Compliance and persistence in patients with primary open-angle glaucoma through the doctor opinions
PURPOSE: Determination of key factors of non-compliance for treatment and duration of recommendations accomplishment in accordance with doctor's instructions and associated with time from therapy start to its discontinuation (persistence) in patients with glaucoma by assessment of personal opinion of ophthalmologists with different amount of experience. METHODS: 509 queries of medical professionals (631 doctors) from Russia and other 6 countries were included into the study. All doctors' queries were grouped according to the duration of their work experience, place of work - depending on medical care type (ambulatory or inpatient) and by hospital propriety type (state or private). Data collection method: online survey. The significance of the 32 selected compliance factors was assessed by the ball system from 10 (maximum significant factor) to 1 (minimally significant factor). Analysis program Statistica 8.0 (StatSoft Inc., USA). RESULTS: Data analysis allowed determining medium terms for continued application of recommended therapy depending on patients group. Persistency of low-compliant patients was considered a period of continued following of recommendations from 15 up to 27.5 days per year, high-compliant - 180-300 days per year. Doctors' opinion depended on time in professional and place of work. Study results allowed recognizing percent's of “low-compliant", “medium- compliant” and “high-compliant" patients. Following patients compliance factors were assessed as well: factors directly associated with treatment, factors, associated with patient's condition, factors of behavioral compliance and social compliance. Moreover, trial results displayed difference in opinion of medical specialists depending on the duration of their work experience, place of work and clinic type. CONCLUSION: Study groups divided by the amount of healthcare experience showed no difference in patients compliance apprehension. Percentage of low-compliant patients was 20 [10; 30] %; medium-compliant - 30 [20; 45] and high-compliant - 50 [30; 60]% in all groups. A longer duration of healthcare experience corresponded with higher persistence requirements. Low-compliant patients followed recommendations for up to 20 days per year [7; 60]; medium-compliant - for 90 [20; 200] and low-compliant - 200 [40; 350]. Primary factors for non-compliancy in all groups were defined as follows: absence of motivation; complicated instillation regimen influencing daily activities; absence of contact with attending physician; low information level concerning condition; age; side effects; medication price; laziness; family history of glaucoma. Factors of behavioral compliance were considered the most important in all groups - 75%.