Physician beliefs and behaviors related to glaucoma treatment adherence: the Glaucoma Adherence and Persistency Study.
OBJECTIVE
Patient adherence with topical glaucoma therapy is recognized as suboptimal. Though some studies have associated physician/patient interaction with adherence, little systematic research has explored the ophthalmologist's perspective of this interaction. Telephone interviews with physicians treating glaucoma were conducted to ascertain the extent to which multivariate analysis of physician demographics, beliefs, and behaviors could reveal differences potentially relevant to future adherence with topical glaucoma therapy for primary open-angle glaucoma, in conjunction with other phases of the Glaucoma Adherence and Persistency Study (GAPS).


METHODS
Structured interviews were conducted with 103 ophthalmologists treating significant numbers of primary open-angle glaucoma patients in a national managed care network. To the maximum extent possible, eligible patients of physicians interviewed were included in the other GAPS phases (claims analysis, patient surveys, and medical chart reviews).


RESULTS
Physicians reported a wide range of beliefs and behaviors regarding patients' medication adherence, but beliefs and behaviors were linked. The segmentation analysis yielded 3 clusters of physicians, which we have described on the basis of their predominant beliefs as "reactives," "skeptics," and "idealists." The "idealists," though the smallest group, more often reported beliefs and behaviors that may be more positively associated with patient adherence, especially in the context of other GAPS findings.


CONCLUSIONS
Physician vigilance for opportunities to detect and address nonadherence is suggested, as is interventional research on the basis of the constructs identified.
Gelb
Laurie
L
HealthCore Inc, Wilmington, DE, USA. lmgelb@comcast.net
Friedman
David S
DS
Quigley
Harry A
HA
Lyon
David W
DW
Tan
Jason
J
Kim
Elizabeth E
EE
Zimmerman
Thom J
TJ
Hahn
Steven R
SR
D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001294:Attitude to Health; D016208:Databases, Factual; D017723:Drug Utilization Review; D005902:Glaucoma, Open-Angle / Q000188:drug therapy*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007345:Insurance Claim Review; D008329:Managed Care Programs / Q000706:statistics & numerical data; D010349:Patient Compliance; D010817:Physician-Patient Relations; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012189:Retrospective Studies
D000959:Antihypertensive Agents