Medication adherence in patients with ocular hypertension or glaucoma

Introduction: Nonadherence to medication is a challenge to effective treatment of many chronic diseases, including glaucoma, and persists even with interventions aimed at improving adherence. The reported rates of nonadherence to topical glaucoma medication vary widely from 16% to 67%, and it is estimated that less than a third of patients remained on their initial therapy after 12 months. Nonadherence can lead to disease progression and increased economic burden. Areas covered: This review examines factors that contribute to nonadherence in patients with glaucoma, including the severity of the disease, complexity of treatment, lack of knowledge in patients, poor communications between physician and patient, difficulty with self-administration of drops, side-effects, and medication costs. We discuss the unique challenges in identifying nonadherence in glaucoma patients and investigate the current approaches to improving adherence. Expert opinion: Strategies for improving adherence should combine new treatment methods with enhanced patient education. New pharmaceuticals may comprise multiple medications in a single bottle, making dosing regimens simpler. Novel drug delivery systems are in development, such as injectable products and implants releasing IOP-lowering medication without the need for self-administration. A comprehensive approach involving these new methods and more effective patient-physician communication may lead to improved adherence.