Clinical Features Of Noncompliance

There are several ways in which patients can fail to adhere to prescribed medical regimens for glaucoma; these may include the following:

1. Failure to take the medication is the most common form of noncompliance and manifests in a variety of ways. Some patients may never intend to take a medication and thus fail to fill the initial prescription.1 Patients can also miss doses of medications2-6 or discontinue a medication prematurely.7 Well-intentioned patients may be unable to deliver doses of medication to their eyes because of physical disabilities.8'9

2. Improper timing of medication can lead patients to space their medications too close together' leaving large stretches of time when they are undertreated (table 14.1).3'10 Patients may also administer two different medications within too short an interval, causing the second drug to wash the first drug from the conjunctival cul-de-sac before it has the opportunity to fully penetrate the eye.

3. Overuse of a medication can be seen in patients who hope to increase a therapeutic effect11 or who are confused with respect to their treatment regimen.

4. Use of the wrong medication may occur in patients whose regimens are complicated or whose regimens have undergone recent change.12

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