Medical treatment: Adherence and persistence

Abstract

Glaucoma is recognized as a significant cause of blindness worldwide. It is a disease that affects over 2 million people in the United States today, a number that is projected to increase to more than 3 million by the year 2020. The mainstay of therapy for open-angle glaucoma is maintaining low intraocular pressure to prevent or retard progression of the disease. However, despite the possibility of devastating vision loss, low adherence to and persistence on medical treatment remains surprisingly poor. Unfortunately, glaucoma is one of the many chronic diseases in which poor adherence leads to disease progression, which in turn leads to increased health costs. In fact, hospital admission data in the United States show that 33-69% of all admissions are the result of noncompliance with medications, costing the system approximately $100 billion a year [1, 9, 10, 16]. Understanding the motivating or demotivating factors behind these behaviors is essential to provide quality care to our patients. The two key concepts involved are those of adherenceand persistence. © 2010 Springer-Verlag Berlin Heidelberg.