Does Knowledge of the Risk Factors of Glaucoma Impact Adherence in patients of African descent?

Abstract

Purpose : The first line of treatment for primary open-angle glaucoma (POAG) is the daily use of eye drops. Adherence to this regimen is known to be challenging for patients. While POAG is more prevalent in people of African descent (AD), worse adherence is reported in this high-risk population. The purpose of this prospective clinical study was to determine whether knowledge of the risk factors associated with glaucoma translates into better adherence.

Methods : Twenty-nine patients with POAG were included in the study. Participants were on average 60.38±9.93 years of age, identified as being of AD by self-report and 16 were male. Adherence was measured using Medical Event Monitoring System (MEMS) bottles. The cap of these bottles electronically records the date and time at which the bottle is opened. Each participant filled out the Brief Illness Perception questionnaire in which they were asked to “Please list in rank-order the three most important factors that you believe caused your illness”. The adherence of patients who reported 1) at least one accurate risk factor was compared to that of patients who reported no accurate risk factor, 2) race as a risk factor was compared to that of patients who did not report race, and 3) any risk factor (accurate or inaccurate) was compared to that of patients who reported no risk factor. Groups were compared using two-tailed t-tests.

Results : Patients who reported at least one accurate risk factor (n=18) had similar adherence (73.39±25.94%) to those who reported no accurate risk factor (n=11) (55.91±33.10%) (p=0.12). Patients who reported race as a risk factor (n=6) had similar adherence (76.50±24.94%) to those who did not report race (n=23) (64.22±30.64%) (p=0.37). Patients reported any risk factor (n=22) had similar adherence (70.36±26.89%) to those who reported no risk factor (n=7) (55.43±36.78%) (p=0.25). While there was an overall trend for higher adherence in patients with more knowledge, statistical significance was not reached in any of the comparisons.

Conclusions : We hypothesized that knowledge of the risk factors of glaucoma would result in better adherence because this knowledge could reflect a better understanding of the disease and of the importance of adhering to treatment. Our results suggest that knowledge of the risk factors of glaucoma does not impact adherence. Future studies will investigate whether educating patients can improve adherence.