assess determinants of treatment adherence among the study participants. A drop instillation technique among the glaucoma patients was also evaluated. Materials and methods: A cross-sectional study was conducted among primary open-angle glaucoma (POAG) patients at a selected tertiary care institute in Ahmedabad city. The calculated sample size was 100. Glaucoma patients receiving treatment for at least 3 months were enrolled. Systematic sampling was applied, wherein every alternate patient fulfilling the inclusion criteria was selected. After obtaining informed consent, interviews were conducted using a pretested and predesigned pro forma including MMAS-8. Participants were instructed to use sterile artificial tears, which were evaluated by the investigator for precision. Results: The mean age of study participants was 62.0 ± 6.28 years. Among the participants, 54% were female. The study revealed that 82% of participants had poor adherence to glaucoma medication. Factors such as education, regular follow-up, and having received prior instruction were significantly associated with adherence to medications. Only 43% of the patients were able to instill the eye drops correctly. Conclusion: Low adherence to medication was found among 82% of cases. Factors significantly associated with adherence were gender, education, duration of treatment, and having received prior instruction. Forgetfulness and the cost of treatment were the most common factors leading to low treatment adherence. Among 79 participants who were observed for the drop instillation technique, 43% were found to have instilled it properly.