Patient and Neighborhood Factors Influencing Glaucoma Medication Adherence
Patrice M. Hicks, Justus N. Dobson, Jamie Mitchell, Deborah Darnley-Fisch, Michele Heisler, Nauman R. Imami, Paula Anne Newman-CaseyPrecis:
This study identified patient-level factors as key barriers and facilitators to glaucoma medication adherence, varying by sex and neighborhood disadvantage (ADI), suggesting targeted interventions could improve glaucoma medication adherence outcomes.
Purpose:
To identify the barriers and facilitators to glaucoma medication adherence for participants in the Support, Educate, Empower Personalized Glaucoma Coaching Program Pilot Study and assess any differences by demographics.
Materials and Methods:
This was a mixed-methods study of participants that reported glaucoma medication adherence of ≤80.00%. Patient (age, sex, and race) and neighborhood (area deprivation index (ADI)) factors were obtained, and participants completed a semi-structured interview. Patient interviews were transcribed and analyzed with the modified Penchansky and Thomas framework to assess barriers and facilitators to glaucoma medication adherence, and participant numbers were computed for each theme.
Results:
Of the 44 participants, 52% were ≥65 years old, 45% female, 45.5% Black race, and 34% lived in high ADI neighborhoods. The most cited theme by participants for barriers and facilitators to medication adherence were patient-level factors (52% and 48%, respectively). Difficulty with the medication schedule was a leading barrier (48%), while location of eye drops in the home (25%) was a leading facilitator. Patient-level barriers and facilitators differed by sex and ADI.
Conclusion:
Patient-level barriers and facilitators to glaucoma medication adherence were most frequently mentioned. Patient-level facilitators differed by sex and ADI, thus patient and neighborhood factors should be considered when assessing glaucoma medication adherence as it may differ by these factors. In this cohort of glaucoma patients with poor medication adherence, patient-level factors served as more significant barriers compared to those related to health care in the US. Consequently, targeted interventions addressing these individual barriers could potentially improve medication adherence outcomes.