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Multicenter Study
. 2024 Dec 1;33(12):951-956.
doi: 10.1097/IJG.0000000000002487. Epub 2024 Aug 15.

Patients' Acceptance of Glaucoma Therapy in Sub-Saharan Africa

Olusola Olawoye  1   2 , Tarela Sarimiye  1 , Jennifer Washaya  3 , Girum W Gessesse  4 , Komi Balo  5 , Jeremie Agre  6 , Boniface Macheka  7 , Nkiru Kizor-Akaraiwe  8   9 , Jonathan Pons  10 , Adeyinka Ashaye  1 , Farouk Garba  11 , Richard Chitedze  12 , Affiong Ibanga  13 , Abdull Mahdi  14 , Adunola Ogunro  15 , Patrick Budengeri  16 , Haroun Adetunji Ajibode  17 , Lemlem Tamrat  4 , Adeola Onakoya  18 , Suhanyah Okeke  19 , Abeba T Giorgis  20 , Chimdi Chuka Okosa  21 , Kayode Fowobaje  22 , Stephen Cook  23 , Scott Lawrence  24 , Ving Fai Chan  2 , Augusto Azuara Blanco  2 , Nathan Congdon  2   25   26 , Tony Realini  27 ; STAGE Research Group
Affiliations
Multicenter Study

Patients' Acceptance of Glaucoma Therapy in Sub-Saharan Africa

Olusola Olawoye et al. J Glaucoma. .

Abstract

Prcis: Patients' acceptance of glaucoma therapy was high overall in this study, but lower for surgery than for laser or medical therapy. Fear and cost were the leading reasons why patients declined recommended therapy and they were treatment-specific. Cost was the primary reason for declining medical and laser therapy, while fear was the most common reason for declining surgical therapy.

Purpose: To determine the frequency at which patients newly diagnosed with glaucoma in sub-Saharan Africa (SSA) decline recommended therapy and to characterize the reasons for declining therapy.

Methods: This was a multicenter, cross-sectional study conducted on adult patients at the time of glaucoma diagnosis at 27 centers in 10 countries in SSA. Data collected from the diagnostic encounter included demographics, clinical glaucoma characteristics, treatment recommendations, patient acceptance of therapy, and reasons for declining therapy.

Results: Among 2282 eyes of 1198 patients offered treatment for glaucoma, initially recommended treatment was accepted in 2126 eyes (93.2%). Acceptance of therapy varied with the nature of treatment offered, with medical therapy accepted in 99.2% of eyes, laser therapy in 88.3%, and surgical therapy in 69.3%. The most common reasons cited for declining therapy were fear (42.9%) and cost (41.7%); cost was the primary reason for declining medical and laser therapy, while fear was the most common reason for declining surgical therapy. Most patients declining laser or surgical therapy accepted medical therapy as an alternate therapy (98.1%).

Conclusions: Patients' acceptance of glaucoma therapy was high overall, but lower for surgery than for laser or medical therapy. Most patients who declined laser or surgical therapy accepted medical therapy as an alternate therapy when offered. Educational interventions, sustainable incentives, and other approaches are needed to enhance patient acceptance of glaucoma therapy in this setting, particularly surgery, when needed.

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Conflict of interest statement

Disclosure: N.C. serves as a paid consultant for Belkin Vision, a company selling devices for the treatment of glaucoma. The remaining authors declare no conflict of interest.

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