Patient behavior when prescribed non-affordable glaucoma medication in the medical unit, National Research Center, Cairo, Egypt

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(1)Identify cost-reducing strategies,including cost related non-adherence(CRN),employed by primary open angle glaucoma (POAG)patients;(2)explore impact of doctor-patient interaction(DPI)on CRN and(3)pinpoint best DPI methods that minimized CRN.


A Cross-sectional study was enrolled on consecutive adult patients attending the eye clinic of the National Research Center,Cairo,Egypt, diagnosed with POAG and on outpatient topical anti-glaucoma drugs in the first 8 months of 2012.Data were collected via an interviewer-administered questionnaire.The impact of factors as education,insurance and drug cost to income ratio were tested statistically.


Data gathered from 280 patients showed that 75% of patients employed at least 1 method of CRN(termed CRN+).Of those, up to 70% skip doses,64% postpone buying prescriptions and 28% ignore buying it altogether.We found significant relationships between lower CRN scores and better insurance coverage(p=0.002),higher education(p=0.002),lower values of “drug cost to monthly income” ratio(p=0.003),lower number of prescriptions(p=0.003)and better DPI regarding drug costs(p=0.004). 58% of CRN+ patients reported having DPI,(termed CRN+DPI).In CRN+DPI,the most common methods were doctors showing sympathy towards patients’ drug costs(72%),ensuring patients’affordability of drugs(65%)and change one to a cheaper alternative(62%).In those who did not have DPI,the most cited cause was “being embarrassed” to ask about drug costs(80%).


Future policies should focus on improving DPI to lower CRN,mainly,ensuring patient education on drug costs, showing strong emotional support and reducing polypharmacy. Encouraging patients to ask for cheaper alternatives can also help.

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