Noncompliance with a physician’s prescribed therapeutic regimen is a serious obstacle to patient care. Although much of the research on noncompliance in ophthalmology has been conducted in patients who required medical therapy for glaucoma, the findings can be applied to medical therapy for other ophthalmic conditions.
Medication compliance is different from adherence. Medication compliance is the act of taking medication as prescribed, whereas medication adherence is the act of filling new prescriptions or refilling prescriptions on time. Generally, the degree of compliance reported by patients is lower than their actual compliance. The degree of adherence to treatment is poor with chronic ophthalmic diseases, similar to adherence with other chronic diseases. Concurrent medical conditions or disabilities may also interfere with compliance or adherence. The list of factors that contribute to noncompliance or nonadherence is long. Selected examples are presented in Table 16-2.
Depending on the factors identified, reasonable options for improving compliance or adherence include patient education about the disease or medical therapy, simplification of the medical regimen, maximized cost reduction, and recruitment of support from family members. Although positive effects of these interventions have not been proven, noncompliance can lead to unnecessary disease progression, additional medical costs and physician visits, and unneeded change or escalation of therapy. Clinicians can play an active role in improving compliance and preventing these outcomes.
Table 16-2 Factors Contributing to Noncompliance or Nonadherence to Therapy
Excerpted from BCSC 2020-2021 series: Section 2 - Fundamentals and Principles of Ophthalmology. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.