Analysis of Factors Affecting Patients’ Compliance to Topical Antiglaucoma Medications in Egypt as a Developing Country Model

Abstract

Purpose. To study factors affecting patients' compliance to antiglaucoma medications in Egypt where there are unique factors as a developing country. Patients and Methods. A cross-sectional descriptive study on 440 Egyptian patients with open angle glaucoma (OAG) recruited for over two years. The patients were thoroughly interviewed about their age, education level, duration of glaucoma, difficulty in instilling the drops, medication regimens, a family history of glaucoma, knowledge of the disease, and the presence of medical insurance. Results. 236 (53.6%) were noncompliant compared to 204 (46.4%) who were compliant. Females had a tendency for higher compliance (p=0.061). Patient age above 50 years and low level of education and negative family history of glaucoma were factors significantly associated with poor compliance (p < 0.0001). Polytherapy and lack of medical insurance could be contributing factors. Conclusion. Egyptian patients have a high rate of noncompliance compared to the average in literature. Great effort is needed in educating patients about the importance of medications and the risk and the prognosis of this disease. Economic factors must also be taken into consideration in developing countries with large number of poor patients. We recommend simplifying drug regimens, incorporating electronic dose monitors, and creating reminders for follow-up visits of glaucoma patients.

Antiglaucoma medication utilization and therapeutic outcome among Nigerian older persons with primary open angle glaucoma

“…The observation of this study contradicted previous reports that reported lower rate of MA among the general population of glaucoma patients. 4,15 The result of this study was however consistent with the observation of a similar study that reported 89% MA among POAG patients. 23 The traditional support system for older persons in the Nigerian society could however have played a role in this study observation.…”

“…Medication adherence in POAG is influenced by many factors including patient's socio-economic demographics, cost of AGM, difficulty in eye drops administration especially among the older persons and the side effects of the AGM. 6,15,16 The AGM are the cornerstones in the management POAG among older persons. However, the relationship between AGM utilization, patients' MA and IOP are relatively rare in the literature.…”

Treatment adherence and associated factors among glaucoma patients attending ophthalmic unit of Debre Markos Referral and Felege Hiwot Comprehensive Specialized Hospitals

“…This study found that patients with good knowledge were 2.24 times more likely adhere to their glaucoma treatment as compared to patients with inadequate knowledge. This finding was supported by studies done in Egypt [15] and Nigeria [25]. If patients know more about glaucoma and the importance of treatment to glaucoma they might be more adherent to their treatment.…”

“…33% had good adherence among a long-distance travelers (>10km) ( Table 5). to long-term therapies among patients suffering from chronic diseases in the general population [32], north India 51.66% [16] and in Egypt 46.4% [15]. However, the adherence rate of the current study was higher than other similar studies done in USA 40% [11], Iran 32.5% [5], Menelik II referral hospital(42.6%) [2] and Jima University Specialized Hospital (32.5%) [33]..…”

“…For example, the overall rate of adherence was 60% in USA, 72.1% in Canada and 72.7% in Dutch [11][12][13]. Similarly hospital based cross-sectional studies showed that in Iran 32.5%, in north India 51.6% and in Egypt 46.4% of glaucoma patients were adherent to their glaucoma medical treatment [ 5,14,15]. In Ethiopia the level of glaucoma medical treatment adherence was 32.5% at Jima University Specialized Hospital and 42.6% at Menelik II Referral Hospital [ 2,16].…”