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J Glaucoma. 2003 Oct;12(5):393-8.

Compliance barriers in glaucoma: a systematic classification.

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Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University College of Physicians and Surgeons, New York, New York 10032, USA.



To systematically identify and describe common obstacles to medication adherence (i.e., compliance) for patients with glaucoma.


A prospective case series of structured interviews were conducted with 48 patients with glaucoma. The subjects' responses were recorded verbatim on interview forms as well as recorded on audiotapes. Situational obstacles to medication adherence were elicited. Using hierarchical cluster analysis, the situational descriptions were stratified, grouped, and analyzed by frequency distribution.


Seventy-one unique situational obstacles were reported. These were then grouped into 4 defined and separate categories: situational/environmental factors (35 of 71 situations; 49%), medication regimen (23 of 71; 32%), patient factors (11 of 71; 16%), and provider factors (2 of 71; 3%).


Significant barriers to compliance exist for patients with glaucoma in addition to those cited by previous ophthalmic studies. A systematic classification (i.e., taxonomy) of these barriers was formulated to assist in optimizing patient education and problem-solving regarding prescribed therapeutic regimens.

[Indexed for MEDLINE]

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