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Abstract #84967 Published in IGR 21-1
Understanding Barriers to Glaucoma Treatment Adherence among Participants in South India
Killeen OJ; Pillai MR; Udayakumar B; Shroff S; Vimalanathan M; Cho J; Newman-Casey PAOphthalmic Epidemiology 2020; 27: 200-208
: Data on glaucoma treatment barriers in South India is limited; improved knowledge of barriers could advance disease self-management. We aimed to understand glaucoma treatment barriers in South India.: Glaucoma patients ≥18 taking ≥1 medication at the Aravind Eye Hospital were screened with a validated medication adherence tool. Patients who self-reported poor adherence and/or were >3 months late for follow-up completed semi-structured interviews on treatment barriers. Interviews were audio-recorded, transcribed, translated and back-translated to ensure accuracy. Researchers used grounded theory to code the transcripts and identify themes using NVivo 11.0. Demographic and clinical characteristics were abstracted from the medical record.: 70/167 (42%) had poor self-reported adherence to drops. The 45 interviewed were 62 ± 12 years and took 1.6 ± 0.7 drops. Forty-two (93%) were non-adherent to medication and 21 (47%) were late for follow-up. Top barriers to medication adherence were difficulty obtaining drops (20, 44%), being busy (18, 40%), and the expense (17, 38%). Top barriers to appointment follow-up were distance to the hospital (21, 47%), expense (20, 44%), and no escort (15, 33%). Other important barriers included mistrust in the health system, poor knowledge of glaucoma and family needs.: Previously, 6% of glaucoma patients in South India self-reported poor medication adherence; the 42% identified in this study is in line with glaucoma medication adherence rates globally. Complex factors caused high rates of non-adherence. Societal-level interventions that address systemic barriers and counselling that supports patients' and families' motivation for behaviour change should be implemented.
Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan, USA.
Full articleClassification:
11.17 Cooperation with medical therapy e.g. persistency, compliance, adherence (Part of: 11 Medical treatment)
