The medication adherence among glaucoma patients during the coronavirus disease 2019 pandemic in Croatia

Abstract

Purpose This study aimed to evaluate the level of treatment adherence and identify predictors of adherence in glaucoma patients during the coronavirus disease 2019 (COVID-19) pandemic in Zagreb, Croatia. Methods The cross-sectional study was conducted among primary open-angle glaucoma (POAG) patients at the Department of Ophthalmology, University Hospital Centre Zagreb, between 1st April 2020 and 1st April 2021. The sociodemographic data, clinical, and drug information were recorded. The treatment adherence was assessed through a self-administered questionnaire, the Culig Adherence Scale (CAS). Statistical analyses were performed using TIBCO Statistica™ 14.0.0. Results 113 POAG patients (48M/65F) with a mean age of 65.89 ± 8.53 years were included in this study. According to the CAS, only 39.8% of patients adhered to topical glaucoma treatment. Educational level was positively related to adherence to treatment (p = 0.022). The main predictors for adherence were the patients' positive attitude towards the drug's effect, family support, and good relationship with the healthcare providers (p < 0.05, respectively). The majority of patients stated forgetfulness as the main reason for skipping drug dosing. Conclusions Non-adherence to treatment was prevalent among patients with POAG during the COVID-19 pandemic in Zagreb, Croatia. Personal beliefs and attitudes towards treatment, family support, and patient-healthcare provider relationship were significant predictors of adherence. Special consideration should be given to the whole health system-level strategies targeting the adherence to treatment, especially in crises, in order to achieve positive therapeutic outcomes. The study protocol was registered in the DRKS - German Clinical Trials Register, DRKS-ID: DRKS00022081.

Glaucoma progression due to refraining examination amid the pandemic of COVID-19

“…To effectively treat glaucoma, regular follow-ups, choice of treatment strategy, taking into account IOP, VF, and adherence, are necessary. Decreased adherence in patients with glaucoma due to the pandemic has been previously reported [9][10][11][12][13]. Adherence in this study was possibly lower, as in previous reports, for patients with worsened MD values.…”

“…Japan approved a special measure allowing prescriptions to be sent remotely during the COVID-19 pandemic, allowing treatment continuation without running out of eye drops. However, patient adherence has reportedly worsened during that period [9][10][11][12][13]. This study aimed to retrospectively investigate the impact of hospital visit interruptions and the progression of visual eld impairment in patients with glaucoma, during the COVID-19 pandemic, using data from medical records.…”

Navigating the intersection of psychiatry and ophthalmology: A comprehensive review of depression and anxiety management in glaucoma patients

“…Onwubiko et al [ 22 ] identified high rates of anxiety (44.0%) and depression (41.8%) among glaucoma patients in Enugu, Nigeria, with key contributing factors being reduced VA and also, blindness. Poor treatment adherence in glaucoma patients was associated with heightened anxiety, negatively affecting therapeutic outcomes[ 23 ]. According to the studies by Mabuchi et al [ 3 ] and Chen et al [ 4 ], the use of eye drops and the number of anti-glaucoma medications were not identified as significant risk factors for depression; furthermore, the use of topical β-blockers for glaucoma, showed no significant correlation with depression.…”

Impact of COVID-19 on glaucoma management: A review

“…Non-adherence to treatment was prevalent among patients with POAG during the COVID-19 pandemic in various studies conducted on the different populations, including India ( 50 ), Croatia ( 51 ), United States ( 52 ), Egypt ( 53 ), and Pakistan ( 54 ). Before the pandemic, the main barriers to glaucoma medication adherence were cost, difficulty with drop instillation, and forgetfulness.…”