Cargando…
Factors associated with adherence to glaucoma pharmacotherapy in the primary care setting
BACKGROUND. Primary open-angle glaucoma is a leading cause of irreversible blindness. OBJECTIVES. To identify factors associated with adherence to glaucoma pharmacotherapy in the primary care setting, focusing on physicians’ role. METHODS. Patients were recruited from primary care clinics and teleph...
Autores principales: | , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2014
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4106405/ https://www.ncbi.nlm.nih.gov/pubmed/24927725 http://dx.doi.org/10.1093/fampra/cmu031 |
_version_ | 1782327507769360384 |
---|---|
author | Cohen Castel, Orit Keinan-Boker, Lital Geyer, Orna Milman, Uzi Karkabi, Khaled |
author_facet | Cohen Castel, Orit Keinan-Boker, Lital Geyer, Orna Milman, Uzi Karkabi, Khaled |
author_sort | Cohen Castel, Orit |
collection | PubMed |
description | BACKGROUND. Primary open-angle glaucoma is a leading cause of irreversible blindness. OBJECTIVES. To identify factors associated with adherence to glaucoma pharmacotherapy in the primary care setting, focusing on physicians’ role. METHODS. Patients were recruited from primary care clinics and telephone-interviewed using a structured questionnaire that addressed patient-, medication-, environment- and physicians-related factors. Patients’ data on pharmacy claims were retrieved to calculate the medication possession ratio for measuring adherence. RESULTS. Seven hundred thirty-eight glaucoma patients were interviewed. The multivariate analysis identified eight variables that were associated independently with adherence. Barriers to adherence were found to be low income, believing that ‘It makes no difference to my vision whether I take the drops or not’ and relying on someone else for drop instillation (exp(B) = 1.91, P = 0.002; exp(B) = 2.61, P < 0.0001; exp(B) = 2.17, P = 0.001, respectively). Older age, having a glaucoma patient among close acquaintances, taking a higher number of drops per day, taking a prostaglandin drug and reporting that the ophthalmologist had discussed the importance of taking eye drops as prescribed, were found to promote adherence (exp(B) = 0.96, P < 0.0001; exp(B) = 0.54, P = 0.014; exp(B) = 0.81, P = 0.001; exp(B) = 0.37, P < 0.0001; exp(B) = 0.60, P = 0.034, respectively). No association was found between the patient’s relationship with the family physician and adherence to glaucoma treatment. CONCLUSION. Adherence to glaucoma pharmacotherapy is associated with patient-related, medication-related, physician-related and environmental factors. Ophthalmologists have a significant role in promoting adherence. However, the potential role of family physicians is unfulfilled and unrecognized. |
format | Online Article Text |
id | pubmed-4106405 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-41064052014-07-22 Factors associated with adherence to glaucoma pharmacotherapy in the primary care setting Cohen Castel, Orit Keinan-Boker, Lital Geyer, Orna Milman, Uzi Karkabi, Khaled Fam Pract Health Service Research BACKGROUND. Primary open-angle glaucoma is a leading cause of irreversible blindness. OBJECTIVES. To identify factors associated with adherence to glaucoma pharmacotherapy in the primary care setting, focusing on physicians’ role. METHODS. Patients were recruited from primary care clinics and telephone-interviewed using a structured questionnaire that addressed patient-, medication-, environment- and physicians-related factors. Patients’ data on pharmacy claims were retrieved to calculate the medication possession ratio for measuring adherence. RESULTS. Seven hundred thirty-eight glaucoma patients were interviewed. The multivariate analysis identified eight variables that were associated independently with adherence. Barriers to adherence were found to be low income, believing that ‘It makes no difference to my vision whether I take the drops or not’ and relying on someone else for drop instillation (exp(B) = 1.91, P = 0.002; exp(B) = 2.61, P < 0.0001; exp(B) = 2.17, P = 0.001, respectively). Older age, having a glaucoma patient among close acquaintances, taking a higher number of drops per day, taking a prostaglandin drug and reporting that the ophthalmologist had discussed the importance of taking eye drops as prescribed, were found to promote adherence (exp(B) = 0.96, P < 0.0001; exp(B) = 0.54, P = 0.014; exp(B) = 0.81, P = 0.001; exp(B) = 0.37, P < 0.0001; exp(B) = 0.60, P = 0.034, respectively). No association was found between the patient’s relationship with the family physician and adherence to glaucoma treatment. CONCLUSION. Adherence to glaucoma pharmacotherapy is associated with patient-related, medication-related, physician-related and environmental factors. Ophthalmologists have a significant role in promoting adherence. However, the potential role of family physicians is unfulfilled and unrecognized. Oxford University Press 2014-08 2014-06-12 /pmc/articles/PMC4106405/ /pubmed/24927725 http://dx.doi.org/10.1093/fampra/cmu031 Text en © The Author 2014. Published by Oxford University Press. http://creativecommons.org/licenses/by-nc-nd/3.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/3.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Health Service Research Cohen Castel, Orit Keinan-Boker, Lital Geyer, Orna Milman, Uzi Karkabi, Khaled Factors associated with adherence to glaucoma pharmacotherapy in the primary care setting |
title | Factors associated with adherence to glaucoma pharmacotherapy in the primary care setting |
title_full | Factors associated with adherence to glaucoma pharmacotherapy in the primary care setting |
title_fullStr | Factors associated with adherence to glaucoma pharmacotherapy in the primary care setting |
title_full_unstemmed | Factors associated with adherence to glaucoma pharmacotherapy in the primary care setting |
title_short | Factors associated with adherence to glaucoma pharmacotherapy in the primary care setting |
title_sort | factors associated with adherence to glaucoma pharmacotherapy in the primary care setting |
topic | Health Service Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4106405/ https://www.ncbi.nlm.nih.gov/pubmed/24927725 http://dx.doi.org/10.1093/fampra/cmu031 |
work_keys_str_mv | AT cohencastelorit factorsassociatedwithadherencetoglaucomapharmacotherapyintheprimarycaresetting AT keinanbokerlital factorsassociatedwithadherencetoglaucomapharmacotherapyintheprimarycaresetting AT geyerorna factorsassociatedwithadherencetoglaucomapharmacotherapyintheprimarycaresetting AT milmanuzi factorsassociatedwithadherencetoglaucomapharmacotherapyintheprimarycaresetting AT karkabikhaled factorsassociatedwithadherencetoglaucomapharmacotherapyintheprimarycaresetting |