Knowledge and Treatment Adherence among Moroccan Glaucoma Patients: A Cross-sectional Study of 400 Cases

Abstract

Background: Glaucoma is a chronic progressive optic neuropathy and represents one of the leading causes of irreversible blindness worldwide. Because the disease is frequently asymptomatic in its early stages, long-term management relies heavily on patient adherence to treatment and regular follow-up. Adequate patient knowledge of the disease and its treatment plays a crucial role in maintaining adherence and preventing disease progression. Aim: The aim of this study was to evaluate the level of knowledge and treatment adherence among Moroccan glaucoma patients and to highlight the importance of therapeutic patient education in improving disease management. Methods: This cross-sectional study included 400 patients previously diagnosed with glaucoma and followed at the Adult Ophthalmology Department of the 20 August 1953 Hospital, Ibn Rochd University Hospital Center, Casablanca. Data were collected over an eight-month period between May and December 2022. Patients were interviewed using a structured questionnaire administered in the glaucoma clinic waiting room. The questionnaire evaluated demographic characteristics, educational level, knowledge of glaucoma, awareness of lifelong treatment necessity, perception of blindness risk, knowledge of prescribed medication, treatment adherence, experience of side effects, and physician involvement. Data were analyzed using Microsoft Excel. Results: The mean age of the patients was 64 years (range 23–92 years). The most represented age group was between 60 and 80 years. Women accounted for 57% of the study population and men for 43%. Regarding educational level, 28% of patients were illiterate, 31.5% had primary education, 25.5% secondary education, and 15% had attended university. Most patients (70.5%) were aware that glaucoma treatment must be continued lifelong. However, 22.5% were uncertain about treatment duration and 7% believed that glaucoma could be cured. Additionally, 80% of patients knew that untreated glaucoma could lead to blindness. Only 50.25% of patients knew the name of their medication, although 75.5% were aware of the dosing schedule. In terms of adherence, 52.5% reported never forgetting their treatment, while 25% admitted occasional forgetfulness and 22.5% reported frequent non-adherence. Less than half of the patients (47.5%) reported receiving instructions on proper eye drop instillation technique. Furthermore, 65% of patients reported experiencing bothersome side effects such as ocular redness, dryness, or allergic reactions. Physician involvement was perceived as low by 9% of patients, average by 42%, and good by 49%. Conclusion: Although Moroccan glaucoma patients demonstrate relatively good awareness of disease severity, treatment adherence remains suboptimal. Structured therapeutic education programs may significantly improve patient understanding, autonomy, and adherence to long-term glaucoma therapy.