OBJECTIVE: To determine how many patients with glaucoma do not comply with medical therapy and study the factors which make them distinguishable from complying patients.
STUDY DESIGN: Cross sectional comparative study
PLACE AND DURATION: At Glaucoma clinic, Al-Shifa Trust Eye Hospital, Rawalpindi over a period of 6 months from 1st May 2006 to 30th Nov 2006.
METHODOLOGY: A pre-tested structured questionnaire was used. The data collected was of patient's age, years of glaucoma diagnosis, number of medicines advised their educational level, socioeconomic conditions and distance they travel to the hospital. Patients were asked of difficulty in self-administration of medicines and whether or not the medicine finished before the visit and is it available near their home? Noncompliance was regarded as the missing of prescribed medicines for 1 day or more as reported by the patient. The patients were grouped as compliers (group 1) and non-compliers (group 2), and all the variables were analyzed to find any significant intergroup differences by using SPSS version 16.
RESULTS: Of 100 patients, 65% were males and 35% were female patients of glaucoma. Among them, the compliers were 61 (group 1) and non-compliers were 39 (group 2). Statistically significant difference in compliance behavior was found in relation to number of medicines prescribed (p=0.039), problems with self-administration of drops (p=0.05), eye drops finished before follow up visit (p=0.001), and non-availability of medicines at pharmacy near home (p=0.034).
CONCLUSION: Several interrelated factors may contribute to noncompliance. Poor compliance may be due to less educated patients, problems with managing multiple eye drops and the complex regimens. Problems with self-administration of medicines and poor socioeconomic status may be the reason behind discontinuation of medicines. All these factors must be looked into in a glaucoma patient non-compliant to medical treatment.
Key words: Compliance, Glaucoma, Glaucoma Management