Multicenter study of compliance and drop administration in glaucoma

Ramin Kholdebarin, Robert J. Campbell, Ya Ping Jin, Yvonne M. Buys, George Beiko, Catherine Birt, Karim Damji, Frederick Feldman, Caroline Lajaoie, Sadhana Kulkarni, Jeffery Martow, Terence Sakamoto, Jon Spencer, Graham E. Trope

Research output: Contribution to journalArticlepeer-review

150 Citations (Scopus)


Background: Poor compliance with medication is a major concern in the management of glaucoma. Improper administration technique can lead to contamination and inaccurate dosing. This study estimates the prevalence and predictors of noncompliance and improper administration technique among Canadian glaucoma patients. Methods: Data were collected using a standardized questionnaire. Noncompliance was defined as missing at least 1 drop of medication per week and (or) the inability to accurately describe the medication regimen. Patients were asked to indicate the most common reason for missing medication. Study personnel assessed drop administration technique as patients were applying eye drops. Physicians provided information, including measures of disease stability, regarding the patient's glaucoma. Predictors were assessed using odds ratios from a logistic regression model. Results: 500 patients from 10 centers across Canada participated in the study. Of these, 25.6% reported missing at least 1 drop of medication per week, and 4.2% were unable to accurately describe their medication regimen. The overall proportion of noncompliance was 27.9%. With regard to drop administration, 6.8% missed their eye and 28.8% contaminated the bottle tip; overall, 33.8% demonstrated improper technique. The most common reasons given for missing eye drops were "forgetfulness" and "being away from drops." Formal education limited to elementary school and treatment duration of <5 years increased patient-reported noncompliance. Factors associated with improper administration technique were age 60 years and older and formal education limited to elementary school. Interpretation: Over 50% of the patients surveyed were either noncompliant or demonstrated improper administration technique. Glaucoma patients should be educated on the importance of compliance and instructed on proper drop administration.

Original languageEnglish
Pages (from-to)454-461
Number of pages8
JournalCanadian Journal of Ophthalmology
Issue number4
Publication statusPublished - Aug 2008


  • Administration
  • Aged
  • Education
  • Glaucoma
  • Patient compliance
  • Prevalence
  • Topical


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