Konstas A G, Maskaleris G, Gratsonidis S, Sardelli C
Department of Ophthalmology, Aristotle University of Thessaloniki, Greece.
Eye (Lond). 2000 Oct;14 Pt 5:752-6. doi: 10.1038/eye.2000.197.
To document the prevalence of non-compliance and to investigate patients' perceptions concerning glaucoma in a Greek cohort.
We investigated 100 consecutive patients referred to our glaucoma clinic and already treated for chronic glaucoma. Compliance and patients' insight were ascertained by two independent observers by means of a predetermined questionnaire. All patients were subsequently assessed for their ability to instil their eyedrops accurately.
Fifty one per cent of our patients were not aware of the nature of glaucoma, but 80% were afraid it might lead to blindness. Clinically significant non-compliance (more than two doses missed per week) was established in 44% of our patients. Men and those using eyedrops more than 4 times a day were more likely to default. Non-compliant patients exhibited higher mean intraocular pressure (22.9 vs 18.5 mmHg; p > 0.001) and worse visual field loss (10.8 vs 7.0 dB; p = 0.008) compared with compliant patients. Involuntary non-compliance was also common in our group, with only 53% instilling their eye drops accurately.
Non-compliance is a significant limiting factor in glaucoma therapy in Greece.
记录希腊一组青光眼患者中不遵医嘱的发生率,并调查患者对青光眼的认知情况。
我们对100例连续转诊至我们青光眼诊所且已接受慢性青光眼治疗的患者进行了调查。由两名独立观察者通过预先设定的问卷来确定患者的依从性和认知情况。随后对所有患者准确滴眼的能力进行评估。
51%的患者不了解青光眼的本质,但80%的患者担心青光眼可能导致失明。44%的患者存在临床上显著的不遵医嘱情况(每周漏用超过两剂眼药水)。男性以及每天使用眼药水超过4次的患者更易出现不遵医嘱。与依从性好的患者相比,不遵医嘱的患者平均眼压更高(22.9 vs 18.5 mmHg;p>0.001),视野缺损更严重(10.8 vs 7.0 dB;p = 0.008)。在我们的研究组中,非故意的不遵医嘱情况也很常见,只有53%的患者能准确滴眼。
在希腊,不遵医嘱是青光眼治疗中的一个重要限制因素。