Medication Compliance in Glaucoma - Assignment Example

Medication Compliance in Glaucoma Abstract The purpose of this study was to gain insights into whether medication label print size affects medication compliance in glaucoma patients. The study included eighty patients diagnosed with glaucoma who were randomly recruited from a tertiary eye hospital in Melbourne, Australia. These patients participated in a cross sectional patient survey and concomitant chart review. The data obtained from the study was analyzed statistically using Pearson's Chi-square test. The results showed that readability of medication instruction labels does not appear to be a factor in the comprehension of treatment instructions and medication compliance for majority of glaucoma patients. However, a small number of glaucoma patients with reduced visual function might benefit from large print labels on their topical eye drops. Aim of the study To evaluate the need for large print medication label to improve readability, comprehension and compliance with medical therapy in a visually impaired glaucoma population. Introduction Glaucoma is an important global public health concern with the proportion of patients burdened with this sight threatening disease ever increasing due to the rapidly ageing population. In Australia, glaucoma causes 3% visual impairment and 14% blindness in patients aged 40 and over. Since the majority of glaucoma patients are managed initially with medical therapy, compliance is critical for decreasing disease progression. Despite the availability of effective pharmacologic therapies, non-compliance in patients with glaucoma has been reported to vary from 24 to 59%. Many obstacles affect treatment compliance including regimen factors (refill, cost, complexity, change, side effects), patient factors (knowledge, skill, memory, motivation, health beliefs, comorbidities), provider factors (dissatisfaction, communication) and situational or environmental factors (lack of support, major life events, travel, competing activities, change in routine). Quality of written instructions such as amount of information and readability is important in ensuring medication compliance especially in visually impaired, elderly patients where written treatment information often supplements verbal instruction. In some cases, especially when a patient has a care giver, this information becomes the main source reference for correct interpretation of their medication regime. The aim of our study was to assess whether readability and comprehension of medication label size was a contributing factor to treatment compliance in glaucoma patients. Materials and methods Eighty subjects with diagnosed glaucoma were recruited from the public out-patient clinic of a tertiary eye hospital in Melbourne, Australia. The duration of study was 6 weeks (27.03.07 to 8.5.07). The selection of participants was random. They participated in a survey which included basic demographic data such as age and gender. Subjects were asked to recall the name, quantity, instructions and compliance of prescribed topical drops for glaucoma. Information was collected regarding visual acuity, refraction, intraocular pressure, visual field tests and optic cup to disc ratio, to assess the severity of their glaucoma. This study was designed as a cross-sectional patient survey and concomitant chart review. Written informed consent was obtained for survey participation and review of the medical records. Inclusion criteria included a diagnosis of primary or secondary glaucoma and visual field tests. Subjects who did not speak English or required an interpreter for understanding English were excluded from the study. Chart information from the preliminary Orthoptic assessment was initially reviewed to ensure that the inclusion criteria were met. Also, details about current use of eye drops, presence of correction spectacles for reading and absence of dilatation were taken in to account. The medical records were reviewed for results of visual acuity, refraction, intraocular pressure, visual field tests and optic cup to disc ratio. Near vision was assessed under standard room lighting using the near-point Snellen acuity card held at usual reading distance, with the subjects wearing their usual reading glasses if indicated. Visual field was graded according to the Glaucoma Staging system (GSS). Two trained interviewers administered the questionnaire to participants in a single interview room one at a time. Participants were then asked if they could recall the name and instructions for their own current eye medications. The accuracy of self reporting was checked against review of the patient’s own medical history. Finally participants were presented with four sample labels and asked the same three questions on each label; 1. Can you tell me the name of the medication? 2. Can you tell me which eye this medicine is for? 3. How often should this medicine be used? The verbatim response was recorded and then judged to be correct or incorrect. The labels were represented in the same order for each participant. The larger label was designed using a software provider (Pharmhos) and contained information deemed the most critical to correct administration such as the medication brand name and directions for use. After the study, the data was statistically analysed. Pearson’s chi square test was utilized to analyse the data (P Read More