Noncompliance with Ocular Hypertensive Treatment in Patients with Primary Open Angle Glaucoma among the Arab Population in Israel: A Cross-Sectional Descriptive Study
Objective. To evaluate the noncompliance treatment rates among primary open angle glaucoma (POAG) Arab patients in Israel and to verify the associated factors for noncompliance. Patients and Methods. A cross-sectional study took place using a questionnaire. Patients were initially interviewed and requested to answer a questionnaire. The questionnaire was developed based on a pilot test. Items included information about age, gender, number of prescribed drugs, and multiple reasons for noncompliance with drug therapy. Setting. Ophthalmologic HMO clinics, located in 3 Arab cities in the center of Israel. Participants. 400 Arab participants (197 men, 203 women) undergoing routine clinical care were recruited. Results. General rate of noncompliance, for both genders, was found to be 50%. Factors associated with nonadherence included inadequate knowledge (32%), underestimation of the disease severity (25.5%), and denial 15.5%. Compliance rates were unaffected by gender or number of prescribed drugs. Compliance was significantly higher in younger patients (age < 50) and in older patients (age > 80), 63% and 77%, respectively, ( ). Conclusion(s). Noncompliance was found to be common among an Arab population in Israel, particularly between the ages of 50 and 80. Educational programs, improving patient-physician relationship, and personalizing treatment could provide means for improved adherence. 1. Introduction Glaucoma is the second leading cause for blindness worldwide [1]. The prevalence of primary open angle glaucoma (POAG) is estimated to be between 1.1% and 3% in Western populations over the age of 40 years [1, 2]. The estimated number of POAG patients in Israel is 60,000. A large survey study including 10,000 Israeli participants demonstrated a similar distribution of the disease among various Israeli ethnicities, including Arabs [3]. In the literature, compliance is reported to vary from as low as 5% to as high as 80% [4]. However, limited information is available on this issue in the Middle East. Moreover, similar studies and information in the specific Israeli-Arab population are still lacking. The aim of this study is to estimate the degree, components, and determinants of noncompliance among POAG Arab patients in Israel and to verify associated factors for noncompliance. Glaucoma is insidious and disabling; the degree of interference with vision varies from imperceptible changes to complete blindness. Noncompliant patients exhibit a higher intraocular pressure and greater visual field loss [5]. Several authors have indicated that noncompliance is an
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