Impact of a Glaucoma Awareness Program on Treatment Adherence

March 18, 2026 updated by: Seva Canada Society

Assessing the Impact of a Structured Glaucoma Awareness Program on Treatment Adherence Among Glaucoma Patients at Tertiary Eye Hospital in Nepal

Glaucoma is a leading cause of irreversible blindness worldwide, with a higher burden in low- and middle-income countries such as Nepal, where public awareness and treatment adherence remain poor. Lifelong adherence to treatment is important to prevent disease progression but still non adherence remains common.

This is a mixed method study which aims to evaluate the effectiveness of structured glaucoma awareness program in improving treatment adherence among glaucoma patients attending a tertiary eye hospital in Nepal. Quantitative assessment will measure changes in treatment adherence using Medication Adherence Scale at baseline and three months post intervention. A qualitative component will explore participants' perceptions of glaucoma program and suggestions for improvement through semi-structured interviews.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Detailed Description

A mixed method interventional study will be conducted to assess the impact of a structured glaucoma awareness program on treatment adherence among the glaucoma follow-up patients attending a tertiary eye hospital in Nepal. The total study duration will be 10 months including preparation, participant recruitment, awareness program and follow up after 3 months, data analysis and reporting.

The primary objective of this study is to compare the treatment adherence scores of glaucoma patients before and three months after participation in the glaucoma awareness program.

The secondary objective is to qualitatively explore the participants' perceptions of the awareness program, identify barriers to treatment adherence and get the suggestions for improving patient education.

Patient ≥18 years with pre-existing diagnosis of glaucoma attending routine follow up visits will be invited to participate. All the eligible patients who meet the inclusion criteria will be selected. A formal sample size calculation will be performed prior to recruitment. Based on prior literature, a target sample size of approximately 60 participants is anticipated to provide adequate statistical power. After obtaining a written informed consent, participants will complete a baseline self-reported questionnaire assessing demographics and treatment adherence using the validated medication adherence scale.

Participants will then attend a structured 30-minute glaucoma awareness program consisting of a PowerPoint presentation covering foundational concepts of glaucoma and related risk factors, disease progression, and the importance of treatment adherence. An illustrated one-page informational leaflet in simple Nepali will be distributed to all participants. An interactive question-and-answer session will be conducted to respond to queries. To ensure the program is inclusive and accessible for glaucoma patients with visual impairment, power point slides and leaflets will use large fonts, high contrast and simple illustration. Key messages and visual content will be reinforced verbally. Participants will be encouraged to ask questions and clarification will be provided as needed.

At three months post-intervention, same participants will be contacted by telephone by the principle investigator to reassess treatment adherence using the same validated tools. Quantitative data will be analyzed using paired statistical tests to compare pre- and post-intervention outcomes.

A selected sub sample of approximately 8 - 10 participants will undergo semi-structured qualitative interviews three months after the awareness program, to explore their experiences with the awareness program, perceived benefits, barriers to implementing learned behaviors, and recommendations for improvement. Interviews will be audio-recorded, transcribed verbatim, translated into English, and analyzed using thematic analysis.

The study will receive approval from NHRC. Confidentiality will be maintained through anonymization of data, and participants may withdraw at any time without impact on their medical care.

Study Type

Interventional

Enrollment (Estimated)

60

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria: - Adults aged ≥18 years

  • Diagnosed with glaucoma
  • Attending follow-up at the study hospital
  • Able to provide informed consent
  • Able to communicate in Nepali language

Exclusion Criteria:

Individuals with cognitive impairments; healthcare professionals; individuals who have participated in a formal glaucoma education program in the past year.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Health Services Research
  • Allocation: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Glaucoma awareness
Glaucoma awareness educational package: Educational session, information leaflets, interactive discussions
Other: Glaucoma awareness and patient education program

Glaucoma awareness educational package: Educational session, information leaflets, interactive discussions.

This study involves a behavioral/educational intervention only. No drugs, devices, or procedures are introduced as part of the study intervention. Participants continue their routine standard-of-care glaucoma treatment as prescribed by their treating ophthalmologist.

No investigational drugs or devices are used as part of this study. Participants continue their usual prescribed anti-glaucoma medications as part of routine clinical care. The study intervention consists solely of a structured educational and awareness program.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Treatment adherence scores
Time Frame: 10 months

Treatment adherence will be assessed using Glaucoma Treatment Compliance Assessment Tool- Short Form(GTCAT-S).

Treatment adherence will be assessed using the Glaucoma Treatment Compliance Assessment Tool-Short Form (GTCAT-S), a validated self-administered questionnaire designed to evaluate adherence behavior, beliefs, and barriers among glaucoma patients. Approval for the use of GTCAT-S in this study has been obtained from the GTCAT development team.

Scale Details:

  • Each item is scored on a 5-point Likert scale: 1 = Disagree a lot to 5 = Agree a lot

  • Patients classified

    • Low adherence: <75%
    • High adherence: ≥75%
  • Direction:

Higher scores indicate better treatment adherence
10 months

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Participants' perceptions of the glaucoma awareness program assessed using semi-structured interview guide
Time Frame: 3 months post-intervention

Participants' perceptions of the glaucoma awareness program, including perceived usefulness, clarity of information, behavioral impact, barriers to treatment adherence, and suggestions for improvement, will be assessed through semi-structured in-depth interviews conducted at three months post-intervention.

Assessment Method:

  • Semi-structured interview guide developed by the research team
  • Open-ended questions exploring:
  • Understanding of glaucoma
  • Perceived benefits of the awareness program
  • Barriers to applying learned information
  • Suggestions for improving patient education
  • Interviews will be audio-recorded, transcribed verbatim, translated into English, and analyzed using thematic analysis Scale Used: Not applicable (qualitative assessment; no numerical scoring)
3 months post-intervention

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Seva Canada Society

Collaborators

Reiyukai Eiko Masunaga Eye Hospital (REMEH)
Pragyaan Sustainable Health Outcomes Foundation

Investigators

  • Study Director: Priya Adisesha Reddy, Seva Canada Society

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

April 1, 2026

Primary Completion (Estimated)

April 1, 2027

Study Completion (Estimated)

June 1, 2027

Study Registration Dates

First Submitted

December 30, 2025

First Submitted That Met QC Criteria

March 18, 2026

First Posted (Actual)

March 23, 2026

Study Record Updates

Last Update Posted (Actual)

March 23, 2026

Last Update Submitted That Met QC Criteria

March 18, 2026

Last Verified

March 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • REMEH/ORCB/1/20251220

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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