Evaluating the effectiveness of motivational interviewing techniques on medication adherence in patients with glaucoma: A systematic review

Glaucoma is a leading cause of irreversible blindness worldwide, and effective management largely depends on long-term adherence to prescribed medications. However, adherence to anti-glaucoma therapy remains suboptimal due to multiple patient-, treatment-, and provider-related factors. This systematic review evaluated the effectiveness of motivational interviewing (MI) techniques in improving medication adherence among patients with glaucoma. A comprehensive search of PubMed, Scopus, Web of Science, and EMBASE was conducted using predefined keywords and the population, intervention, comparison, and outcome framework. Eligible studies published in English within the last 10 years included randomised controlled trials, observational studies, and systematic reviews that assessed MI interventions and reported medication adherence outcomes. A total of 3,912 articles were identified, of which 24 met the inclusion criteria. The findings demonstrated that MI interventions consistently improved medication adherence, with mean adherence increasing from 59.8% at baseline to 74.5% post-intervention, and some studies reporting adherence rates as high as 90%. MI was also associated with improved patient satisfaction, self-efficacy, and eye drop instillation techniques. Common barriers to adherence included forgetfulness, high cost of medications, side effects, complex treatment regimens, and poor patient understanding, while facilitators included improved patient education, motivation, and use of reminder strategies. Despite generally good reporting quality and external validity, many studies showed limitations in internal validity. Overall, MI appears to be an effective, patient-centered approach to enhancing medication adherence in glaucoma management, although sustained benefits may require repeated interventions. Further high-quality studies are recommended to assess long-term effectiveness .