Journal of Current Glaucoma Practice

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VOLUME 9 , ISSUE 2 ( May-August, 2015 ) > List of Articles

Original Article

Strategies to Improve Glaucoma Compliance Based on Cross-Sectional Response-Based Data in a Tertiary Healthcare Center: The Glauco-Jung Study

Vishnu S Gupta, Harindersingh Sethi, Mayuresh Naik

Keywords : Compliance, Cost of medications, Glaucoma

Citation Information : Gupta VS, Sethi H, Naik M. Strategies to Improve Glaucoma Compliance Based on Cross-Sectional Response-Based Data in a Tertiary Healthcare Center: The Glauco-Jung Study. J Curr Glaucoma Pract 2015; 9 (2):38-46.

DOI: 10.5005/jp-journals-10008-1182

License: CC BY-NC 4.0

Published Online: 01-04-2019

Copyright Statement:  Copyright © 2015; The Author(s).


Abstract

Purpose: To elucidate compliance rates among glaucoma patients in a tertiary healthcare center, reasons for noncompliance and response-based-solutions to improve compl iance in the same cohort. Materials and methods: In the Glauco-Jung study, a cross-sectional descriptive epidemiological one, information was obtained from 500 patients from 1st January, 2014 to 30th June, 2014. Patients were intercepted at entry point where they get their intraocular pressure (IOP) checked, wherein they were asked to fill an exhaustive questionnaire. At the same setting, they were also asked to demonstrate how they (or their relatives or helpers) instill eyedrops, following which any irregularities were brought to notice and corrected. Finally, they were also asked any suggestions to improve compliance to medications. Noncompliance rates were determined based on the number of patients who did not instill anti-glaucoma medications as per prescribed dosage or frequency schedule. Noncompliance rates were then evaluated by the Chi-square test for any association with distributions based on various parameters. Results: In case of a positive association, correlation coefficient was further calculated to know the strength of this association. No association was observed in distributions based on diet, associated co-morbidities, daily dosage frequency and side-effects experienced by patients. Positive association was noted in distributions based on age, sex, duration of treatment, social structure and number of medications (p < 0.05); but correlation coefficients were very weak (c < 0.3). Cost of medications not only had positive association but also had a very strong correlation coefficient (c = 0.9188), proving that cost of medications had a modest bearing on compliance rates. Conclusion: The Glauco-Jung study concluded that besides availability of medications at reasonable cost, simplification of treatment regimen and interactive health education appear to be the most important factors for improving compliance so that patients do not feel guilty or inadequate because they have problems while administering their eyedrops.


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  1. Rudd P. In search of the gold standard for compliance measurement. Arch Intern Med 1979 Jun;139(6):627-628.
  2. Kass MA. Compliance and prognosis in glaucoma. Arch Ophthalmol 1985 Apr;103(4):504.
  3. Kass MA, Gordon M, Meltzer DW. Can ophthalmologists correctly identify patients defaulting from pilocarpine therapy. Am J Ophthalmol 1986 May;101(5):524-530.
  4. Cramer JA, Mattson RH, Prevey ML, Scheyer RD, Ouellette VL. How often is medication taken as prescribed: a novel assessment technique. JAMA 1989 Jun;261(22):3273-3277.
  5. Grant A. A cross-sectional, descriptive study to measure: Knowledge, attitudinal and behavioural effects which a positive diagnosis of glaucoma may have on affected patients of the Eye [Internet]. St. Andrew, Jamaica: April-May 2010. Available at: http://www.eyecarecaribbean.com/vision-2020- caribbean/glaucoma-study-fish-april-may-2010-jamaica.
  6. Hasford, J. Compliance in Medical Practice and Clinical Trials. Biometric issues in measuring and analysing partial compliance in clinical trials. New York: Raven Press; 1991. p. 265-281.
  7. Burrell A, Wong P, Ollendorf DA, Fuldeore MJ, Roy A, Fairchild CJ, Cramer JA. PHP46 Defining compliance/adherence and persistence: ISPOR Special Interest Working Group. Value Health 2005 Nov;8(6):A194-A195.
  8. Sclar DA. Improving medication compliance: a review of selected issues. Clin Ther 1991 Jul-Aug;13(4):436-440.
  9. Sclar DA, Skaer TL, Chin A, Okamoto MP, Nakahiro RK, Gill MA. Effectiveness of the C Cap in promoting prescription refill compliance among patients with glaucoma. Clin Ther 1991 May-Jun;13(3):396-400.
  10. Ashburn FS Jr, Goldberg I, Kass MA. Compliance with ocular therapy. Surv Ophthalmol 1980 Jan-Feb;24(4):237-238.
  11. Sverrisson T, Gross R, Pearson J, Rusk C, Adamsons I. The dorzolamide/timolol combination versus timolol plus pilocarpine: patient preference and impact on daily life. United States Patient Preference Study Group. International Patient Preference Study Group. J Glaucoma 1999 Oct;8(5): 315-324.
  12. Winfield AJ, Jessiman D, Williams A, Esakowitz L. A study of the causes on noncompliance by patients prescribed eyedrops. Br J Ophthalmol 1990 Aug;74(8):477-480.
  13. Kass MA, Meltzer DW, Gordon M, Cooper D, Goldberg J. Compliance with topical pilocarpine treatment. Am J Ophthalmol 1986 May 15;101(5):515-523.
  14. Granström PA. Glaucoma patients not compliant with their drug therapy: clinical and behavioural aspects. Br J Ophthalmol 1982 Jul;66(7):464-470.
  15. Zimmerman TJ, Zalta AH. Facilitating patient compliance in glaucoma therapy. Surv Ophthalmol 1983 Dec;28 Suppl:252-257.
  16. Rosenthal AR, Zimmerman JF, Tanner J. Educating the glaucoma patient. Br J Ophthalmol 1983 Dec;67(12):814-817.
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