International Ophthalmology

, Volume 31, Issue 5, pp 369–376 | Cite as

Compliance and knowledge about glaucoma in patients at tertiary glaucoma units

  • Kaweh Mansouri
  • Milko E. Iliev
  • Kaspar Rohrer
  • Tarek Shaarawy
Original Paper


To document the rate of self-reported compliance and glaucoma-related knowledge in Swiss patients and to identify risk factors for their poor compliance. This was an observational study, including a total of 200 consecutive patients already under glaucoma medication in two Swiss tertiary glaucoma clinics (Geneva and Bern). Personal characteristics, presence of systemic disease, compliance with glaucoma medication, attitude to the ophthalmologist, and glaucoma-related attitudes were ascertained by means of a predetermined questionnaire with 40 questions. Patients were subsequently assessed for the ability to correctly instil placebo eye drops. Non-compliance with glaucoma medication was defined as omitting more than two doses a week as reported by the patient. Logistic regression was used to evaluate how patient characteristics and knowledge about the disease were related to compliance. Overall, 81% (n = 162) of patients reported to be compliant. Forgetfulness was the most frequently cited reason for non-compliance with dosing regimen (63%). Although 90.5% (n = 181) of patients believed glaucoma medication to be efficient, only 28% (n = 56) could correctly define glaucoma. Factors positively associated with compliance were ‘knowledge of glaucoma’ [adjusted odds ratio (OR) 4.77 (95% CI 1.36–16.70)] and ‘getting help for administration of drops’ [OR 2.95 (1.25–6.94)]. These findings indicate that despite the comparatively high compliance rate among glaucoma patients, knowledge of glaucoma remains poor in long-term glaucoma sufferers. Improving knowledge about the disease is important since it is positively associated with compliance in our study.


Glaucoma Compliance Knowledge Switzerland Vascular dysregulation 


  1. 1.
    Osterberg L, Blaschke T (2005) Adherence to medication. N Engl J Med 353(5):487–497PubMedCrossRefGoogle Scholar
  2. 2.
    Ashburn FS Jr, Goldberg I, Kass MA (1980) Compliance with ocular therapy. Surv Ophthalmol 24(4):237–248PubMedCrossRefGoogle Scholar
  3. 3.
    Bloch S, Rosenthal AR, Friedman L, Caldarolla P (1977) Patient compliance in glaucoma. Br J Ophthalmol 61(8):531–534PubMedCrossRefGoogle Scholar
  4. 4.
    Resnikoff S, Pascolini D, Etya‘ale D et al (2004) Global data on visual impairment in the year 2002. Bull World Health Organ 82(11):844–851PubMedGoogle Scholar
  5. 5.
    Musch DC, Gillespie BW, Niziol LM et al (2008) Factors associated with intraocular pressure before and during 9 years of treatment in the Collaborative Initial Glaucoma Treatment Study. Ophthalmology 115(6):927–933PubMedCrossRefGoogle Scholar
  6. 6.
    Olthoff CM, Schouten JS, van de Borne BW, Webers CA (2005) Noncompliance with ocular hypotensive treatment in patients with glaucoma or ocular hypertension an evidence-based review. Ophthalmology 112(6):953–961PubMedCrossRefGoogle Scholar
  7. 7.
    Khandekar R, Shama Mel S, Mohammed AJ (2005) Noncompliance with medical treatment among glaucoma patients in Oman—a cross-sectional descriptive study. Ophthalmic Epidemiol 12(5):303–309PubMedCrossRefGoogle Scholar
  8. 8.
    Sleath B, Robin AL, Covert D et al (2006) Patient-reported behavior and problems in using glaucoma medications. Ophthalmology 113(3):431–436PubMedCrossRefGoogle Scholar
  9. 9.
    Ngan R, Lam DL, Mudumbai RC, Chen PP (2007) Risk factors for noncompliance with follow-up among normal-tension glaucoma suspects. Am J Ophthalmol 144(2):310–311PubMedCrossRefGoogle Scholar
  10. 10.
    Hansen AC (1986) Compliance with topical pilocarpine treatment. Am J Ophthalmol 102(4):547PubMedGoogle Scholar
  11. 11.
    Kholdebarin R, Campbell RJ, Jin YP, Buys YM (2008) Multicenter study of compliance and drop administration in glaucoma. Can J Ophthalmol 43(4):454–461PubMedCrossRefGoogle Scholar
  12. 12.
    Konstas AG, Maskaleris G, Gratsonidis S, Sardelli C (2000) Compliance and viewpoint of glaucoma patients in Greece. Eye (Lond) 14(Pt 5):752–756CrossRefGoogle Scholar
  13. 13.
    Rigal K, Mansouri K, Wanderer S (2008) Survey of 100 glaucoma patients (German). Spektrum Augenheikd 22(4):252–255CrossRefGoogle Scholar
  14. 14.
    DiMatteo MR (2004) Variations in patients’ adherence to medical recommendations: a quantitative review of 50 years of research. Med Care 42(3):200–209PubMedCrossRefGoogle Scholar
  15. 15.
    Spooner JJ, Bullano MF, Ikeda LI et al (2002) Rates of discontinuation and change of glaucoma therapy in a managed care setting. Am J Manag Care 8(10 Suppl):S262–S270PubMedGoogle Scholar
  16. 16.
    Robin AL, Novack GD, Covert DW et al (2007) Adherence in glaucoma: objective measurements of once-daily and adjunctive medication use. Am J Ophthalmol 144(4):533–540PubMedCrossRefGoogle Scholar
  17. 17.
    Okeke CO, Quigley HA, Jampel HD et al (2009) Interventions improve poor adherence with once daily glaucoma medications in electronically monitored patients. Ophthalmology 116(12):2286–2293PubMedCrossRefGoogle Scholar
  18. 18.
    Okeke CO, Quigley HA, Jampel HD et al (2009) Adherence with topical glaucoma medication monitored electronically the Travatan Dosing Aid study. Ophthalmology 116(2):191–199PubMedCrossRefGoogle Scholar
  19. 19.
    Hollo G, Vargha P, Kothy P (2005) Influence of switching to travoprost on intraocular pressure of uncontrolled chronic open-angle glaucoma patients compliant to previously-used topical medication. Curr Med Res Opin 21(12):1943–1948PubMedCrossRefGoogle Scholar
  20. 20.
    Friedman DS, Okeke CO, Jampel HD et al (2009) Risk factors for poor adherence to eyedrops in electronically monitored patients with glaucoma. Ophthalmology 116(6):1097–1105PubMedCrossRefGoogle Scholar
  21. 21.
    Mansouri K, Orgul S, Meier-Gibbons F, Mermoud A (2006) Awareness about glaucoma and related eye health attitudes in Switzerland: a survey of the general public. Ophthalmologica 220(2):101–108PubMedCrossRefGoogle Scholar
  22. 22.
    Mansouri K, Shaarawy T (2009) Will improvement of knowledge lead to improvement of compliance with glaucoma medication? Acta Ophthalmol 87(4):468–469 (author reply 9–71)PubMedCrossRefGoogle Scholar
  23. 23.
    Hollo G, Kothy P, Geczy A, Vargha P (2009) Personality traits, depression, and objectively measured adherence to once-daily prostaglandin analog medication in glaucoma. J Glaucoma 18(4):288–292PubMedCrossRefGoogle Scholar
  24. 24.
    de Klerk E, van der Heijde D, Landewe R et al (2003) The compliance-questionnaire-rheumatology compared with electronic medication event monitoring: a validation study. J Rheumatol 30(11):2469–2475PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2011

Authors and Affiliations

  • Kaweh Mansouri
    • 1
  • Milko E. Iliev
    • 2
  • Kaspar Rohrer
    • 2
  • Tarek Shaarawy
    • 1
  1. 1.Glaucoma Sector, Division of OphthalmologyUniversity of GenevaGenèveSwitzerland
  2. 2.University Eye ClinicUniversity of BernBernSwitzerland

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