Medication adherence and barriers to long-term anti-glaucoma therapy among glaucoma patients. A cross-sectional study.

Abstract

Background

Glaucoma is a chronic optic neuropathy that requires lifelong reduction of intraocular pressure, commonly achieved through topical therapy. Suboptimal adherence to eye drops remains a major contributor to disease progression.

Objectives

To assess the level of medication adherence and to identify perceived barriers to long-term topical anti-glaucoma therapy among patients attending a tertiary care centre.

Methods

A questionnaire-based cross-sectional study was conducted on one hundred adults with diagnosed glaucoma receiving topical anti-glaucoma therapy were enrolled. Adherence was classified as good, moderate, or poor using predefined questionnaire criteria, and perceived barriers were documented using multiple-response items.

Results

A total of 100 glaucoma patients were analysed. Most participants were aged 41–60 years (46%) or >60 years (36%), and 58% were male. Primary open-angle glaucoma was the commonest diagnosis (62%). Regarding treatment exposure, 41% had been on therapy for 1–3 years, and 61% were receiving monotherapy. Based on the adherence scale, 58% demonstrated good adherence, while 27% and 15% had moderate and poor adherence, respectively. Among individuals with suboptimal adherence (n = 42), the leading immediate reasons were forgetting to instil eye drops (71.4%) and skipping doses because vision appeared normal (50.0%). The most frequently reported barriers to long-term topical therapy were forgetfulness (42%), the long-term nature of treatment (36%), medication cost (31%), and difficulty in self-administration (29%). Other barriers included fear of adverse effects (24%), low perceived need due to lack of immediate feedback (22%), inadequate knowledge regarding disease progression (19%), and limited family/social support (14%)

Conclusion

More than two-fifths of glaucoma patients reported suboptimal adherence, largely driven by behavioral and practical barriers. Targeted counselling, skill-based instillation training, and reminder-based support can strengthen persistence with therapy and improve long-term outcomes.

Recommendations

Integrate structured adherence counselling into routine visits, introduce reminder strategies, and improve affordability and accessibility of glaucoma medications.