Will improvement of knowledge lead to improvement of compliance with glaucoma medication?

Abstract

ABSTRACT.Purpose: To identify specific items on knowledge and need for information that could be used to improve compliance with glaucoma medication. Methods: Forty-four randomly selected ophthalmologists assigned 166 consecutive glaucoma patients to complete a questionnaire. The questionnaire was developed systematically based on focus group interviews, consultation of experts and a pilot test. Items included knowledge about glaucoma and its treatment, need for information and compliance with therapy. Results: No statistically significant correlation was found between the total level of knowledge and compliance. Concerning knowledge of glaucoma, one out of 19 items had a statistically significant negative correlation with compliance. Concerning knowledge of glaucoma treatment, one out of 18 items had a statistically significant positive correlation with compliance. Regarding total need for information, no statistically significant correlation with compliance was found. Three out of 22 items had a statistically significant positive correlation with compliance. Conclusion: Given the number of related items, their direction and limited strength of correlation and the difficulty of hypothesizing a causal relation for some items, it is unlikely that further improving knowledge will greatly improve compliance with glaucoma medication. Interventions focused on attitude and discipline may be of more benefit in improving compliance with therapy.

Individualised patient care as an adjunct to standard care for promoting adherence to ocular hypotensive therapy: an exploratory randomised controlled trial

“…16,26 Our intervention involved a number of elements, but these were centred around a prescriptive assessment of health-care needs and beliefs on which education and ongoing support was based. Although education is frequently highlighted as being important in improving adherence, 7,27 we feel as others do, 6,28 that education alone may not adequately tackle the problem.…”

“…7,8 A systematic review found inconsistencies in the assessment of knowledge. 9 A survey by Hoevenaars et al 6 did not find an overall improvement in adherence with better education, but found certain factors to correlate with adherence, such as previous knowledge of glaucoma, social support, and fulfilled information needs. Patients' ability to manage glaucoma medications can differ according to their socioeconomic status, health-care experiences, and health beliefs.…”

“…However, achieving good reduction rates can be hindered by poor adherence to therapy, which is known to be highly prevalent in chronic, asymptomatic diseases such as glaucoma. 5 Poor adherence can be mistaken for suboptimal drug efficacy, which can result in additional medications or necessitate surgery, 6 potentially increasing risk, cost, and further aggravating adherence issues.…”

Preliminary survey of educational support for patients prescribed ocular hypotensive therapy

“…However, improving education alone may not improve adherence levels; focusing on behavioural aspects may provide a more effective solution. 19 A patient-centred approach following an assessment of needs, health beliefs, and lifestyle may be the key to improving adherence and providing a lasting intervention effect. Further research is needed to enable eye care services to provide the most effective care for improving adherence levels for this patient group.…”

“…3,5,6,[19][20][21][22][23] One ophthalmic study objectively monitored doctor-patient interactions, 24 yet the authors are unaware of any studies that have objectively observed clinical consultations to compare the nature and depth of educational support provided with patients' knowledge of glaucoma and adherence to therapy. The aims of this survey were to investigate educational support, patients' knowledge, and self-reported adherence via observation and interview, to generate hypotheses about the impact of educational support on patients' knowledge of glaucoma and adherence, in preparation for an intervention study.…”