Purpose To assess the association between insufficient follow-up and clinical parameters such as disease severity and medication use among glaucoma patients at a metropolitan county hospital. Design Cross-sectional study Methods Two-hundred and six patients with established glaucoma were recruited from San Francisco General Hospital. Subjects were classified based upon compliance with recommended follow-up examination intervals over the year preceding commencement of the study as determined by patient medical records. Glaucoma severity was determined based upon the American Academy of Ophthalmology Preferred Practice Patterns guidelines. Multivariate logistic regression analysis was used to assess the relationship between adherence with follow-up visits and disease severity. Results After adjustment for the impact of potential confounding variables, subjects with severe glaucomatous disease were found to have been less adherent to their recommended follow-up than those patients with mild or moderate glaucomatous disease (adjusted OR 1.89, 95% CI 1.21–2.94; P = .01). Subjects who were on glaucoma medications were found to be less adherent to follow-up recommendations (adjusted OR 3.29, 95% CI 1.41–7.65, P = .01). Conclusion Subjects with poor follow-up adherence were significantly more likely to have severe glaucomatous disease suggesting that poor follow-up may contribute to disease worsening or, alternatively, those with more severe disease are less inclined to follow up at appropriate intervals.

Objective To assess the association between disease severity and adherence with glaucoma medications in a county hospital population. Design Cross-sectional study. Participants One hundred and twenty-six patients diagnosed with glaucoma receiving intraocular pressure (IOP) lowering medication were recruited from the San Francisco General Hospital Ophthalmology Clinic. Methods Subjects completed an oral questionnaire to assess demographic information, knowledge of glaucoma, and perceptions of glaucoma medication adherence. Glaucoma disease severity was classified according to the American Academy of Ophthalmology’s Preferred Practice Pattern guidelines. Medication adherence was measured for each patient by obtaining pharmacy refill data and calculating medication possession ratio (MPR)—ratio of total days’ supply of medication during a 365-day period. Adherence was measured retrospectively over the 18-month period prior to study entry. Subjects with a MPR > 80% were considered adherent. Main Outcome Measure Medication adherence Results Subjects with mild or moderate glaucoma were more likely to be non-adherent to their prescribed glaucoma medications than those with severe disease (adjusted odds ratio (OR), 1.54; 95% confidence interval (CI), 1.03–2.31; P = 0.04). Age, gender, race, education level, years of glaucoma, number of medications and glaucoma diagnosis were not found to be statistically significantly associated with adherence. Conclusion Patients with severe glaucoma were more likely to adhere to their topical IOP lowering medication regimen than those with milder glaucomatous disease.