Causes of Non-Compliance in Diagnosed Primary Open-Angle Glaucoma Patients

Abstract

Sumit Sachdeva1 , Sandeep Kumar2 , Manisha Rathi3 , C. S. Dhull4 , Ritesh Verma5

BACKGROUND Glaucoma consists of a group of optic neuropathies characterized by progressive degeneration of retinal ganglion cells. These cells are central nervous system neurons that have their cell bodies in the inner retina and axons in the optic nerve. Degeneration of these cells results in optic disc cupping and vision loss. The objective of this study was to determine the cause of noncompliance in diagnosed cases of open angle glaucoma in Rohtak district of Haryana. METHODS A total of 50 patients having confirmed diagnosis of primary open-angle glaucoma on anti-glaucoma medication of either sex attending the glaucoma clinic of PGIMS, Rohtak, was enrolled in this follow up study. Diagnosed patients of glaucoma on treatment underwent applanation tonometry for intraocular pressure and patients were asked about number of times they missed their medication and what were the reasons for the same. Visual field analysis was done at the end of follow up period of 4 months. The data was analysed using SPSS (Statistical Package for Social Sciences) version 21.0. Chi square test was applied for comparison. Point of statistical significance was considered if p < 0.05. RESULTS 68.0% patients were compliant to the treatment and 32.0% patients were noncompliant. 43.8% (7 patients) were non-compliant due to forgetfulness, 31.3% (5 patients) due to high cost of drugs, 6.3% due to improper instillation, long duration of treatment, side effect of medication and more number of drugs. CONCLUSIONS In our study, it was also observed that forgetfulness (60%) was the most common cause of non-compliance in high income groups whereas high cost of drug (25%) was the most common cause of non-compliance in low income groups. In our study, lower compliance was found in elderly patients (above 60 years of age) which may be due to the reduced vision, coordination or memory and lack of family support.

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