Appropriateness and determinants of proper administration technique of ocular hypotensive agents among glaucoma patients in Menelik II Referral Hospital, Ethiopia

Introduction: Appropriate administration of ocular hypotensive agents is required to lower an elevated intraocular pressure, prevent progressive damage of optic nerve head and visual field loss.

Objective: The main purpose of the study was to assess appropriateness of administration technique of ocular hypotensive agents and to identify factors associated with the proper technique.

Methods: A hospital-based cross-sectional study was conducted among 359 study participants in Menelik II Referral Hospital from June, 2015 to July 3, 2015. Eligible patients were interviewed and their medical charts were reviewed using a pretested structured questionnaire. Administration technique was assessed using nine-items of World Health Organization guide and associated factors were identified using multivariate binary logistic regression analysis. The association was declared significant at p<0.05.

Results: The rate of appropriate administration technique was 17.3%. Patients with advanced glaucoma (AOR=3.46, 95% CI: 1.09-10.97, p<0.035) and who had a more frequent follow-up (AOR=5.94, 95% CI: 1.19-29.62, p<0.030) were significantly associated with the appropriate administration technique. Patients with primary angle closure glaucoma (AOR=0.0, 95% CI: 0.00-0.25, p<0.022) and open angle glaucoma (AOR=0.0, 95% CI: 0.00-0.36, p<0.027), who immediately administered a second drop (AOR=0.0, 95% CI: 0.01-0.58, p<0.027), who experienced a side effect (AOR=0.13, 95% CI: 0.02-0.92, p<0.041) and who had low vision (AOR=0.0, 95% CI: 0.00-0.37, p<0.024) were inversely associated with the technique.

Conclusion: The administration technique was poor and sub-optimal according to the World Health Organization guide. Adoption and implementation of the guide are required to improve the instillation proficiency and optimize the glaucoma therapy.