City Research Online

Abstract

Purpose
Long-term adherence to glaucoma medication is often suboptimal, compromising treatment efficacy and increasing the risk of glaucoma progression. Existing interventions have limited success. This study explored behavioral factors influencing adherence from the perspectives of United Kingdom (UK)-based patients with glaucoma and eye care professionals (ECPs), using the Theoretical Domains Framework (TDF).

Methods
Semi-structured interviews were conducted with adults prescribed intraocular pressure–lowering eyedrops whose adherence status was classified based on self-reported medication use and UK-registered ECPs involved in glaucoma care. Interview data were analyzed using deductive and inductive thematic analysis guided by the TDF to identify key barriers and enablers influencing adherence-related behaviors.

Results
Twenty-six participants were interviewed (13 patients and 13 ECPs). For patients, adherence was influenced by factors relating to knowledge and understanding of glaucoma, skills required to administer and obtain medication, memory and routine formation, beliefs about treatment necessity, social support, and healthcare system factors such as medication availability. ECPs identified time constraints, limited resources, and uncertainty in assessing adherence as key challenges, whereas communication skills, multidisciplinary support, and tailored decision-making were viewed as important enablers.

Conclusions
Glaucoma medication adherence is shaped by a complex interplay of behavioral, professional and systemic factors. Applying the TDF highlights modifiable influences on adherence and supports the development of targeted, theory-informed interventions to improve glaucoma outcomes.

Significance
Poor adherence to glaucoma medication remains a major barrier to effective treatment. This study identifies behavioral factors influencing adherence from both patient and clinician perspectives, using a validated framework. These insights can inform the development of tailored interventions that may improve outcomes and guide clinical management of nonadherence.

Publication Type:	Article
Additional Information:	© The Authors. Published by Wiley. This is an open-access article distributed under the terms of Creative Commons: Attribution International Public License 4.0 (http://creativecommons.org/licenses/by/4.0/).
Subjects:	H Social Sciences > HM Sociology H Social Sciences > HN Social history and conditions. Social problems. Social reform R Medicine > RC Internal medicine R Medicine > RE Ophthalmology
Departments:	School of Health & Medical Sciences School of Health & Medical Sciences > Department of Optometry & Visual Science
SWORD Depositor:	Symplectic Administrator

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