Intentional and unintentional nonadherence to ocular hypotensive treatment in patients with glaucoma.
OBJECTIVE
To determine the rate of intentional and unintentional nonadherence in glaucoma patients and to identify associations between adherence behavior and patients' beliefs.


METHODS
Cross-sectional study.


METHODS
One hundred thirty-one glaucoma patients using topical eye drops for at least 6 months.


METHODS
Interviewer-administered surveys.


METHODS
Self-reported adherence and beliefs about glaucoma and its treatment were assessed using the Reported Adherence to Medication scale, the Brief Illness Perception Questionnaire, and the Beliefs about Medicines-Specific Questionnaire.


RESULTS
Overall, 59 (45%) participants reported some degree of nonadherence, among whom 39 (66.1%) reported unintentional nonadherence (e.g., forgetting), 10 (16.9%) reported intentional nonadherence (deliberate nonadherence), and 10 (16.9%) reported both forms of nonadherence. Compared with adherers, nonadherers were significantly younger, were less likely to have other nonocular health conditions or to use medicines other than their eye drops, and reported lower belief in the necessity of eye drops for glaucoma (P<0.05). Degree of unintentional nonadherence was associated with lower belief in necessity of eye drops, whereas degree of intentional nonadherence was associated with concerns about eye drops.


CONCLUSIONS
Strategies aimed at improving adherence in glaucoma patients need to address both intentional and unintentional dimensions. Interventions focused on eliciting and addressing patients' beliefs and concerns about their eye drops require evaluation.
Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, University of Melbourne, Melbourne, Australia. grees@unimelb.edu.au
Gwyneth
G
Rees
Omega
O
Leong
Jonathan G
JG
Crowston
Ecosse L
EL
Lamoureux
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000008:administration & dosage*; D003430:Cross-Sectional Studies; D005260:Female; D005901:Glaucoma / Q000188:drug therapy / Q000523:psychology*; D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects*; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D008875:Middle Aged; D009883:Ophthalmic Solutions / Q000008:administration & dosage; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D010349:Patient Compliance / Q000523:psychology*; D011795:Surveys and Questionnaires; D055815:Young Adult
D000959:Antihypertensive Agents; D009883:Ophthalmic Solutions