Barriers and Facilitators of Glaucoma Medication Adherence by Patient and Neighborhood-level Factors in the Support, Educate, Empower Personalized Glaucoma Coaching Program Pilot Study

Document Type

Conference Proceeding

Publication Date

6-1-2025

Publication Title

Invest Ophthalmol Vis Sci

Abstract

Purpose : To identify barriers and facilitators to glaucoma medication adherence for participants in the Support, Educate, Empower Personalized Glaucoma Coaching Program Pilot Study and assess any differences by age, sex, race, and Area Deprivation Index (ADI). Methods : This was a mixed-methods study of patients that reported glaucoma medication adherence of ≤80.00%. Patient (age, sex, and race) and neighborhood (ADI) factors were obtained, and patients completed an interview. To better understand the barriers and facilitators to glaucoma medication adherence, patient interviews were transcribed and analyzed using the modified Penchansky and Thomas framework. This framework is instrumental in identifying and analyzing potential barriers to accessing healthcare services, and it helps in developing strategies to improve service delivery and patient outcomes. Results : Of the 44 patients, 52.27% were ≥65 years old, 45.45% female, 50% Black, and 34.09% lived in high ADI neighborhoods. Barriers and facilitators were reported across all domains except accommodation/adequacy. The most frequent barriers were patient-level factors (50%), and the most common facilitator were patient-level factors (45%). Difficulty with medication schedule was the top barrier for various demographics, including age groups, genders, races, and ADI levels. A daily routine around taking eye drops was the leading facilitator for 40-64-year-olds (19%). Location of eye drops was the leading facilitator for patients ≥65 years old (33%), females (25%), Black race (20%), White race (30%), low-ADI (36%) and mid-ADI (16%). Having an additional medication supply was the leading facilitator for males (25%) and social support for high-ADI (13%). Conclusions : Among glaucoma patients with poor adherence, difficulty with the medication schedule was the most frequent barrier to optimal adherence among all patients regardless of age, race, or ADI score, while having a daily routine around taking eye drops was reported as the most common facilitator to optimal medication adherence among patients of all ages and races, women, and those who lived in low and medium ADI areas. The issue of providing support to integrate glaucoma medication taking into the daily routine is a highly salient issue to address in coaching for glaucoma disease selfmanagement.

Volume

66

Issue

8

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