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Impressum
Compliance in prevention of a chronic disease: a national evaluation in the European Glaucoma Prevention Study
1Vogel A., 2Kaiser S., 2Krausgrill U., 2Pfeiffer N., 1Kersten I., EGPS-Study- Group
1Departement of Ophthalmology, University of Mainz, 2Departement of Psychology, University of Mainz
Objective: The objective of this study was to evaluate the compliance
of study patients within the ongoing European Glaucoma Prevention Study
(EGPS) in order to identify factors interfering with patient compliance.
Second purpose was to develop possible strategies to improve it.
Patient and methods: An anonymous compliance questionnaire based
on a psychological model, called Health Action Process Approach by Ralf
Schwarzer, was applied to 145 patients in a masked way, containing 64
questions with the following domains: demographic data about the patient
(13), medical history and interest in medical issues (11), dropping behaviour
and side effects (9) and factors that might influence compliance (31).
Results: In our substudy compliance was defined as not missing
applications more than once per week that is not more than 5% of all applications.
This was fullfilled by 78,3% of the patients. Reasons for not taking medication
were e.g. forgetting application (31%), interfering with job (19%) and
stress (6%). It was mainly the application at lunch time that was left
out. Knowledge about the disease improved compliance. In the factor analysis
5 factors were determined to be essential regarding compliance: 1. confidence
in drop application (self-efficacy) 2. believement in the preventive effect
of eye drops (outcome expectancies), 3. social support, 4. situative barriers,
5. threat/risk perception.
Conclusion: We speculate that our rate of noncompliance was rather
low compared to the estimation of noncompliance in glaucoma therapy in
literature which is between 27 and 59%. Informing, educating and caring
for a patient are important factors that might improve compliance.