Improving Compliance via Education, Reminders, and Evaluating Physician-Patient Concerns in Glaucoma

PURPOSE: To improve glaucoma treatment compliance via education, medication reminders, and understanding of patient and physician concerns. DESIGN: Prospective Comparative Case Series SUBJECTS: 194 consecutive eligible patients diagnosed with primary open angle glaucoma or ocular hypertension at a single academic center (92 male and 102 female) and 16 glaucoma specialists volunteered their responses. METHODS: All 194 eligible patients were interviewed regarding glaucoma knowledge, medication usage, concerns, and fears. They were counseled, given educational handouts, and reinterviewed after 4 weeks. All 16 glaucoma specialists were also surveyed regarding their concerns for their patients. MAIN OUTCOME MEASURE: Patient's knowledge of the basic premise of glaucoma, compliance to their medications, including concerns and fears of glaucoma in both patients and physicians. RESULTS: In this study, patients aged ≥ 65 years were more compliant than those < 65 years (76% vs 50%, p<0.05). In follow-up interviews of 125 (64%) patients, I found significant increase in glaucoma knowledge from 53% to 67% (p<0.05) and compliance from 77% to 94% (p<0.05). In addition, patients' major fear was becoming dependent on others (p<0.05), while physicians were more concerned about patients' ability to administer eyedrops and understanding of instructions (p<0.05). CONCLUSION: I found that patients aged ≥ 65 were more compliant. Our intervention improved patient compliance by 17 % and represents a potential model for glaucoma management. In addition, the disparity between patient and physician fears suggest that communication barriers must be addressed to improve patient care.