Psychosocial Predictors of Glaucoma Medication Adherence Among the Support, Educate, Empower (SEE) Personalized Glaucoma Coaching Pilot Study Participants

Salman, Mariam; Andrews, Chris; Heisler, Michele; Darnley-Fisch, Deborah; Newman-Casey, Paula Anne

doi:10.1016/j.ajo.2020.02.009

Cited by 19 publications

(18 citation statements)

References 40 publications

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“…Educational level is a predictor of knowledge and awareness of glaucoma by patients and their relatives ( 17 ). Educational attainment has a significant negative impact on poor adherence to glaucoma medication ( 18 ).…”

Section: Discussionmentioning

confidence: 99%

Factors Associated with Non-Adherence to Glaucoma Treatment in a Korean Nationwide Survey

Hwang¹,

Suh²,

Choi³

2022

ijph

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Background: Glaucoma is a main cause of blindness despite the effectiveness of treatments, and adherence to treatment is a critical aspect of glaucoma management. We aimed to identify the factors associated with non-adherence to treatment among Korean glaucoma patients. Methods: Data were collected from 4,833 glaucoma patients during the Korea Community Health Survey (KCHS) in 2008 and 2011 regarding current treatment for glaucoma, demographics, comorbidities, perceived health status, and health-related behaviors were subjected to analysis. A multivariable regression model was applied to identify factors related to non-treatment for glaucoma. Results: Approximately, half of the 4,883 patients failed to adhere to treatment. Compared to the treatment group, the non-treatment group had lower social status, fewer comorbid conditions, were more optimistic about their health statuses, and more likely to adopt unhealthy behaviors. Stepwise regression analysis showed that poor social status (low level of education and unmarried), self-perception of a satisfactory health status, and unhealthy behaviors (smoking and no flu-vaccination) were significantly associated with non-adherent to treatment. Conclusion: More attention should be paid to glaucoma patients with low social status or that are overconfident about their health. Future prospective studies that more comprehensively assess treatment compliance, are needed to confirm our findings.

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Section: Discussionmentioning

confidence: 99%

Factors Associated with Non-Adherence to Glaucoma Treatment in a Korean Nationwide Survey

Hwang¹,

Suh²,

Choi³

2022

ijph

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“…[ 27 28 ] Anxiety and stress due to the pandemic was found to have significant impact on non-adherence to medication by multivariant analysis in our study which is in accordance with prior studies where psychological factors had an impact on the medication adherence of glaucoma patients. [ 18 29 ]…”

Section: Discussionmentioning

confidence: 99%

Impact of COVID-19 on follow-up and medication adherence in patients with glaucoma in a tertiary eye care centre in south India

Subathra

Rajendrababu

Senthilkumar

et al. 2021

Indian Journal of Ophthalmology

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Purpose: COVID-19 pandemic has affected the healthcare system worldwide hindering the continuum of treatment of chronic disease patients. The objective of the study is to analyze the barriers encountered by the glaucoma patients for the follow-up visit and medication adherence during the pandemic. Methods: This cross-sectional study included glaucoma patients who did not attend the scheduled appointment from April 1, 2020 to July 31, 2020 in a tertiary eye care center (88.21%). Eligible patients of age >18 years and advised antiglaucoma medication in Madurai Zone were interviewed with validated questionnaire through telephonic call. Results: 363 patients answered the questionnaire through telephonic interview. 57.3% of the patients were found to be non-adherent to medication. The main barriers for glaucoma follow-up visit during the pandemic were lockdown restriction, transport problem, and financial difficulties. The top barriers for medication adherence were non availability of medication (54.81%), financial difficulties (30.29%), did not feel much improvement with eye drops (20.19%). On multiple regression analysis, longer distance to hospital, low socioeconomic status, more than one antiglaucoma medication use, lack of awareness of glaucoma, non-complaint before COVID-19 and stress due to the pandemic were found to be significant factors for medication non adherence. Conclusion: COVID-19 pandemic has emphasized the need for reformation in health care system for accessibility of medical care to patients in rural areas. Decentralization of health system to primary care level and utilization of teleophthalmology should be considered by health care planners in future.

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“…Mit einer schlechten Adhärenz sind vor allem die ethnische Abstammung (Patienten afrikanischer Abstammung besitzen eine signifikant niedrigere Adhärenz) und eine geringe Selbstwirksamkeitserwartung assoziiert 13 , 29 , 30 . Des Weiteren wirken sich ein geringeres Einkommen, ein niedriger Bildungsgrad und ein schwerwiegenderes glaukomassoziiertes Leiden negativ auf die Adhärenz aus 30 , 31 . Es zeigt sich, dass auch das Alter (Patienten zwischen 60 und 80 sind am adhärentesten), eine lange Krankheitsdauer, eine kurze Zeitspanne bis zum Tod, Pflegebedürftigkeit und mindestens 3 schwere Komorbiditäten (darunter auch der Diabetes mellitus) einen negativen Einfluss auf die Adhärenz haben 23 , 30 .…”

Section: Adhärenz Beim Glaukomunclassified

“…Ethnic origin (patients of African descent have significantly lower adherence rates) and low expectations of self-efficacy are particularly associated with poor adherence 13 , 29 , 30 . Lower income, lower educational attainment, and a higher level of glaucoma-related distress also have a negative impact on adherence 30 , 31 . Furthermore, age (patients between 60 and 80 are the most adherent), a long duration of the disease, a short interval before death, the need for care, and the presence of at least three severe comorbidities (including diabetes mellitus) have a negative impact on adherence 23 , 30 .…”

Section: Adherence In Glaucoma Patientsmentioning

confidence: 99%

Beeinflusst Diabetes mellitus die Adhärenz von Glaukompatienten?

Zhao

Hirneiß

2022

Klin Monbl Augenheilkd

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Bei chronisch progredienten und therapierbaren Erkrankungen ist die Adhärenz der Patienten ausschlaggebend für den Krankheitsverlauf und entscheidet maßgeblich über den Therapieerfolg. Dabei ist nicht nur eine geringe Adhärenz bei der Medikamenteneinnahme problematisch, sondern auch beim Einhalten der empfohlenen Nachuntersuchungen. Eine akkurate Einschätzung der Adhärenz ist insbesondere bei Glaukom-Patienten nur schwer möglich aufgrund der Darreichungsform als Augentropfen bei den meisten drucksenkenden Medikamenten. In der Literatur lässt sich eine große Variabilität an Angaben für die Adhärenz von Glaukom-Patienten finden. Die meisten Studien berichten eine durchschnittliche Arzneimittel-Adhärenz von ungefähr 70% mit einem Patientenanteil von um die 50% mit einer guten Adhärenz (mindestens 80% der Medikation wird wie geplant appliziert). Des Weiteren landen 6.8 – 31.4% der Augentropfen nicht im Auge, wodurch noch weniger Wirkstoff einen therapeutischen Effekt erzielen kann. Auch weisen Glaukom-Patienten eine geringe Persistenz und Adhärenz in puncto Kontrolluntersuchungen auf. Da ein bestehender Diabetes das Risiko für ein POAG und sekundäre Glaukom-Formen steigert und Diabetiker eine besonders niedrige Adhärenz aufweisen, stellte sich die Frage, ob eine Diabetes-Diagnose mit einer erniedrigten Adhärenz bei Glaukom-Patienten assoziiert ist. Bisherige Studien fanden keine signifikante Assoziation zwischen einer Diabetes-Komorbidität und einer erniedrigten Adhärenz bei Glaukom-Patienten, allerdings wurde ein signifikanter Einfluss von einem erhöhten HbA1c-Wert auf die Adhärenz bei Glaukom-Patienten in einer Studie festgestellt. Dieser Zusammenhang muss allerdings noch in Studien mit größeren Stichproben genauer untersucht werden. In case of chronic diseases, patient adherence plays a decisive role for delaying disease progression and determine the success of therapy. Not only low medication-adherence is problematic, but also non-adherence to recommended follow-up examinations. An accurate estimate of adherence is difficult, especially in glaucoma, due to the way of administration for most antihypertensive drugs in the form of eye drops. In literature, there is a great variability of adherence found in glaucoma patients. Most studies report an average medication-adherence of approximately 70%, with around 50% of patients with good adherence (at least 80% of medication administered as planned). Furthermore, 6.8 – 31.4% of the eye drops do not end up in the eye, which means that even less active ingredient can achieve a therapeutic effect. Glaucoma patients also show low persistence and adherence to follow-up appointments. Since diabetes increases the risk for POAG and secondary glaucoma and given that diabetics have a particularly low adherence, the question arose whether a diabetes diagnosis is associated with reduced adherence in glaucoma patients. Previous studies found no significant association between diabetes and reduced adherence in glaucoma patients. But a significant impact of elevated HbA1c on adherence in glaucoma patients was found in one study. However, this connection still needs to be examined more closely in studies with larger samples.

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Psychosocial Predictors of Glaucoma Medication Adherence Among the Support, Educate, Empower (SEE) Personalized Glaucoma Coaching Pilot Study Participants

Cited by 19 publications

References 40 publications

Factors Associated with Non-Adherence to Glaucoma Treatment in a Korean Nationwide Survey

Factors Associated with Non-Adherence to Glaucoma Treatment in a Korean Nationwide Survey

Impact of COVID-19 on follow-up and medication adherence in patients with glaucoma in a tertiary eye care centre in south India

Beeinflusst Diabetes mellitus die Adhärenz von Glaukompatienten?

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