Tip of the Month
Publishing date: December 2007
Tip Editors: Ann Hoste, John Salmon and John Thygesen
Tip reviewer: Roger Hitchings
The Science behind the Tip
Poor medication compliance (i.e. patients not taking their medication as directed) is a major problem in glaucoma care. In the literature noncompliance rates of at least 25% commonly have been reported(1). It may be mistaken for poor medication efficacy, resulting in unnecessary changes to a therapeutic regimen or in surgery. Approaches to improve medication compliance can target 2 sets of factors:
1. Medication regimen. Minimizing the number of drugs prescribed and the frequency of dosing(2) in order to reduce side effects and the complexity of the therapeutic regimen(3) is crucial. Forgetfulness is another major reason for noncompliance(2,4). Telling patients to put the eye drops in with a particular daily event such as teeth brushing may help them remember to instill the drops.
2. Communication between physicians and patients. Maximizing the patient?s motivation and understanding of the disease is imperative in treating any progressive condition that most often has no immediate symptoms with drugs that may produce side effects. Patients need to be aware of the seriousness of glaucoma and the benefits of strict therapy compliance and regular follow-up visits(1). Further, patients should be asked regularly about compliance. The very act of checking this may help to stimulate patients to think using the medication as prescribed. Thus, education is key and this requires a good patient-physician relationship that continues over years.
Contributor: Ann Hoste, Antwerp
Co-editors: John Thygesen and Ann Hoste
Peer reviewers: Roger Hitchings and Anders Heijl
1. Schwartz GF. Compliance and persistency in glaucoma follow-up treatment. Curr Opin Ophthalmol. 2005;16:114-21.
2. Patel SC, Spaeth GL. Compliance in patients prescribed eyedrops for glaucoma. Ophthalmic Surg. 1995;26:233-6.
3. Tsai JC, McClure CA, Ramos SE, et al. Compliance barriers in glaucoma: a systematic classification. J Glaucoma. 2003;12:393-8.
4. Taylor SA, Galbraith SM, Mills RP. Causes of non-compliance with drug regimens in glaucoma patients: a qualitative study. J Ocul Pharmacol Ther. 2002;18:401-9.