title: Doctor-patient communication, health-related beliefs, and adherence in glaucoma results from the Glaucoma Adherence and Persistency Study.
abstract: OBJECTIVE
  To use multiple data sources to determine drivers of patient adherence to topical ocular hypotensive therapy.
  
  
  METHODS
  Retrospective database and chart reviews in combination with prospective patient surveys. Diverse medical environments where insured patients in the research database seek care.
  
  
  METHODS
  Three hundred patients with a new claim diagnosis for open-angle glaucoma who initially were prescribed one of three prostaglandins and 103 physicians participating in the same medical plans.
  
  
  METHODS
  A structured interview addressing self-reported adherence, experiences with medication, communication with the physician, and health-related beliefs associated with adherence behavior was administered to surveyed patients. Phone interviews were conducted with participating ophthalmologists.
  
  
  METHODS
  Of adherence, medication possession ratio.
  
  
  RESULTS
  Eight variables were associated independently with a lower medication possession ratio: (1) hearing all of what you know about glaucoma from your doctor (compared with some or nothing); (2) not believing that reduced vision is a risk of not taking medication as recommended; (3) having a problem paying for medications; (4) difficulty while traveling or away from home; (5) not acknowledging stinging and burning; (6) being nonwhite; (7) receiving samples; and (8) not receiving a phone call visit reminder. The multivariate model explained 21% of the variance.
  
  
  CONCLUSIONS
  These findings indicate that doctor-patient communications and health-related beliefs of patients contribute to patient adherence. Patient learning styles that are associated with less concern about the future effects of glaucoma and the risks of not taking medications are associated with lower adherence. Specifically, knowledge about potential vision loss from glaucoma is a critical element that tends to be missed by more passive doctor-dependent patients who tend to be poorly adherent. These findings suggest that educational efforts in the office may improve patient adherence to medical therapies.
authors.affiliation: Wilmer Eye Institute, Baltimore, Maryland 21287, USA. David.Friedman@jhu.edu
authors.forename: David S
authors.initials: DS
authors.lastname: Friedman
authors.forename: Steven R
authors.initials: SR
authors.lastname: Hahn
authors.forename: Laurie
authors.initials: L
authors.lastname: Gelb
authors.forename: Jason
authors.initials: J
authors.lastname: Tan
authors.forename: Sonali N
authors.initials: SN
authors.lastname: Shah
authors.forename: Elizabeth E
authors.initials: EE
authors.lastname: Kim
authors.forename: Thom J
authors.initials: TJ
authors.lastname: Zimmerman
authors.forename: Harry A
authors.initials: HA
authors.lastname: Quigley
mesh_terms: D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001294:Attitude to Health; D003142:Communication; D005260:Female; D005902:Glaucoma, Open-Angle / Q000188:drug therapy*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D010349:Patient Compliance; D010817:Physician-Patient Relations; D011446:Prospective Studies; D011465:Prostaglandins, Synthetic / Q000627:therapeutic use; D012189:Retrospective Studies
chemical_list: D000959:Antihypertensive Agents; D011465:Prostaglandins, Synthetic