A PHARMACIST INTERVENTION ON KNOWLEDGE AND ADHERENCE IN PATIENTS WITH OPEN-ANGLE GLAUCOMA

DEEPA KUMARI KARN; SHILA GURUNG

doi:10.22159/ajpcr.2024.v17i1.48661

Authors

DEEPA KUMARI KARN Department of Pharmaceutical Sciences, Council for Technical Education and Vocational Training, Nepal. https://orcid.org/0009-0001-1880-9380
SHILA GURUNG Department of Pharmaceutical Sciences, School of Health and Allied Sciences, Pokhara University, Nepal.

DOI:

https://doi.org/10.22159/ajpcr.2024.v17i1.48661

Keywords:

Open-angle glaucoma, Medication adherence, Morisky–Green–Levine medication adherence scale

Abstract

Objective: The objective of the study is to assess the pharmacist’s intervention on knowledge and adherence in patients with open-angle glaucoma therapy.

Methods: The study was conducted at the glaucoma outpatient department of Shree Rana Ambika Shah Eye Hospital, Rupandehi, Nepal. Census sampling was performed among the glaucoma patients meeting the inclusion criteria from August 2018 to November 2018. Data were collected using a structured questionnaire that included questions about demography, knowledge of glaucoma, medication adherence, and factors associated with medication non-adherence to glaucoma therapy. Each patient was counseled by a pharmacist, and the relevant information was provided in the form of an information leaflet. Knowledge level and adherence level were re-assessed during the follow-up visit after 1 month. The Morisky–Green–Levine medication adherence scale was used to assess adherence.

Results: A total of 103 patients were enrolled in the study, and the majority of the patients were of age ≥59 years. After intervention by the pharmacist, the knowledge level on glaucoma improved from poor to good. Before intervention, about 31% of patients were adherent to the medication therapy, but after intervention, about 73% of patients were adherence to the medication therapy. There was a significant difference in the mean of the knowledge level score and the mean of the medication adherence score before and after intervention. The common causes of non-adherence were reported to be forgetfulness, a stressful life, and difficulties with medication time.

Conclusion: The study demonstrates that pharmacist intervention is effective in improving both knowledge and medication adherence to open-angle glaucoma therapy.

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References

Walker R, Whittlesea C. Clinical Pharmacy and Therapeutics. 5th ed. London: Churchiill Livingstone; 2012. p. 861-2.

Weinreb RN, Leung CK, Crowston JG, Medeiros FA, Friedman DS, Wiggs JL, et al. Primary open-angle glaucoma. Nat Rev Dis Primers 2016;2:16067.

Wells BG, Dipiro JT, Schwinghammer TL, Dipiro CV. Pharmacotherapy Handbook. 7th ed. United States: The McGraw-Hill Companies; 2009. p. 719-21.

Distelhorst JS, Hughes GM. Open-angle glaucoma. Am Fam Physician 2003;67:1937-43.

Gray TA, Fenerty C, Harper R, Spencer AF, Campbell M, Henson DB, et al. Individualised patient care as an adjunct to standard care for promoting adherence to ocular hypotensive therapy: An exploratory randomised controlled trial. Eye (Lond) 2012;26:407-17.

Optometric Clinical Practice Guideline. Care of the Patient with Open Angle Glaucoma 2011: 44-51 (OCP Guideline A).

Taylor SA, Galbraith SM, Mills RP. Causes of non-compliance with drug regimens in glaucoma patients: A qualitative study. J Ocul Pharmacol Ther 2002;18:401-9.

Ozar MA, Acar M, Yildrim C. Intraocular pressure-lowering effects of commonly used fixed combination drugs with timolol in the management of primary open angle glaucoma. Int J Ophthalmol 2014;7:832-6.

De Castro AN, Mesquita WA. Noncompliance with drug therapy of glaucoma: A review about intervening factors. Braz J Pharm Sci 2009;45:453-9.

Tham YC, Li X, Wong TY, Quigley HA, Aung T, Cheng CY. Global prevalence of glaucoma and projections of glaucoma burden through 2040: A systematic review and meta-analysis. Ophthalmology 2014;121:2081-90.

Quigley HA, Broman AT. The number of people with glaucoma worldwide in 2010 and 2020. Br J Ophthalmol 2006;90:262-7.

Thapa SS, Paudyal I, Khanal S, Twyana SN, Paudyal G, Gurung R, et al. A population-based survey of the prevalence and types of glaucoma in Nepal: The Bhaktapur glaucoma study. Ophthalmology 2012;119:759-64.

Paudyal I, Thapa SS, Paudyal G, Gurung R, Ruit S. Glaucoma at a tertiary referral eye hospital in Nepal. Nepal J Ophthalmol 2011;3:123-7.

Muthu KV, Baba D, Kumar R, Natarajan S, Swaminathan D. Prevalence of awareness and knowledge of glaucoma in urban Puducherry. Schol J Appl Med Sci 2015;3:2561-7.

Pérez-Escamilla B, Franco-Trigo L, Moullin JC, Martínez-Martínez F, García-Corpas JP. Identification of validated questionnaires to measure adherence to pharmacological antihypertensive treatments. Patient Prefer Adherence 2015;9:569-78.

Beyhaghi H, Reeve BB, Rodgers JE, Stearns SC. Psychometric properties of the four-item morisky green levine medication adherence scale among atherosclerosis risk in communities (ARIC) study participants. Value Health 2016;19:996-1001.

Ribeiro MV, Ribeiro LE, Ribeiro EA, Ferreira CV, Barbosa FT. Adherence assessment of eye drops in patients with glaucoma using 8 item morisky score: A cross sectional study. Rev Bras Oftalmol 2016;75:432-7.

Vijaya L, George R, Paul PG, Baskaran M, Arvind H, Raju P, et al. Prevalence of open-angle glaucoma in a rural South Indian population. Invest Ophthalmol Vis Sci 2005;46:4461-8.

Sarkar S, Mardin C, Hennig A. Profile of the glaucomas and intervention in a large eye care centre in South-East Nepal. Nepal J Ophthalmol 2010;2:3-9.

Mbadugha CA, Onakoya AO. The awareness, perceptions and experiences of primary open angle glaucoma patients in Lagos Nigeria. Sci Rep 2014;4:7585.

Movahedinejad T, Hajbaghery MA. Adherence to treatment in patients with open-angle glaucoma and its related factors. Electron Physician 2016;8:2954-61.

Mansouri K, Iliev ME, Rohrer K, Shaarawy T. Compliance and knowledge about glaucoma in patients at tertiary glaucoma units. Int Ophthalmol 2011;31:369-76.

Lacey J, Cate H, Broadway DC. Barriers to adherence with glaucoma medications: A Qualitative research study. Eye (Lond) 2009;23:924-32.

Newman-Casey PA, Robin AL, Blachley T, Farris K, Heisler M, Resnicow K, et al. The most common barriers to glaucoma medication adherence: A cross-sectional survey. Ophthalmology 2015;122:1308-16.

Tsai JC, Mcclure CA, Ramos SE, Schlundt DG, Pichert JW. Compliance barriers in glaucoma: A systematic classification. J Glaucoma 2003;12:393-8.