Health literacy plays an important role in reproductive knowledge and may impact behaviors and outcomes. While further research is necessary, healthcare providers should utilize health literacy best practices now to promote high-quality care for patients.

Objectives The objective of this study was to examine the extent to which patient characteristics, eye drop technique self-efficacy, and ophthalmologist–patient communication about eye drop administration are associated with glaucoma patients’ ability to instil a single drop, have the drop land in the eye, and avoid touching the applicator tip of the medication bottle to the eye or face while self-administering eye drops. Methods Glaucoma patients (n = 279) were recruited from six ophthalmology clinics. Medical visits were videotape-recorded. Afterwards, patients were interviewed and demonstrated administering an eye drop on a videotaped-recording. Generalized estimating equations were used to analyse the data. Key findings Ophthalmologists provided eye drop administration instruction to 40 patients. Patients with more years of education were significantly more likely to both instil a single drop (P = 0.017) and have the drop land in their eye (P = 0.017). Women were significantly more likely to touch the applicator tip to their eyes or face (P = 0.014). Patients with severe glaucoma (P = 0.016), women (P = 0.026), and patients who asked at least one eye drop administration question (P = 0.001) were significantly less likely to instil a single drop. Patients with arthritis were significantly less likely to have the drop land in their eye (P = 0.008). African American patients were significantly less likely to touch the applicator tip to their eyes or face (P = 0.008). Conclusions Some glaucoma patients have a difficult time self-administering eye drops. As so few patients received eye drop administration instruction from their providers, there is an opportunity for pharmacists to complement care.

Purpose The purpose of this study was to examine if patient demographic factors influenced self-reporting of medication side effects, difficulty with drop instillation and nonadherence to glaucoma therapy. Methods English-speaking adult glaucoma patients (n=279) from six ophthalmology clinics were enrolled. Patients’ medical visits were videotaped and patients were interviewed immediately afterwards by research assistants. The videotapes were transcribed verbatim and coded to identify patients who expressed problems with medication side effects, eye drop administration, and non-adherence during the glaucoma office visits. Generalized estimating equations were performed to identify whether patient characteristics were associated with expression of problems with glaucoma medication and medication non-adherence during the office visit. Results Patients with lower health literacy were significantly less likely to express problems with side effects (OR (95%CI) = 0.47 (0.25, 0.88)) and eye drop administration (OR (95%CI) = 0.26 (0.11, 0.63)) during the visit. Patients who reported eye drop administration and side effect problems during the interview were significantly more likely to express these problems to their ophthalmologists, (OR (95%CI) = 3.13 (1.82, 5.37)); (OR (95%CI) = 1.86 (1.12, 3.08)) respectively. Patients who expressed a problem with eye drop administration and with side effects were significantly more likely to express medication non-adherence to their ophthalmologist (OR (95%CI) = 2.89 (1.44, 5.80)); (OR (95%CI) = 2.03 (1.16, 3.54)). Patients who reported greater than 80% medication adherence during the interview were significantly less likely to express non-adherence to their ophthalmologist (OR (95%CI) = 0.22 (0.12, 0.40)). Conclusions Eye care providers should be aware that glaucoma patients with lower health literacy are less likely to express problems with side effects and eye drop administration. Providers should work with patients to assess medication-related problems in order to mitigate potential barriers to medication adherence since patients who expressed medication problems were also more likely to express non-adherence.

Objective The purpose of this study was to: (a) describe the extent to which ophthalmologists and glaucoma patients discuss vision quality-of-life during office visits, and (b) examine the association between patient and ophthalmologist characteristics and provider-patient communication about vision quality-of-life. Methods Patients with glaucoma who were newly prescribed or on glaucoma medications were recruited at six ophthalmology clinics. Patients' visits were video-tape recorded and quality-of-life communication variables were coded. Generalized estimating equations were used to analyze the data. Results Two hundred and seventy-nine patients participated. Specific glaucoma quality-of-life domains were discussed during only 13% of visits. Older patients were significantly more likely to discuss one or more vision quality-of-life domains than younger patients. African American patients were significantly less likely to make statements about their vision quality-of-life and providers were less likely to ask them one or more vision quality-of-life questions than non-African American patients. Conclusion Eye care providers and patients infrequently discussed the patient's vision quality-of-life during glaucoma visits. African American patients were less likely to communicate about vision quality-of-life than non-African American patients. Practice Implications Eye care providers should make sure to discuss vision quality-of-life with glaucoma patients.