Clinical Ophthalmology (Nov 2020)
Decreasing Avoidable Vision Loss: Identifying Antecedents of Adherence
Abstract
Alan R Morse,1,2 William H Seiple1,3 1Lighthouse Guild, New York, NY, USA; 2Harkness Eye Institute, Columbia University, New York, NY, USA; 3Department of Ophthalmology, New York University School of Medicine, New York, NY, USACorrespondence: Alan R Morse; William H SeipleLighthouse Guild, 250 West 64th Street, New York, NY 10023, USATel +1 212 769 6215Email [email protected]; [email protected]: Adherence to medication treatment protocols and active participation by individuals in their medical care are important for all patients, but especially for those with chronic conditions such as vision loss. Adherence is crucial for decreasing avoidable vision loss. Failure to take medications as prescribed and keep scheduled appointments reduces treatment effectiveness, increases complications and results in poorer outcomes. Reasons for nonadherence vary by diagnosis and include not understanding the importance of adherence, low health literacy, lack of adequate self-efficacy, low level of activation and behavioral issues including depression. Patients may lack information about their condition and its prognosis, available treatment alternatives, and other essential information such as how to monitor their eye condition, what to do if vision deteriorates and how to get needed community-based help. Each of these factors impedes patients’ ability to engage with their physician and participate in their own care. The ability of individuals with vision loss to actively and effectively manage their health care, ie, activation, has been understudied. When patients are involved with their own care, their care experience, and most importantly, their outcomes, are improved. Identifying antecedents of adherence may help provide disease- and patient-specific pathways to reduce avoidable vision loss.Keywords: avoidable vision loss, adherence, activation, engagement, patient activation, patient engagement, AMD, diabetic eye disease, glaucoma
