Assessment of medication therapy adherence in glaucoma: scoping review

ABSTRACT

Introduction: Glaucoma is an asymptomatic disease, which can cause irreversible blindness, with a worldwide prevalence around 64.3 million people. Adherence to glaucoma treatment is crucial to control the disease and to prevent its complications. Low medication adherence results in a visual loss, which can leads to irreversible blindness. In this sense it is important to know and evaluate adherence to pharmacological therapy among patients with glaucoma.

Areas covered: A scoping review was conducted, according to the methodology proposed by Arksey and O’Malley. The databases used were Medical Literature Analysis and Retrieval System Online (MEDLINE) and the Biblioteca do Conhecimento Online (B-on). Our research used as primary sources articles in Portuguese and English.

Expert opinion: The identified adherence rates were very different, and the conditions how under medication adherence was assessed were highly variable. These conditions impossibilities a proper comparative study. Further efforts are needed to increase health literacy and thus identify and support patients with low medication adherence rates. It is important that health care personnel could improve patients’ knowledge about the importance of medication adherence, glaucoma disease, and the consequences that result from the lack of treatment.

KEYWORDS:

• Adherence/compliance
• glaucoma
• glaucoma treatment
• medication adherence
• medication persistence

Article highlights

• Glaucoma is one of the main causes of irreversible blindness in developed countries and its therapy aims to reduce the intraocular pressure.

• Glaucoma medication adherence is crucial to control the disease and prevent its complications.

• Poor glaucoma medication adherence can lead to a greater visual loss, which can also lead to blindness.

• It is important to define the extent of the problem, identify the associated factors, and define strategies to improve patients’ medication adherence.

• Different adherence rates found may be due to different definitions of medication adherence and also to the different methods used to evaluate it.

• A greater/better investment in the identification and support of patients with low medication adherence must be done.

• Among the barriers to glaucoma medication adherence, the most commonly found are: forgetfulness, followed by decreased self-efficacy, skepticism that glaucoma would lead to visual loss and that therapy would prevent it and insufficient knowledge about glaucoma.

• Bigger efforts should be done to increase health literacy and promote patients education, about the importance of medication adherence, glaucoma, and its consequences. Additionally, to inform them about the aids that minimize forgetfulness and systems that facilitate instillation of eye drops.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants, or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This manuscript was not funded.