Predictors of Adherence to Glaucoma Treatment in a Multisite Study

Abstract

Background: Poor adherence hinders glaucoma treatment. Studies have identified demographic and clinical predictors of adherence but fewer psychological variables. Purpose: We examined predictors from four health behavior theories and past research. Methods: In the baseline phase of a three-site adherence study, before any intervention, 201 participants used electronic Medication Event Monitoring System (MEMS) bottles to monitor eyedrop use for 2 months, and completed questionnaires including self-reported adherence. Results: MEMS showed 79 % adherence and self-report 94 % (0.5–1.5 missed weekly doses), but they correlated only rs = 0.31. Self-efficacy, motivation, dose frequency, and nonminority race/ethnicity predicted 35 % of variance in MEMS. Cues to action, self-efficacy, and intention predicted 20 % of variance in self-reported adherence. Conclusions: Self-efficacy, motivation, intention, cues to action, dose frequency, and race/ethnicity each independently predicted adherence. Predictors from all theories were supported in bivariate analyses, but additional study is needed. Researchers and clinicians should consider psychological predictors of adherence. (ClinicalTrials.gov ID# NCT01409421.)