Treatment adherence in primary open angle glaucoma: barriers and ways to overcome them

Abstract

Purpose of the presentation: assessment of glaucoma adherence, identification of barriers and ways to overcome them. The adherence rate is low in glaucoma (40-70%); it is a major factor in the evolution of the disease; low adherence is accompanied by perimetric progression in glaucoma. The most common factors associated with low adherence are: costs of monitoring for disease and medication, side effects, duration of treatment, poor health, low confidence of patients in terms of treatment effectiveness, forgetfulness, physical and mental difficulties that limit the accuracy of administration. Factors associated with increased adherence: the patient’s belief that treatment is necessary and useful, the use of a small number of drugs (prostaglandin analogues or beta-blockers), the severity of the disease. We can improve glaucoma treatment adherence in a variety of ways: offer correct and detailed patient information (including educational materials), simplify the treatment regimen, inform the patient of possible side effects, incorporate and associate medication with daily activities, the choice of drugs with few and mild side effects, the use of fixed combinations, modern techniques, such as voice messaging, electronic signalling systems, automatic monitoring systems attached to the bottle cap. Patient adherence is an essential condition for therapeutic success, and both education and accountability are very important. Barriers for low glaucoma adherence need to be identified and overcome through the combined action of physician, patient, family, and health care systems.