Abstract：
OBJECTIVE: To examine barriers and adherence to topical glaucoma medication in a pediatric glaucoma population in Saudi Arabia.
METHODS: This cross-sectional study was undertaken at the King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia during 2016-2017. Parents (father or mother) of children aged 6 months to 15 years with a history of glaucoma were interviewed. Rasch analysis was performed to assess the psychometric properties of the developed 12-item barriers-to-adherence tool (BAT-12) and to identify barriers deemed highly important. The 12-items were adapted from previous studies examining different barriers to adherence in different populations. Medication adherence was assessed by asking parents a series of closed-ended questions about the frequency of missed medications. Determinants of missed medications on at least 1 out of the last 3 days were examined using Poisson regression.
RESULTS: One hundred and six parents were interviewed. The 12-item scale had acceptable psychometric properties. Barriers deemed important were forgetfulness (logit -0.59), complex dosing regimen (logit 0.09), and being too busy with other work/activities (logit 0.14). When asked how often, on average, their child missed the prescribed medication, 26 (24.5%) reported daily, 17(16.0%) reported few times per week, and 32 (30.2%) reported once per week. A third of parents (n = 37, 34.9%) reported having missed giving all drops on at least one day in the last 3 days. Poisson regression with robust variance revealed that increase in age of the child (prevalence ratio, 1.08 [95% CI, 1.03-1.14]; p = 0.003) and increase in parents\' barriers score (prevalence ratio, 2.13 [95% CI, 1.49, 3.03]; p < 0.001) were significantly associated with having missed medications on at least one out of the last three days while adjusting for the effect of father\'s current employment status and area of residence.
CONCLUSIONS: The tool we used to examine barriers to glaucoma medication had acceptable psychometric properties and could be used and strengthened in future studies. Our study highlights poor adherence to glaucoma medications among children with glaucoma.
METHODS: This cross-sectional study was undertaken at the King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia during 2016-2017. Parents (father or mother) of children aged 6 months to 15 years with a history of glaucoma were interviewed. Rasch analysis was performed to assess the psychometric properties of the developed 12-item barriers-to-adherence tool (BAT-12) and to identify barriers deemed highly important. The 12-items were adapted from previous studies examining different barriers to adherence in different populations. Medication adherence was assessed by asking parents a series of closed-ended questions about the frequency of missed medications. Determinants of missed medications on at least 1 out of the last 3 days were examined using Poisson regression.
RESULTS: One hundred and six parents were interviewed. The 12-item scale had acceptable psychometric properties. Barriers deemed important were forgetfulness (logit -0.59), complex dosing regimen (logit 0.09), and being too busy with other work/activities (logit 0.14). When asked how often, on average, their child missed the prescribed medication, 26 (24.5%) reported daily, 17(16.0%) reported few times per week, and 32 (30.2%) reported once per week. A third of parents (n = 37, 34.9%) reported having missed giving all drops on at least one day in the last 3 days. Poisson regression with robust variance revealed that increase in age of the child (prevalence ratio, 1.08 [95% CI, 1.03-1.14]; p = 0.003) and increase in parents\' barriers score (prevalence ratio, 2.13 [95% CI, 1.49, 3.03]; p < 0.001) were significantly associated with having missed medications on at least one out of the last three days while adjusting for the effect of father\'s current employment status and area of residence.
CONCLUSIONS: The tool we used to examine barriers to glaucoma medication had acceptable psychometric properties and could be used and strengthened in future studies. Our study highlights poor adherence to glaucoma medications among children with glaucoma.
摘要：
目的：研究沙特阿拉伯儿童青光眼人群对局部青光眼药物治疗的障碍和依从性。
方法：这项横断面研究是在哈立德国王眼科专科医院进行的，利雅得,沙特阿拉伯在2016-2017年期间。采访了6个月至15岁有青光眼病史的儿童的父母（父亲或母亲）。进行了Rasch分析，以评估开发的12项依从性障碍工具（BAT-12）的心理测量特性，并确定被认为非常重要的障碍。这12个项目改编自以前的研究，研究了不同人群中不同的依从性障碍。通过向父母询问一系列关于错过药物的频率的封闭式问题来评估药物依从性。使用泊松回归检查最后3天中至少1天的错过药物的决定因素。
结果：采访了一百一十六位家长。12项量表具有可接受的心理测量特性。被认为重要的障碍是健忘(logit-0.59)，复杂的给药方案（logit0.09），并且忙于其他工作/活动（logit0.14）。当被问及多久，平均而言,他们的孩子错过了处方药物，每日报告26份（24.5%），17人（16.0%）每周报告几次，32例（30.2%）每周报告一次。三分之一的父母（n=37，34.9％）报告说在过去3天中至少有一天错过了所有滴剂。具有稳健方差的泊松回归显示，儿童年龄的增加(患病率，1.08[95%CI，1.03-1.14]；p=0.003)和父母障碍得分增加(患病率，2.13[95％CI，1.49，3.03]；p<0.001）与过去三天中至少有一天错过药物治疗显着相关，同时调整了父亲当前的就业状况和居住地区的影响。
结论：我们用于检查青光眼药物治疗障碍的工具具有可接受的心理测量特性，可以在未来的研究中使用和加强。我们的研究强调了青光眼儿童对青光眼药物的依从性差。
方法：这项横断面研究是在哈立德国王眼科专科医院进行的，利雅得,沙特阿拉伯在2016-2017年期间。采访了6个月至15岁有青光眼病史的儿童的父母（父亲或母亲）。进行了Rasch分析，以评估开发的12项依从性障碍工具（BAT-12）的心理测量特性，并确定被认为非常重要的障碍。这12个项目改编自以前的研究，研究了不同人群中不同的依从性障碍。通过向父母询问一系列关于错过药物的频率的封闭式问题来评估药物依从性。使用泊松回归检查最后3天中至少1天的错过药物的决定因素。
结果：采访了一百一十六位家长。12项量表具有可接受的心理测量特性。被认为重要的障碍是健忘(logit-0.59)，复杂的给药方案（logit0.09），并且忙于其他工作/活动（logit0.14）。当被问及多久，平均而言,他们的孩子错过了处方药物，每日报告26份（24.5%），17人（16.0%）每周报告几次，32例（30.2%）每周报告一次。三分之一的父母（n=37，34.9％）报告说在过去3天中至少有一天错过了所有滴剂。具有稳健方差的泊松回归显示，儿童年龄的增加(患病率，1.08[95%CI，1.03-1.14]；p=0.003)和父母障碍得分增加(患病率，2.13[95％CI，1.49，3.03]；p<0.001）与过去三天中至少有一天错过药物治疗显着相关，同时调整了父亲当前的就业状况和居住地区的影响。
结论：我们用于检查青光眼药物治疗障碍的工具具有可接受的心理测量特性，可以在未来的研究中使用和加强。我们的研究强调了青光眼儿童对青光眼药物的依从性差。
