Prevalence and determinants of non-adherence to topical hypotensive treatment in Dutch glaucoma patients

Graefes Arch Clin Exp Ophthalmol. 2009 Feb;247(2):235-43. doi: 10.1007/s00417-008-0944-y. Epub 2008 Sep 19.


Background: To assess the prevalence and determinants of non-adherence to topical hypotensive treatment in glaucoma patients in order to support interventions targeting enhancement of patient adherence.

Methods: One-hundred and sixty-six glaucoma patients, recruited by nationwide multi-stage sampling, filled in an extensive and carefully developed questionnaire covering various theoretically relevant determinants of patient adherence which were categorized as psychosocial aspects, barriers and skills.

Results: Prevalence of self-reported non-adherence was 27.3%. Younger patients (<55 years of age) had a higher risk of being non-adherent. Forgetfulness, unavailability of eye drops and difficulties with holding the bottle above the eye when applying the eye drops were the most cited reasons for non-adherence. Fifty percent of the patients indicated that they required more information on the correct administration of eye drops. There was no association between non-adherence and sex, level of education, type of insurance, duration of disease or family history of glaucoma.

Conclusions: Non-adherence to topical glaucoma medication is fairly common. Aids that minimize forgetfulness and delivery systems facilitating the delivery of medications to the eye could be considered to enhance patient adherence before advancing to other therapies with additional risks and costs.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Topical
  • Aged
  • Antihypertensive Agents / administration & dosage*
  • Antihypertensive Agents / economics
  • Drug Costs
  • Female
  • Glaucoma / drug therapy*
  • Glaucoma / epidemiology*
  • Humans
  • Male
  • Middle Aged
  • Netherlands / epidemiology
  • Ophthalmic Solutions / administration & dosage
  • Ophthalmic Solutions / economics
  • Patient Compliance / statistics & numerical data*
  • Prevalence
  • Psychology
  • Risk Factors
  • Self Administration / statistics & numerical data
  • Surveys and Questionnaires


  • Antihypertensive Agents
  • Ophthalmic Solutions