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青光眼药物依从性的促进因素与障碍

Facilitators and Barriers to Glaucoma Medication Adherence.

作者信息

Gatwood Justin, Brooks Callee, Meacham Ryan, Abou-Rahma Joseph, Cernasev Alina, Brown Eric, Kuchtey Rachel W

机构信息

University of Tennessee Health Science Center College of Pharmacy.

Department of Ophthalmology and Visual, Sciences, Vanderbilt Eye Institute, Vanderbilt University Medical Center, Vanderbilt University.

出版信息

J Glaucoma. 2022 Jan 1;31(1):31-36. doi: 10.1097/IJG.0000000000001965.

Abstract

PRCIS

Patient education and dosing self-efficacy are important factors related to ongoing adherence to glaucoma topical treatment, and patients view their disease management as a shared effort with their provider.

PURPOSE

Glaucoma affects nearly 3 million Americans, and medication adherence has been reported to be as low as 20% in this patient population; however, key limitations to our understanding of this behavior in adults with glaucoma exist.

PATIENTS AND METHODS

This research used an electronic survey including validated concepts related to topical medication use and an in-person interview to investigate the influencers of and solutions for challenges to medication adherence in adults with glaucoma. Patient eligibility was determined upon arrival to a regularly-scheduled visit to the Vanderbilt Eye Institute, during which they were asked for consent to complete the survey. Responses were captured by tablet and assessed using descriptive and inferential statistics. The primary focus was instrument correlations with the Adherence to Refills and Medications Scale score and were run between Adherence to Refills and Medications Scale, and the totaled score for each individual questionnaire as well as individual items. Recorded interviews were thematically assessed by multiple study team members.

RESULTS

Survey results of adults with glaucoma suggested that self-efficacy, forgetfulness, fear of side effects, and dosing ability were all related to self-reported medication adherence. Despite most having glaucoma for several years, discrepancies in disease knowledge were observed. Patient interviews uncovered 3 overall themes related to glaucoma treatment: (1) glaucoma management as a shared responsibility; (2) the importance of patient education; and (3) specific adherence facilitators and barriers.

CONCLUSION

Glaucoma medication adherence interventions may benefit from focusing on developing patient medication-taking self-efficacy, disease-related education, and engagement with their provider.

摘要

精准用药信息系统(PRCIS):患者教育和用药自我效能是与持续坚持青光眼局部治疗相关的重要因素,并且患者将其疾病管理视为与医疗服务提供者的共同努力。

目的

青光眼影响着近300万美国人,据报道该患者群体的药物依从性低至20%;然而,我们对青光眼成年患者这种行为的理解存在关键局限性。

患者与方法

本研究采用电子调查问卷,其中包括与局部用药相关的经过验证的概念,并进行面对面访谈,以调查青光眼成年患者药物依从性挑战的影响因素和解决方案。患者在按常规预约前往范德比尔特眼科研究所就诊时确定是否符合资格,在此期间询问他们是否同意完成调查。通过平板电脑获取回复,并使用描述性和推断性统计进行评估。主要重点是各工具与药品续用和用药依从性量表评分的相关性,并在药品续用和用药依从性量表与每份单独问卷的总分以及各个项目之间进行分析。多名研究团队成员对记录的访谈进行主题评估。

结果

青光眼成年患者的调查结果表明,自我效能、健忘、对副作用的恐惧和给药能力均与自我报告的药物依从性相关。尽管大多数患者患有青光眼已有数年,但仍观察到疾病知识存在差异。患者访谈揭示了与青光眼治疗相关的3个总体主题:(1)青光眼管理是一项共同责任;(2)患者教育的重要性;(3)具体的依从性促进因素和障碍。

结论

青光眼药物依从性干预措施可能受益于专注于培养患者的用药自我效能、疾病相关教育以及与医疗服务提供者的互动。

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