[Causes of patients' non-adherence with glaucoma medication dosing: systemic classification based on dosing schedule].
OBJECTIVE
To study the causes of patients' nonadherence with the instruction of glaucoma medication dosing and to analyze them based on the dosing schedules by means of systemic classification.


METHODS
Four hundred twenty eight patients who had been prescribed glaucoma medication for at least six months were studied. Adherence was ascertained by means of a predetermined questionnaire. Nonadherent patients were interviewed with stratified questionnaires to elicit the causes for the non-adherence, which were analyzed with cluster analysis.


RESULTS
The total number of non-adherents (more than 3 doses missed per month) was 114 (26.6%). The non-adherence rate in the morning was 18.2% (51/280) and in the evening 24.7% (75/304); there was no significant difference. Structured interviews for the 114 non-adherents elicited 194 unique situational problems (1.7 +/- 0.6/individual), which were grouped into four major categories: 25 medication regimen factors (12.9%), 119 patients' related factors (61.3%), 6 provider-related factors (3.1%) and 44 environmental factors (22.7%). Patients' related factors showed the higher incidence compared with other factors in both dosing time (p<0.01): Sleeping and taking a bath caused 39 patients (20.1%) to miss medication in patients with eye-drops' application in the evening.


CONCLUSIONS
Each dosing time may have its own situational problems, which may be likely to be multidimensional and must considered with each individual patient.
Department of Ophthalmology, Kanmon Medical Center National Hospital Organization, Japan. kobi@earth.ocn.ne.jp
Hiroshi
H
Kobayashi
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D016000:Cluster Analysis; D004334:Drug Administration Schedule; D005260:Female; D005901:Glaucoma / Q000188:drug therapy* / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009883:Ophthalmic Solutions; D010349:Patient Compliance / Q000523:psychology* / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D013997:Time Factors; D055815:Young Adult
D009883:Ophthalmic Solutions