Compliance barriers in glaucoma: a systematic classification.
OBJECTIVE
To systematically identify and describe common obstacles to medication adherence (i.e., compliance) for patients with glaucoma.


METHODS
A prospective case series of structured interviews were conducted with 48 patients with glaucoma. The subjects' responses were recorded verbatim on interview forms as well as recorded on audiotapes. Situational obstacles to medication adherence were elicited. Using hierarchical cluster analysis, the situational descriptions were stratified, grouped, and analyzed by frequency distribution.


RESULTS
Seventy-one unique situational obstacles were reported. These were then grouped into 4 defined and separate categories: situational/environmental factors (35 of 71 situations; 49%), medication regimen (23 of 71; 32%), patient factors (11 of 71; 16%), and provider factors (2 of 71; 3%).


CONCLUSIONS
Significant barriers to compliance exist for patients with glaucoma in addition to those cited by previous ophthalmic studies. A systematic classification (i.e., taxonomy) of these barriers was formulated to assist in optimizing patient education and problem-solving regarding prescribed therapeutic regimens.
Tsai
James C
JC
Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University College of Physicians and Surgeons, New York, New York 10032, USA. jct2002@columbia.edu
McClure
Cori A
CA
Ramos
Sarah E
SE
Schlundt
David G
DG
Pichert
James W
JW
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D016000:Cluster Analysis; D005260:Female; D005901:Glaucoma / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000706:statistics & numerical data*; D011446:Prospective Studies
D000959:Antihypertensive Agents