Original Research

Loss to follow-up amongst glaucoma patients in selected hospitals of the Limpopo Province, South Africa

Shonisani E. Tshivhase, Lunic B. Khoza, Takalani G. Tshitangano
African Vision and Eye Health | Vol 79, No 1 | a559 | DOI: https://doi.org/10.4102/aveh.v79i1.559 | © 2020 Shonisani E. Tshivhase, Lunic B. Khoza, Takalani G. Tshitangano | This work is licensed under CC Attribution 4.0
Submitted: 17 February 2020 | Published: 28 October 2020

About the author(s)

Shonisani E. Tshivhase, Department of Public Health, Faculty of Health Science, University of Venda, Thohoyandou, South Africa
Lunic B. Khoza, Department of Advanced Nursing Science, Faculty of Health Science, University of Venda, Thohoyandou, South Africa
Takalani G. Tshitangano, Department of Public Health, Faculty of Health Science, University of Venda, Thohoyandou, South Africa


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Abstract

Background: Glaucoma is associated with visual field loss for which elevated intraocular pressure is the primary risk factor. Proper medication adherence requires daily intake of prescribed medication for a lifetime. Non-adherence patients are at greater risk of poor outcome than adherent patients.

Aim: To identify behavioural determinants contributing to loss to follow-up amongst glaucoma patients.

Setting: The study was conducted in selected hospitals of South Africa.

Methods: A hospital-based cross-sectional study was conducted on glaucoma patients with age ranging from 18 years and above. Quantitative methods were used to collect data from purposefully selected glaucoma patients. Structured questionnaires were distributed to collect data from patients attending glaucoma clinics. The patients should have missed an appointment review at least once during the 12-month period.

Results: Amongst the 429 glaucoma patients interviewed, the majority (79%, n = 341) of the patients missed their follow-up more than once during the 12-month period. The most cited contributory barriers to poor follow-up were accessibility (26%) followed by lack of escort and financial cost at 22% and 21%, respectively. About 115 of the 429 study respondents were found to be non-adherent. The main reasons given were shortage of medication and forgetfulness at 36% and 29%, respectively.

Conclusion: Accessibility and lack of escort were significant barriers to loss to follow-up. Identifying the predictors of poor follow-up can help in improving follow-up care. Therefore, patient education and support may improve adherence to glaucoma therapy.


Keywords

glaucoma; glaucoma patient; loss to follow-up; intraocular pressure; medication adherence; non-adherence

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