Age, race among factors for nonadherence to glaucoma treatment

This prospective study identified risk factors for nonadherence to topical daily glaucoma medication, including younger age, lower education level and African descent.

This is the first part of a two-part study that will test the effect of an automated voice or text messaging reminder on adherence. Investigators monitored adherence to once-a-day glaucoma treatment in 407 patients using an electronic bottle cap to record openings. Patients used the electronic monitors for three months and were administered standardized tests of depression and mental status.

Nearly 20% of patients were found to be nonadherent. Risk factors for nonadherence included lower education level, African descent, shorter duration of prior treatment, lower reported estimates of adherence, younger age, and lower scores on mental and depression assessments. Noncompliant patients also were less likely to be able to name their medicine, less likely to agree that remembering their eye drops is easy, more likely to strongly agree with the statement that eye drops can cause problems, and less likely to agree that they followed physicians’ orders.

The authors conclude that risk factors should be considered by clinicians when assessing their patient compliance. Given that most patients are taking their eye drops as prescribed, identifying patients at risk of nonadherence is a critical step. These results may be useful in creating risk calculators that could find those patients most in need of intervention.