TY - JOUR
T1 - Glaucoma patient expression of medication problems and nonadherence
AU - Slota, Catherine
AU - Sayner, Robyn
AU - Vitko, Michelle
AU - Carpenter, Delesha M.
AU - Blalock, Susan J.
AU - Robin, Alan L.
AU - Muir, Kelly W.
AU - Hartnett, Mary Elizabeth
AU - Sleath, Betsy
N1 - Publisher Copyright:
© 2015 American Academy of Optometry.
PY - 2015/5/6
Y1 - 2015/5/6
N2 - Purpose. The purpose of this study was to examine if patient demographic factors influenced self-reporting of medication side effects, difficulty with drop instillation, and nonadherence to glaucoma therapy. Methods. English-speaking adult glaucoma patients (n = 279) from six ophthalmology clinics were enrolled. Patients' medical visits were videotaped and patients were interviewed immediately afterward by research assistants. The videotapes were transcribed verbatim and coded to identify patients who expressed problems with medication side effects, eye drop administration, and nonadherence during the glaucoma office visits. Generalized estimating equations were performed to identify whether patient characteristics were associated with expression of problems with glaucoma medication and medication nonadherence during the office visit. Results. Patients with lower health literacy were significantly less likely to express problems with side effects (odds ratio [OR], 0.47; 95% confidence interval [CI], 0.25 to 0.88) and eye drop administration (OR, 0.26; 95% CI, 0.11 to 0.63) during the visit. Patients who reported eye drop administration and side effect problems during the interview were significantly more likely to express these problems to their ophthalmologist (OR, 3.13; 95% CI, 1.82 to 5.37 and OR, 1.86; 95% CI, 1.12 to 3.08, respectively). Patients who expressed a problem with eye drop administration and with side effects were significantly more likely to express medication nonadherence to their ophthalmologist (OR, 2.89; 95% CI, 1.44 to 5.80 and OR, 2.03; 95% CI, 1.16 to 3.54, respectively). Patients who reported greater than 80% medication adherence during the interview were significantly less likely to express nonadherence to their ophthalmologist (OR, 0.22; 95% CI, 0.12 to 0.40). Conclusions. Eye care providers should be aware that glaucoma patients with lower health literacy are less likely to express problems with side effects and eye drop administration. Providers should work with patients to assess medication-related problems to mitigate potential barriers to medication adherence because patients who expressed medication problems were also more likely to express nonadherence.
AB - Purpose. The purpose of this study was to examine if patient demographic factors influenced self-reporting of medication side effects, difficulty with drop instillation, and nonadherence to glaucoma therapy. Methods. English-speaking adult glaucoma patients (n = 279) from six ophthalmology clinics were enrolled. Patients' medical visits were videotaped and patients were interviewed immediately afterward by research assistants. The videotapes were transcribed verbatim and coded to identify patients who expressed problems with medication side effects, eye drop administration, and nonadherence during the glaucoma office visits. Generalized estimating equations were performed to identify whether patient characteristics were associated with expression of problems with glaucoma medication and medication nonadherence during the office visit. Results. Patients with lower health literacy were significantly less likely to express problems with side effects (odds ratio [OR], 0.47; 95% confidence interval [CI], 0.25 to 0.88) and eye drop administration (OR, 0.26; 95% CI, 0.11 to 0.63) during the visit. Patients who reported eye drop administration and side effect problems during the interview were significantly more likely to express these problems to their ophthalmologist (OR, 3.13; 95% CI, 1.82 to 5.37 and OR, 1.86; 95% CI, 1.12 to 3.08, respectively). Patients who expressed a problem with eye drop administration and with side effects were significantly more likely to express medication nonadherence to their ophthalmologist (OR, 2.89; 95% CI, 1.44 to 5.80 and OR, 2.03; 95% CI, 1.16 to 3.54, respectively). Patients who reported greater than 80% medication adherence during the interview were significantly less likely to express nonadherence to their ophthalmologist (OR, 0.22; 95% CI, 0.12 to 0.40). Conclusions. Eye care providers should be aware that glaucoma patients with lower health literacy are less likely to express problems with side effects and eye drop administration. Providers should work with patients to assess medication-related problems to mitigate potential barriers to medication adherence because patients who expressed medication problems were also more likely to express nonadherence.
KW - adherence
KW - glaucoma
KW - health literacy
KW - medications
KW - patient expression
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U2 - 10.1097/OPX.0000000000000574
DO - 10.1097/OPX.0000000000000574
M3 - Article
C2 - 25875690
AN - SCOPUS:84929453377
SN - 1040-5488
VL - 92
SP - 537
EP - 543
JO - Optometry and Vision Science
JF - Optometry and Vision Science
IS - 5
ER -