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A theory-driven qualitative study exploring issues relating to adherence to topical glaucoma medications

Authors McDonald S, Ferguson E, Hagger MS, Foss AJE, King AJ

Received 22 May 2018

Accepted for publication 22 November 2018

Published 17 May 2019 Volume 2019:13 Pages 819—828


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Dr Johnny Chen

Stephanie McDonald,1 Eamonn Ferguson,1 Martin S Hagger,2 Alexander JE Foss,3 Anthony J King3

1School of Psychology, University of Nottingham, Nottingham, UK; 2School of Psychology, Curtin University, Perth, WA, Australia; 3Department of Ophthalmology, Nottingham University Hospital, Nottingham, UK

Purpose: Investigating patients’ perceptions of their illness can provide important insights into the experience and management of the illness and associated treatment, and enhance understanding of variations in adherence to prescribed medication. The Common-Sense Model of Self-Regulation (CSM) provides a theoretical framework for the study of illness cognitions, health behavior, and adherence to health recommendations. The aim of this study was to use the CSM to investigate the experience of glaucoma and its treatment from the patients’ perspective, and to apply these insights to classify and clarify issues related to nonadherence with treatment.
Patients and methods: A qualitative investigation using semi-structured interviews took place in two outpatient glaucoma clinics. Thirty-three patients with primary open-angle glaucoma using hypotensive eye drops participated in the study. Deductive content analysis was used to analyze the interview data.
Results: Issues relating to nonadherence with hypotensive eye drops and patients’ experience with their glaucoma and treatment were identified. Treatment schedule and patient factors were classified as common barriers to adherence. Further themes include experienced symptoms of glaucoma, illness coherence, and the emotional and practical consequences of the illness.
Conclusion: Findings provide important insights into the emotional and practical outcomes of glaucoma for patients, perceived symptoms of the illness, and insights into patient memory and cognition. These findings provide supporting evidence for the importance of conducting theoretically driven qualitative investigations of patients’ experience with glaucoma and their treatment, and provide suggestions on key issues that need to be addressed in future multidimensional interventions aimed at improving adherence and patient quality of life.

Keywords: glaucoma, adherence, patient experience, qualitative research, Common-Sense Model of Self-Regulation

Creative Commons License This work is published by Dove Medical Press Limited, and licensed under a Creative Commons Attribution License. The full terms of the License are available at The license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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