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Indian J OphthalmolIndian J OphthalmolIJOIndian Journal of Ophthalmology0301-47381998-3689Medknow Publications & Media Pvt Ltd India IJO-66-122910.4103/ijo.IJO_80_18Letters to the EditorDeterminants of medication adherence to topical ocular hypotensives and application of health belief model among glaucoma patients visiting a tertiary care hospital in coastal Karnataka, India Kaup Soujanya Oomman Sithara Sara Shivalli Siddharudha 1Department of Ophthalmology, Yenepoya Medical College, Yenepoya University, Mangalore, Karnataka, India1 Department of Public Health, Yenepoya Medical College, Yenepoya University, Mangalore, Karnataka, India
Correspondence to: Dr. Soujanya Kaup, 2-98/11, “Shreeshaila,” Gurunagar, Maryhill, Mangalore - 575 008, Karnataka, India. E-mail: drsoujanyak@gmail.com8 2018 66 8 1229 1230 Copyright: © 2018 Indian Journal of Ophthalmology2018This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
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Sir,

The health belief model (HBM) is a classical behavior theory that explains health behaviors. It contains cognitive constructs (including perceived susceptibility, benefits, barrier; cues to action, and self-efficacy) that predict why people take actions to control their illnesses.[1234] Applicability of HBM in glaucoma medication adherence has not been explored fully among the Indian population. An attempt was made to discover this using a semi-structured, pretested, interview schedule based on HBM.

The following HBM-related factors [Fig. 1] were associated with low adherence: poor understanding of the disease and importance of medications, lack of self-efficacy (individual belief regarding their capabilities to carry out a specific task to achieve a desired outcome),[5] side effects of glaucoma medications, additional medications for other comorbidities, lack of family and social support, and no follow-up visit in the past 6 months.

Figure 1 Health belief model and glaucoma medication adherence

By understanding the cognitive constructs of poor adherence behavior, we can circumvent them by formulating a targeted approach. The physician can play a key role by educating the patient about the nature of the disease, its prognosis with emphasis on the impact of medication and their expected side effects. Patients have to be trained to self-administer the drops. The family of the patient needs to be involved in the treatment plan.

Financial support and sponsorship
Nil.

Conflicts of interest
There are no conflicts of interest.
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