DEPRESSION, ANXIETY, AND TREATMENT ADHERENCE IN PATIENTS WITH PRIMARY OPEN-ANGLE GLAUCOMA

Abstract

Background: Primary open-angle glaucoma (POAG) is a progressive and lifelong treatable chronic optic neuropathy. Psychological comorbidities like depression and anxiety are progressively being identified and can negatively influence treatment compliance, which results in the development of the disease, loss of vision and poor quality of life.

Objectives: To establish the extent of depression and anxiety among POAG patients and their relationship with adherence to the treatment in a tertiary care environment.

Methodology: This cross-sectional study Conducted at Department of Ophthalmology, Bacha khan Medical College, Mardan.kpk Pakistan from jan 2022 to june 2022. 100 POAG patients aged 40 years and above were involved and were chosen according to the consecutive sampling. Patients who had secondary glaucoma or known psychiatric disease were excluded. PHQ-9 and GAD-7 scales were used to determine depression and anxiety, and MMAS-8 was used to determine adherence. SPSS version 25 was used to analyse data. Quantitative variables were represented in the mean, such as the standard deviation, and qualitative variables in frequencies and percentages. Chi-square and independent t-tests were used to test associations.

Results: 100 patients (58 males, 42 females), the mean age was 59.4 ± 10.2 years. Depression and anxiety were observed in 28% and 34% of patients, respectively, while 46% demonstrated poor adherence. Poor adherence was significantly higher in depressed patients (68% vs. 34%; p = 0.003) and in anxious patients (p = 0.01). Mean adherence scores were lower in depressed patients (5.1 ± 1.3) compared to non-depressed individuals (6.8 ± 1.1; p = 0.002). Combined anxiety and depression were associated with the highest non-adherence (72%). Longer disease duration correlated with higher psychological distress and poorer adherence.

Conclusion: In POAG, depression and anxiety are common and have a great effect on treatment adherence. It is possible to enhance adherence and clinical outcomes by incorporating mental health assessment into glaucoma care.