CRITIQUE ON TWO ARTICLES

Critique on Two Articles

Critique on Two Articles

Introduction

Paper critically analyses two articles from Ebscohost about glaucoma outpatient clinic, it particularly focuses the issue of non-compliance to ant-glaucoma medication (eye drops) which lead to blindness. The first article for analysis is “Causes of Non-Compliance with Drug Regimens in Glaucoma Patients: A Qualitative Study” and the second article is “Factors affecting compliance with eye drop therapy for glaucoma in a multicultural outpatient setting”.

Causes of Non-Compliance with Drug Regimens in Glaucoma Patients: A Qualitative Study

Study participants (N=80) were patients recruited from two eye clinics located in hospitals in the Southeast United States: a Veterans Affairs (VA) hospital and a large public hospital. Both of these hospitals offer subsidized onsite or mail-order pharmacies, making pharmacy records available for nearly all prescriptions. Eligibility for study inclusion required that all participants: were between the ages of 18-80; White or African American; had a telephone; spoke and understood English; were diagnosed with open angle glaucoma, glaucoma suspect or ocular hypertension; and were taking daily doses of topical glaucoma treatments for at least the past year. Participants who had eye surgery within 3 months of the date of medical chart review were excluded. While acuity and visual fields were not recorded, participants had to have sufficient corrected or aided vision to read and sign the informed consent and HIPAA (Health Insurance Portability and Accountability) authorization form on their own. The study received approval from the University Institutional Review Board and the respective research oversight committees of both participating hospitals.

Participants were recruited in two ways. Initially, flyers describing the study were placed in the eye clinics. Interested participants either approached study staff in waiting rooms or called the phone number listed on the flyer. Participants were screened for eligibility after signing a combined informed consent and HIPAA authorization form. If screening questions suggested eligibility, participants were interviewed and a medical chart review was conducted to confirm treatment and diagnosis. Medical chart review consisted of abstracting administrative and medical record data on adherence, including prescription medication-taking behavior, prescription renewals, and clinic appointments. This strategy resulted in the recruitment of few non-adherent individuals, so recruitment strategies were modified to obtain a more diverse sample.

With a Partial Waiver of HIPAA authorization, administrative clinic data were used to identify glaucoma patients who had missed at least one clinic appointment in the last year. For those patients, a medical chart review was conducted to screen for eligibility. Potential participants were then contacted by mail and then phone, and interviews were arranged after participants signed the combined informed consent and HIPAA authorization form.

Interviews were conducted by trained research assistants between April and December 2007. Participants were interviewed either over the telephone or in-person at a private room in each eye clinic.

Interviews included questions about background characteristics of the patient and open-ended questions about the participant's eye condition, prescription medication usage, facilitators and barriers to medication adherence, refill and clinic visit behavior, medication knowledge and health literacy, as well as psychosocial factors such as ...