Predictors of adherence to glaucoma treatment in a multisite study

Abstract

Background: Poor adherence hinders glaucoma treatment. Studies have identified demographic and clinical predictors of adherence but fewer psychological variables.

Purpose: We examined predictors from four health behavior theories and past research.

Methods: In the baseline phase of a three-site adherence study, before any intervention, 201 participants used electronic Medication Event Monitoring System (MEMS) bottles to monitor eyedrop use for 2 months, and completed questionnaires including self-reported adherence.

Results: MEMS showed 79% adherence and self-report 94% (0.5-1.5 missed weekly doses), but they correlated only r(s) = 0.31. Self-efficacy, motivation, dose frequency, and nonminority race/ethnicity predicted 35% of variance in MEMS. Cues to action, self-efficacy, and intention predicted 20% of variance in self-reported adherence.

Conclusions: Self-efficacy, motivation, intention, cues to action, dose frequency, and race/ethnicity each independently predicted adherence. Predictors from all theories were supported in bivariate analyses, but additional study is needed. Researchers and clinicians should consider psychological predictors of adherence. (ClinicalTrials.gov ID# NCT01409421.).

Conflict of interest statement

Drs. Schmiege, Mansberger, Kammer, and Fitzgerald declare that they have no other conflict of interest.

Figures

Figure 1

Median and Variability for Two Measures of Adherence