- Dr. Ankit S. Varshney, PhD, M.Optom, FIACLE, FASCO1*, Ms. Arwa Shabbir Ranalawala, B.Optom2, Hardeepsinh B. Mahida, PhD pursuing, M.Optom3, Dr. Chetna S. Patel, M.S. Ophthal, PhD4, Dr. Mahendrasinh D. Chauhan, D.O.M.S, M.S. Ophthal, PhD5
- 1Associate Professor, Department of Optometry, Shree Bharatimaiya College of Optometry & Physiotherapy, Veer Narmad South Gujarat University, Surat, Gujarat, India
- ISR Journal of Surgery (ISRJS)
Abstract: Purpose: To evaluate adherence patterns to topical anti-glaucoma medications (AGMs) among patients with primary open-angle glaucoma (POAG) and primary angle-closure glaucoma (PACG) in a tertiary eye care setting, and to identify demographic, clinical, socioeconomic, and behavioral determinants influencing adherence. Methods: A cross-sectional study was conducted on 100 adults aged ≥40 years with a confirmed diagnosis of POAG or PACG, receiving AGMs for ≥6 months. Data were collected using a structured, pre-validated 42-item questionnaire covering sociodemographic details, disease awareness, medication administration practices, procurement patterns, and barriers to adherence. Adherence was defined as self-reported intake of ≥80% of prescribed doses in the preceding month without missing more than two consecutive doses, combined with correct instillation technique. Statistical analyses included Chi-square tests, Fisher’s exact tests, independent t-tests, and binary logistic regression to identify independent predictors of non-adherence. Results: The mean participant age was 53.7 ± 8.6 years; 54% were male. Overall, 48% were classified as non-adherent. Common barriers included forgetfulness (41%), cost (40%), and absence of symptoms (37%). Multivariate analysis identified low monthly income (<₹10,000) (AOR 3.42; 95% CI 1.58–7.38; p = 0.002), multiple AGM therapy (AOR 2.67; 95% CI 1.18–6.04; p = 0.018), incorrect instillation technique (AOR 3.98; 95% CI 1.73–9.14; p = 0.001), and cost as a barrier (AOR 3.19; 95% CI 1.39–7.28; p = 0.006) as independent predictors of non-adherence. The model demonstrated good fit (Hosmer–Lemeshow p = 0.623) and explained 41.5% of variance (Nagelkerke R² = 0.415). Conclusions: Nearly half of glaucoma patients in this cohort were non-adherent to AGMs, with modifiable factors—particularly economic constraints and instillation technique errors—playing a major role. Interventions such as patient education on drop administration, fixed-dose combinations, and cost-reduction strategies could substantially improve adherence and align with WHO Vision 2030 goals.
