Educational Intervention On Glaucoma Patients For Knowledge Enhancement And Treatment Adherence

Abstract

Background: Glaucoma remains a leading cause of irreversible blindness globally, with poor disease awareness and suboptimal treatment adherence acting as critical barriers to effective management. Despite advancements in therapeutic interventions, the preventable nature of glaucoma-related vision loss continues to pose a significant public health challenge particularly in low-resource settings. This study investigated the impact of a structured, theory-driven educational intervention on enhancing glaucoma knowledge and treatment adherence in a demographically diverse patient population.

Study Objective: To evaluate the effects of educational intervention on glaucoma patients for knowledge enhancement and treatment adherence

Methodology: A quasi-experimental (one-group pretest–posttest design) was utilized to evaluate the efficacy of a nursing-led educational intervention informed by the Health Belief Model (HBM). The study was conducted between June 2024 and February 2025 in the ophthalmology outpatient department of Tertiary care Hospital, Lahore. Using purposive sampling, 80 adults aged 40–60 years with a confirmed diagnosis of primary open-angle glaucoma were enrolled. Inclusion criteria required cognitive capacity for health education, while individuals with significant visual impairment (BCVA ≤ 20/200), cognitive or hearing disabilities, or psychiatric disorders were excluded.

Data collection employed two psychometrically validated instruments: the Glaucoma Knowledge Questionnaire (Content Validity Index = 0.819; Cronbach’s α = 0.774) and the Treatment Adherence Questionnaire (CVI = 0.897; Cronbach’s α = 0.799). The intervention comprised a culturally tailored, linguistically appropriate educational session focused on glaucoma pathophysiology, intraocular pressure regulation, medication adherence, and the importance of consistent follow-up. Pre- and post-intervention outcomes were assessed using non-parametric statistical test Mann-Whitney U.

Results: The participant cohort was predominantly male (63.7%), with the majority aged 51–60 years (61.3%) and primarily Punjabi-speaking (53.8%). Educational attainment was generally low, with 22.5% of participants reporting no formal schooling. Statistically significant improvements were observed following the intervention. Glaucoma knowledge scores demonstrated a substantial increase, with mean rank shifting from 59.50 pre-intervention to 100.50 post-intervention (U = 3120.500, p < 0.001). Likewise, treatment adherence improved markedly, as reflected by the increase in mean rank from 53.33 to 107.68 (U = 1026.000, p < 0.001). Notably, the proportion of participants with poor adherence dropped dramatically from 55% to 5%.

Conclusion: This study presents robust evidence that theory-informed, culturally tailored educational interventions substantially improve disease-specific knowledge and treatment adherence among patients with glaucoma. The findings emphasize the critical role of patient-centered health education strategies that are attuned to the linguistic, cultural, and educational needs of diverse populations particularly within under-resourced healthcare settings. By effectively addressing knowledge disparities and fostering sustained engagement with treatment regimens, these interventions demonstrate significant potential as scalable public health tools to reduce preventable vision loss due to glaucoma, especially among socioeconomically vulnerable groups.