Could Religious Beliefs Affect Compliance With Ocular Treatment?

The effectiveness of glaucoma treatment, in particular, often depends on patients' ability and willingness to self-administer eye drop medications on a regular schedule over months or years. Glaucoma patients often notice no symptoms in the early stages of the disease, which poses challenges for physicians in motivating patients to stick to treatment regimens. If patients neglect treatment until their vision noticeably declines, the damage is often irreversible.

Many of the world's religions practice obligatory or voluntary fasting---abstaining from food and often also fluid---during periods that can last from a few days to more than a month, on an annual basis.

Researchers led by Nishant Kumar, MBBS, of the University Hospital, Liverpool, UK, studied patient compliance in relation to fasting by analyzing 350 surveys completed by members of the worlds' major faiths: Islam, Hinduism, Jainism, Christianity, Judaism, Bahai, and Buddhism (50 surveys per religion)—the first study of its kind, the researchers believe. Population reports show that approximately 20 percent of the world's people are Muslim and about 15 percent are Hindu; fasting is important to both religions. It is mandatory during the daylight hours of the month of Ramadan for Muslims; for Hindus fasting is generally voluntary.

Dr. Kumar's team previously surveyed Muslim patients on their use of prescribed eye drops during Ramadan and concluded that treatment compliance was significantly reduced in patients who kept the fast. If patients reduced or stopped their glaucoma treatment for an extended period, such as the month of Ramadan or other continuous fasting periods, their vision could be adversely affected.

In the new survey, the majority of patients self-identified as Hindus, Muslims and Jains stated that the use of eye drops during their fasting hours would break their fast, and therefore they would not use drops while fasting. However, these patient groups said they would be more likely to use drops while fasting for painful eye conditions or if vision was affected. The majority of Christian, Buddhist, Bahai and Jewish survey respondents did not believe that using drops would break their fasts, and stated that they would use eye drops during their fasting periods.

Dr. Kumar concludes: "A broad awareness among ophthalmologists regarding the religious beliefs of the patient groups they treat will allow them to formulate management plans in keeping with these beliefs without compromising care." He adds that medical specialties such as hematology, neurology, endocrinology, in the treatment of diabetes, have led the way in developing such management strategies.

This research was presented at the 2008 Joint Meeting of the American Academy of Ophthalmology (Academy) and European Society of Ophthalmology (SOE ) that runs November 8 to 11 at the Georgia World Congress Center, Atlanta.