Compliance: clear communication's critical

Buller, Alex

doi:10.1136/bjo.2005.066175

Cited by 14 publications

(17 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…4,5 However, despite the availability of effective medications, nonadherence and lack of persistence in using prescribed therapy is a significant problem. 6 Approximately 50% of the individuals who start on glaucoma medications discontinue them within 6 months. 7,8 Further, even when patients attempt to adhere to their eye drop medications, research has shown that patient performance during eye drop administration is poor.…”

Section: Introductionmentioning

confidence: 99%

Development of an instrument to measure glaucoma medication self-efficacy and outcome expectations

Sleath

Blalock

Robin

et al. 2009

Eye

View full text Add to dashboard Cite

Purpose The purpose of this study was to develop and evaluate the psychometric properties of (a) a glaucoma medication selfefficacy scale and (b) a glaucoma outcome expectations scale.Patients and Methods Two instruments were developed: a glaucoma medication selfefficacy scale and a glaucoma outcome expectations scale. Packets containing (a) the instruments and patient demographic questions and (b) a letter explaining the study were distributed to 225 glaucoma patients from three ophthalmology practices between August and December 2007. The instrument was completed by 191 patients for a response rate of 85%. Principal components factor analysis with a varimax rotation and Cronbach's a reliability were used to analyse the data. To assess discriminant validity, we administered the scales and two self-reported measures of adherence in a separate sample of 43 glaucoma patients who were currently using at least one glaucoma medication.Results Our results yielded a 21-item self-efficacy in overcoming barriers that might interfere with the use of glaucoma medications scale, a 14-item self-efficacy in carrying out specific tasks required to use eye drops correctly scale, and a four-item glaucoma outcome expectations scale. Results of the Cronbach's a reliability indicated that the scales are internally consistent. The selfefficacy scales were both significantly associated with two patient self-reported measures of glaucoma medication adherence, which show discriminant validity.Conclusions Eye care providers and researchers can use these scales to identify patients with low self-efficacy in using their glaucoma medications and patients who do not believe that following their eye care providers' advice can help their vision.

show abstract

Section: Introductionmentioning

confidence: 99%

Development of an instrument to measure glaucoma medication self-efficacy and outcome expectations

Sleath

Blalock

Robin

et al. 2009

Eye

View full text Add to dashboard Cite

show abstract

“…The importance of patient-physician communication for medication adherence in the glaucoma patient population has been demonstrated in several studies. 12, 20, 21 Buller et al investigated 100 glaucoma patients taking topical medication to lower IOP. They found that poor communication between providers and patients caused nearly one in five patients to use the wrong regimen.…”

Section: Discussionmentioning

confidence: 99%

“…They found that poor communication between providers and patients caused nearly one in five patients to use the wrong regimen. 20 According to the American Academy of Ophthalmology’s Preferred Practice Patterns ophthalmologists should work collaboratively with patients and provide care that is cost effective without compromising accepted standards of quality. 22 The guidelines specifically mention adjusting glaucoma therapy if the patient does not adhere due to cost.…”

Section: Discussionmentioning

confidence: 99%

Patient-Physician Communication on Medication Cost during Glaucoma Visits

et al. 2017

View full text Add to dashboard Cite

Significance This paper is the first to investigate the nature of medication cost discussions between ophthalmologists and glaucoma patients. Only 87 of the 275 office visits analyzed had a discussion of medication cost. Providers should consider discussing medication cost with patients to identify potential cost related barriers to medication use. Purpose Glaucoma is an incurable chronic eye disease affecting a growing portion of the aging population. Some of the most commonly utilized treatments require life-long use, requiring high patient adherence to ensure effectiveness. There are numerous barriers to glaucoma treatment adherence in the literature, including cost. The aim of this secondary analysis was to describe the frequency and nature of patient-physician communication regarding medication cost during glaucoma office visits. Methods: This was a mixed methods secondary analysis of video recorded participant office visits (n=275) from a larger observational study of glaucoma communication. We analyzed medical information, demographic characteristics, and interviewer-administrated questionnaires, as well as verbatim transcripts of interviews. Results Only 87 participants discussed medication cost during their glaucoma office visit. The majority of the subjects that discussed cost had mild disease severity (51%), took one glaucoma medication (63%) and had Medicare (49%) as well as a form of prescription insurance (78%). The majority of glaucoma office visits did not discuss medication cost and providers often did not ask about cost problems. Of the few conversations related to cost, most focused on providers offering potential solutions (n=50), medical and prescription service coverage (n=41), and brand or generic medication choices (n=41). Conclusions Our findings are similar to previous studies showing few patients have conversations with providers about the cost of glaucoma medications. Providers should consider bringing up medication cost during glaucoma office visits to prompt a discussion of potential cost related barriers to medication use.

show abstract

“…Potential approaches for improving compliance are electronic alarm systems that remind the patients to use their eye drops if a certain dosage interval is exceeded [18]. Drugs with less side-effects and easy handling, adapted designs for eye drops and dosage devices, improved patient education and electronic compliance feedback allowing patients to monitor compliance on their own may render effective methods to improve treatment outcome for a wide range of diseases in ophthalmology [19,20]. …”

Section: Resultsmentioning

confidence: 99%

Electronic compliance monitoring of topical treatment after ophthalmic surgery

2010

View full text Add to dashboard Cite

The success of many medical treatments is built on compliance. Electronic monitoring is the most accurate tool to quantify compliance by measuring adherence. In order to assess the efficiency of a recently introduced miniature monitoring device for eye drop application, we evaluated adherence in ophthalmic patients undergoing post-operative shortterm topical treatment. This pilot study enrolled 30 outpatients (mean age 61.8 ± 18.5 years) after cataract (n = 24) and glaucoma filtration surgery (n = 6) applying fixed-combination eye drops containing prednisolone and gentamicin five times daily for 2 weeks. Patients received eye drops in conventional bottles each equipped with a miniature monitoring device recording events of application. Two patients failed to bring back the monitoring device; therefore data collected from only 28 patients could be examined. Data showed highly variable results with a mean dose compliance of 50.2%. Dose compliance was below 25% in approximately one out of five patients. Four cataract patients, but no glaucoma patient, discontinued therapy prematurely. The observed mean dosage interval was calculated for each patient and ranged 4.6-19.7 h. Thirty percent of analysed dosage intervals exceeded 12.0 h. Different patterns of compliance behaviour-like early nonpersistence, drug holiday and low treatment frequency could be identified and illustrated using electronic data. Age or gender did not significantly influence compliance rates. Our pilot study demonstrates successful electronic compliance monitoring using a technology capable of continuous data recording over weeks of treatment. The low compliance rate for a relevant part of the patients demonstrates the necessity to study and improve compliance in ophthalmology. In future, new application methods and electronic application devices may improve treatment response in eye care.

show abstract

Compliance: clear communication's critical

Cited by 14 publications

References 3 publications

Development of an instrument to measure glaucoma medication self-efficacy and outcome expectations

Development of an instrument to measure glaucoma medication self-efficacy and outcome expectations

Patient-Physician Communication on Medication Cost during Glaucoma Visits

Electronic compliance monitoring of topical treatment after ophthalmic surgery

Contact Info

Product

Resources

About