City Research Online

Abstract

Purpose:
Adherence to glaucoma medication helps prevent disease progression. Barriers to adherence exist, particularly in low- and middle-income countries. We explored factors influencing medication adherence from the perspectives of patients and ophthalmologists in India.

Design:
Cross-sectional, qualitative study.

Methods:
Semi-structured interviews with a purposive patient sample prescribed intraocular pressure (IOP)-lowering eyedrops and ophthalmologists involved in glaucoma care at a tertiary center. The theoretical domains framework (TDF) of behavior change guided deductive and inductive thematic analysis of interview transcripts to identify personal, sociocultural, and environmental influences on adherence.

Results:
Twenty-two participants (n = 11 patients, n = 11 ophthalmologists) were recruited. Seven TDF domains were key to patient adherence and practitioner management. Patient barriers mapped to TDF domains: Environmental context and resources (difficulties obtaining medication, lifestyle changes, hospital system issues), Memory, attention and decision processes (forgetfulness), and Skills (difficulty administering drops). Practitioner barriers related to Environmental context and resources (time constraints and medication availability). Patient enablers mapped to Social influences (family support), Knowledge (understanding glaucoma and treatments), Beliefs about consequences (perceived treatment necessity), and Behavioral regulation (establishing routines). Ophthalmologist enablers included Environmental context and resources (organizational infrastructure), Knowledge (knowing how to classify adherence, awareness of non-adherence), Skills (effective communication), Memory, attention and decision processes (tailoring patient care), Social professional role/identity (professional responsibility), and Social influences (practitioner influence).

Conclusions:
A complex interplay of factors influences adherence. Identifying modifiable behaviors provides a basis for developing culturally sensitive interventions to reduce barriers, enhance patient and family support, and equip practitioners with tools to manage non-adherence effectively.

Publication Type:	Article
Additional Information:	This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBYNC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
Publisher Keywords:	Glaucoma medication adherence, India, patient and practitioner perspectives, theoretical domains framework
Subjects:	D History General and Old World > DS Asia R Medicine > RE Ophthalmology R Medicine > RT Nursing
Departments:	School of Health & Medical Sciences School of Health & Medical Sciences > Department of Optometry & Visual Science
SWORD Depositor:	Symplectic Administrator

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