Adherence to topical glaucoma medications and associated factors among primary open angle glaucoma patients attending Mulago hospital eye clinic

Abstract

Background: Primary Open Angle Glaucoma is the leading cause of irreversible blindness worldwide and in Africa. Adherence to topical glaucoma medications plays a crucial role in disease management and preventing visual loss. There are several studies about adherence to topical glaucoma medications among glaucoma patients around the world, however, no similar study has been done in Uganda. Aim: To determine adherence to topical glaucoma medications and associated factors among Primary Open Angle Glaucoma patients attending Mulago Hospital- Eye clinic. Methods: A hospital based cross sectional study was done from December 2022 to February 2023 in Mulago hospital eye clinic. We consecutively sampled patients aged 40 years and above on treatment for Primary Open Angle Glaucoma with topical medications for more than a month until a sample size of 131 was reached; Informed consent was obtained from all study participants. Relevant sociodemographic information, medical history and examination, memory, cognitive function, knowledge about glaucoma were assessed as potential factors associated with adherence. Adherence (measured using the Morisky Medication Adherence Scale-8) and details from other findings were recorded using a questionnaire. Data was entered using Epidata v4.6.0.2 and analyzed using STATA version 17.0. Results: A total of 131 patients were recruited for the study. Their mean age was 58.05 (+/-11.67SD). Majority (59.5%) were females. The prevalence of adherence to topical glaucoma medications among patients was 50.4% (66/131); 95%CI. Having intact memory (aPR 4.30, p-value<0.001) and having a caretaker to help administer the medications (aPR 1.54, p-value=0.020) were the factors that statistically increased likelihood of adherence whereas having highest level of education attained as secondary level (aPR 0.51, p-value 0.031), having other chronic medical illnesses (aPR 0.62, p-value 0.030), mild- moderate cognitive impairment (aPR 0.44, p-value 0.017) and having severe Primary Open Angle Glaucoma (aPR 0.74, p-value. Conclusion and recommendations: the prevalence of adherence to topical glaucoma medications was average. There is still need to improve adherence through: development of tools and guidelines to routinely assess for adherence among primary open angle glaucoma patients, having early glaucoma surgeries and continous involvement of caretakers in patient management especially those with cognitive impairment and severe disease.