Glaucoma medications: issues with adherence in a tertiary hospital in Nigeria

Background
Patient adherence with glaucoma medical therapy remains a global challenge.

Objectives
To determine the prevalence of non-adherence and identify the determinants and deterrents to glaucoma medications in Enugu, southeast Nigeria.

Material and methods
This study adopted a cross-sectional, descriptive, hospital-based survey involving 114 glaucoma patients on topical medications. They were recruited from the ophthalmic clinic of the University of Nigeria Teaching Hospital, Enugu. Information on their socio-demographic characteristics, clinical profile and issues of adherence with glaucoma medications were collected using a pre-tested, close-ended, interviewer–administered questionnaire. The data collected was analysed using SPSS version 21. Bivariate analysis was done to identify the associations of different factors of adherence with glaucoma medications. The level of significance was set at p < 0.05.

Results
The participants were comprised of 58 males (50.9%) and 56 females (49.1%), with a mean age of 60.0 ± 14.8 years. Most were mainly on two or less glaucoma medications (92 (80.7%)) and were diagnosed with glaucoma for less than 5 years (73 (64.0%)). 42 (36.8%) participants were non-adherent with their glaucoma medications. Assisted administration of glaucoma medication was the most important determinant of non-adherence to medication. Gender, good/fair vision, distance from the pharmacy, knowledge of the disease and educational status also contributed. Cost was the major deterrent (59 (51.7%)) to adherence with glaucoma medications.

Conclusions
The prevalence of non-adherence with medications among glaucoma patients in Enugu was high. Assisted drug administration was the most significant determinant, while the cost of drugs was a major deterrent to non-adherence with glaucoma medication.