Perspectives on Adherence to Glaucoma Medical Therapy in Brazilian Patients

• Published in: Pharmaceutical medicine Vol. 37; no. 5; pp. 377 - 384
• Main Authors: da Costa Andrade, Julia, Motta, Guilherme Samomiya, Kasahara, Niro
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01-09-2023; Springer Nature B.V
• Subjects: Biomedical and Life Sciences; Biomedicine; Cross-sectional studies; Drug dosages; Electronic records; Family income; Glaucoma; Original Research Article; Patient compliance; Pharmaceutical Sciences/Technology; Pharmacology/Toxicology; Pharmacotherapy; Questionnaires; Brazil; United States > US
• ISSN: 1178-2595; 1179-1993
• DOI: 10.1007/s40290-023-00482-y

Background
Poor adherence to glaucoma medication regimens may be associated with subsequent optic nerve damage and irreversible visual loss. Specific barriers to effective patient adherence in low-middle income countries are not fully recognized and new disease-specific instruments to assess adherence have been developed.
Objective
The purpose of this cross-sectional study was to evaluate adherence of primary open-angle glaucoma (POAG) patients to treatment in a middle-income country.
Methods
POAG patients were recruited from the Glaucoma Service – Irmandade da Santa Casa de Misericordia de Sao Paulo, Sao Paulo, Brazil. Clinical and demographic data were retrieved from participants’ electronic records. All patients answered the Glaucoma Treatment Compliance Assessment Tool (GTCAT). This 27-item questionnaire was designed to evaluate multiple behavioral factors associated with glaucoma medication adherence.
Results
The sample comprised 96 patients with POAG. The mean age was 63.2 ± 8.9 years; 48 were male and 48 female; 55 (57.3%) were White, 36 (37.5%) African-Brazilian, and five (5.2 %) were of mixed color. Most patients (97.9%) had less than a high school degree and all had a family income < US$10,000. The GTCAT identified 69 (71.8%) patients who “sometimes forget to use drops,” 68 (70.8%) patients who “sometimes fall asleep before dosing time,” and 60 (62.5%) patients “whose drops aren’t with them at the time to take them”; 82 (85.4%) patients admitted to using “reminders to take medications.” Eighty-two (85.4%) patients agreed that “doctor answers my questions,” and 77 (80.5%) said “they are happy with their eye doctor.”
Conclusions
The GTCAT identified a number of mostly unintentional factors associated with adherence in this cohort of Brazilian patients. The data may impact on how to understand and improve adherence to ocular hypotensive treatment in the Brazilian population.