Evaluating the Impact of Educational Interventions on Medication Adherence Among Glaucoma Patients in Kazakhstan: A Public Health Perspective

Abstract

Objective: Glaucoma, a prevalent eye condition stemming from optic neuropathy, can cause irreversible blindness if not treated. Lack of adherence to medical treatments for glaucoma  often  results  in  severe  outcomes,  including  ongoing  vision  loss  and eventual  blindness.  The  aim  of  this  study  was  to  assess  treatment  adherence among  glaucoma  patients  who  attended  the  Glaucoma  School  at  urban  clinics in Aktobe, Kazakhstan.

Material and Methods: A  cross-sectional  study  was  conducted  involving  183  glaucoma  patients  who sequentially  underwent  training  at  Glaucoma  Schools  in Aktobe,  Republic  of Kazakhstan.  Data  on  adherence  to  glaucoma  treatment  were  collected  using the  standardized  Morisky  Medication  Adherence  Scale-8  (MMAS-8)  through a  questionnaire.  Analysis  was  performed  using  the  statistical  software  SPSS (version  27.0.0.0,  IBM  Corporation,  USA)  and  GraphPad  Prism  9.5.1.733.  A p-value  of  <0.05  was  considered  statistically  significant.  The  study  proposal was  approved  by  the  local  bioethics  committee  of  the West  Kazakhstan  Marat Ospanov Medical University.

Results: The  study  has  identified  a  significant  improvement  in  medication  adherence among  glaucoma  patients,  with  reductions  in  the  frequency  of  forgetting  to administer eye drops—from daily forgetfulness (p < 0.001) to specific situations like travel (p = 0.001). There was a notable increase in the proportion of patients properly  administering  their  eye  drops  the  day  before,  with  a  significant  rise from 63.9% to 72.1% (p < 0.001). Overall, the median adherence score improved significantly from 4,75 to 5,5 (p < 0.001) and there was a minor, non-significant shift towards higher adherence categories after the educational intervention (p = 0.166). Socioeconomic factors such as education and income levels significantly influenced adherence before the intervention, with higher levels associated with better adherence (p < 0.001 for education, p = 0.020 for income).

Conclusions: The  study  underscores  that  while  educational  interventions  at  the  glaucoma school  have  shown  improvements,  adherence  levels  continue  to  be  low, underscoring  the  necessity  for  sustained  endeavors  to  bolster  treatment adherence.  Initiatives  such  as  lectures,  workshops,  and  seminars  have  proven successful  in  heightening  awareness  and  garnering  community  support,  thus positively affecting adherence. Socioeconomic factors exert a notable influence on  adherence,  indicating  the  importance  of  integrating  social  support  into medical programs to assist economically disadvantaged groups. Limitations of the study include its brief duration and narrow geographical scope, potentially limiting  the  generalizability  of  the  findings.Nonetheless,  it  provides  valuable insights  into  managing  glaucoma  and  underscores  the  necessity  for  continued research to refine educational and support strategies for glaucoma patients.

Bangladesh Journal of Medical Science Vol. 23 No. 03 July’24 Page : 787-796