Publication:

Compliance to glaucoma topical therapy and barriers to glaucoma surgery acceptance in a tertiary hospital, Nigeria

Background Glaucoma is a leading cause of irreversible blindness globally. Intraocular pressure (IOP) is the only modifiable factor in the management of glaucoma patients in order to slow down the disease progression. Poor compliance, uncontrolled IOP despite adequate topical therapy and patients’ preference were indications for surgical intervention. The aim of the study is to determine compliance to topical glaucoma therapy, acceptance of glaucoma surgery and its barriers with a view to improve glaucoma surgery acceptance.

Methods This was a hospital-based longitudinal study. Ninety-six primary open angle glaucoma patients were surveyed for compliance to medication and acceptance of glaucoma surgery. Morisky Medication Adherence Scale item 8 (MMAS-8) and visual analogue scale (VAS) was used as tool in assessing the compliance level. A pretested semi-structured interviewer administered questionnaire was used to assess the socio-demographics, compliance to medication, glaucoma surgery awareness and barriers to glaucoma surgery acceptance. All participants were counseled and also grouped based on gender for group discussion as means of intervention. Results were presented in frequency tables, figures and charts. The statistical significance level was set at p<0.05%.

Results At baseline, 35.40% of the participants were compliant to medications with MMAS-8 (VAS; 51%). With intervention (counseling and group discussion), at 180 days 76.00% of the participants were compliant to antiglaucoma medications. At baseline and 180 days, 18 (19%) and 25 (26.04%) participants were willing to undergo glaucoma surgery respectively, 5 (20%) out of 25 (26.04%) participants willing to undergo glaucoma surgery accepted trabeculectomy. Fifty-one out of 96 participants have heard of glaucoma surgery at baseline.

Conclusions There was an improvement in compliance to medication, willingness to undergo glaucoma surgery and acceptance of trabeculectomy following counseling and group discussion.