ADHERENCE TO GLAUCOMA TREATMENT DEPENDING ON VARIOUS FACTORS
Authors:   Novosibirsk State Medical University, Novosibirsk, Russia, Fursova A.Zh. ,   State Novosibirsk Regional Clinical Hospital, Novosibirsk, Russia, Gamza Yu.A. ,   Novosibirsk State Medical University, Novosibirsk, Russia; State Novosibirsk Regional Clinical Hospital, Novosibirsk, Russia, Gryaznov А.А. ,   Novosibirsk State Medical University, Novosibirsk, Russia
Published: August 2024

Introduction. Primary open-angle glaucoma (POAG) is the most common among the clinical forms of the disease. The main way to treat POAG is to reduce intraocular pressure (IOP). In most patients, treatment begins with a conservative method of reducing blood pressure by selecting medications for topical use. At the same time, studies show that only about a third of patients fully comply with doctors' prescriptions. In this regard, the concept of compliance is currently becoming relevant – the degree to which patients comply with the prescribed regimen of medicines and other recommendations. Aim. To study the degree of compliance in patients with glaucoma, and identify factors contributing to decreased adherence to treatment. Materials and methods. The study involved 45 patients (24 women (53.3%), 21 men (46.7%), average age 68.2 ± 6.7 years. Distribution by stages of glaucoma: stage I – 14 patients, stage II – 11 patients, stage III – 20 patients. Average duration of glaucoma disease – 6.25 ± 2.33 years. The study of compliance in patients with glaucoma was carried out using a questionnaire on the basis of the ophthalmology department of the State Novosibirsk Regional Clinical Hospital in the period from January 2023 to March 2023. The questionnaire was developed by the authors. Compliance was assessed according to degrees: high – compliance with doctor’s recommendations for at least 29 days a month, average – from 15 to 28 days, low – for less than 15 days. Clinical, medical, social and behavioral factors influencing the level of compliance were analyzed. Results. Among patients with stage III glaucoma, high compliance was detected in 80% of cases; in stages I and II – 50%, which may be due to the fact that this group of patients already has functional disorders that reduce the quality of life and the motivation of such patients is significantly higher than in the initial stages of the disease. In patients with initial and advanced stages of glaucoma, the reasons for low compliance were: presence of side effects (86.4 and 85.4%), complex instillation regimen (32.6 and 30.2%), low awareness of the disease (75 and 70 %) number of instillations per day (42.1 and 40.1%), inconvenient bottle (14.5 and 13.7%). In stage III, the decrease in adherence to treatment was facilitated by: presence of disability (24.3%), other systemic diseases requiring treatment with multiple drugs (85.4%), inconvenient bottle (5.3%), side effects (32.5%). The cost and availability of drugs played an important role in adherence to treatment regimens at all stages of glaucoma. Conclusion. To increase compliance, it is necessary to inform patients about the disease itself, its outcomes, complications, and identify the goals of local antihypertensive therapy for understanding and motivation to comply with the prescribed treatment regimen. It is equally important to involve the patient himself in drawing up a treatment plan and report possible consequences and side effects from the use of drugs.