Study of adherence to topical anti-glaucoma therapy in rural India with exploration of adherence barriers

Abstract

Anti-glaucoma medications form the first line of treatment in glaucoma management. However, the effectiveness of medical management for glaucoma is dented by poor adherence to anti-glaucoma medications. There is a need to elucidate the barriers to anti-glaucoma adherence and address them in order to increase effectivity of glaucoma therapy. This study is an attempt in estimating anti-glaucoma adherence behavior along with understanding various barriers to adherence. This cross-sectional, hospital based study was conducted in District Hospital Kupwara, Kashmir division, India over a period of 2 years from June 2020 to June 2022. 303 consecutive patients who were consented were included in this study. Adherence data was collected using self-reporting method in the form of visual analogue scale and 8-item morisky scale. 303 patients having glaucoma were included in this study. Mean age of patients was 53.86 ± 8.04 years ranging from 35–70 yrs. On Visual Analogue Scale, 78 percent were adherent while as 22 percent were non-adherent. As per Morisky Scale, 9 percent showed low adherence, 17 percent had medium adherence and 74 percent were having high adherence. Study patients with poor adherence reported many barriers to adherence especially forgetfulness, cost and side effects.Non-adherence is a significant problem in medical management of glaucoma seen in almost one-fourth of our patients. Educating patients and their caretakers is a must in preventing glaucoma morbidity and associated economic drain.