Real-world strategies increase medication compliance

Chicago-Compliance with medical regimens for glaucoma decreases over time, and patients receiving more than one medication have lower rates of compliance. Despite advances in glaucoma therapy, such as once-daily dosing and dosing aids, patient compliance has not improved, said Douglas J. Rhee, MD.

Dr. Rhee, of Harvard Medical School, Boston, discussed some commonsense methods to help patients with glaucoma achieve higher rates of compliance with their treatment regimens.

He advised educating patients about the goals of treatment. An important point that he emphasized is that glaucoma drugs do not improve vision. The ophthalmologist is the patient’s best source of information, and he urges patients to visit the numerous Internet sites and read brochures to learn about glaucoma control.

Dr. Rhee also uses some simple approaches to improving compliance, such as prescribing drugs that require once-daily dosing or combination agents, and coupling the daily dosing with a daily activity, such as brushing one’s teeth or drinking coffee.

In addition, he prefers giving patients written instructions that use the same generic or trade name as that on their medication.

“This improves their level of understanding,” he said.

Because eye drop instillation is a well-recognized problem, Dr. Rhee has patients watch a video that demonstrates the correct method of instilling drops. Technicians are also involved with teaching patients.

“There is preliminary evidence that indicates that using this patient educator improves patient motivation and adherence to treatment and builds rapport with patients,” he said.

“Compliance with mediation regimens is a substantial barrier to medical therapy,” Dr. Rhee said. “Numerous tools are available that can help educate patients as much as possible. Educate patients about their disease, eye drop instillation, provide written instructions, minimize the cost and side effects, and simplify the regimens.”

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