Poor patient compliance ‘underestimated' in glaucoma therapy

The extent of the problem has probably been considerably underestimated. The truth is that it is difficult for us physicians to really get a full understanding of the extent to which our patients are able and willing to take their medications. There are also few good studies to show that adherence interventions are effective, especially long-term, and there are no good methods for measuring adherence,' Dr Sherwood told delegates attending the World Glaucoma Congress. Dr Sherwood, professor of ophthalmology at the University of Florida, said that adherence is defined as the extent to which a patient consistently and continually self-administers medication exactly as prescribed. 'They should take the correct number of eye drops, in the correct eye, at the correct time of day, plus or minus a very small window. It sounds very easy but in practice it is considerably less easy to achieve,' he said. Dr Sherwood said that adherence has four distinct components: acceptance, compliance, persistence and execution. 'Acceptance means that the patient has to accept that he or she has a disease that needs treating. We then have the compliance stage, which is the ability of the patient to take the correct dose of medication at the correct time. Persistence refers to the length of time over which a patient continues to take a medication as prescribed, and execution is the ability to deliver the medication correctly so that it reaches the intended target,' he said.