Table 3.

Summary of NGT Steps for Glaucoma Medication Barrier Themes, Examples, and Rank-Ordering Votes Across Focus Groups.

Rank-Ordering Category Themes and Examples of Barriers Nominated Across Groups (Steps 1 & 2)	Rank-Ordering Votes Across Groups (Step 4)	Sum of Rank-Ordering Votes Across Groups (Step 5)
Forgetfulness “Problems remembering to take them right before going to sleep” “Forgetting to take my drops, and how many drops to put in each eye” “I have trouble remembering to put my drops in” “I have a hard time remembering to get my prescription refilled and to put my eye drops in” “Trying to remember the sequence in applying your eye drops” “Forgetting to take drops with me when I go out of town”	Rank 5 Sum = 95; Rank 4 Sum = 40; Rank 3 Sum = 36; Rank 2 Sum = 14; Rank 1 Sum = 6	191
Side effects “Side effects really mess with me (burning, stinging, light sensitivity, red eyes, dry eyes, tired eyes)” “Side effects of headaches” “When I initially put my drops in, I have to wait 30 minutes before I can really see again” “I sometimes over-medicate and have dry, itchy eyes” “Having drops build up in corner of eye, leaving a milky film” “My eyes will burn bad in the morning after taking the drops the night before”	Rank 5 Sum = 45; Rank 4 Sum = 60; Rank 3 Sum = 36; Rank 2 Sum = 24; Rank 1 Sum = 6	171
Cost/affordability “Insurance co-pays and increasing cost if you don’t have insurance” “The price of the brand name versus the generic drug” “Healthcare costs” “My eye drops are expensive” “They are expensive, and I don’t have insurance” “The cost of my prescription”	Rank 5 Sum = 60; Rank 4 Sum = 28; Rank 3 Sum = 6; Rank 2 Sum = 6; Rank 1 Sum = 2	102
Difficulty with drop administration “I have a hard time getting the right amount of drops out of the bottle” “Trying to get my drops in my eye” “It was hard for me initially to put my eye drops in, also holding my eyes open” “I put too much pressure on the bottle and put to much in” “The technique of putting the drops in” “The bottles are small, and I use the drops quickly”	Rank 5 Sum = 40; Rank 4 Sum = 28; Rank 3 Sum = 18; Rank 2 Sum = 8; Rank 1 Sum = 2	96
Eye drop schedule “Trying to take the eye drops at the same time each day is hard for me” “Not following the directions of when to take the eye drops” “I get confused because of the time variation” “The timing of when to put my drops in makes it harder to put my drops in” “Problems falling asleep before I could take all my drops at night” “Taking a lot of drops and trying to coordinate the times to take them”	Rank 5 Sum = 45; Rank 4 Sum = 24; Rank 3 Sum = 6; Rank 2 Sum = 2; Rank 1 Sum = 3	80
Low on eye drop medications “Low on medication, taking only when needed” “Not having enough of my drops & staying within the timeline to purchase the medications” “Staying within the time line to purchase medications” “Running out of the eye drops”	Rank 5 Sum = 10; Rank 4 Sum = 8; Rank 3 Sum = 21; Rank 2 Sum = 4; Rank 1 Sum = 2	45
Lack of understanding or knowledge about eye drop medications and glaucoma “When I was first diagnosed with glaucoma, I didn’t think it was that important to take the drops” “Didn’t think I needed to take the drops in the beginning” “Wondering if they were really working”	Rank 5 Sum = 15; Rank 4 Sum = 8; Rank 3 Sum = 9; Rank 2 Sum = 6; Rank 1 Sum = 1	39
Laziness “Being lazy” “Sometimes I thought I could get away with not using the drops. Sometimes being lazy about using them” “Once I get into bed, if I haven’t already taken the drops, I don’t worry about it”	Rank 5 Sum = 15; Rank 4 Sum = 16; Rank 3 Sum = 3; Rank 2 Sum = 0; Rank 1 Sum = 2	36
Being out/away or traveling “Being hospitalized and not having my drops” “Being out and not knowing if I need to bring it with me” “Not having the drops on me at all times in case I don’t get home before the next dosage is due” “Traveling and leaving my medications at home”	Rank 5 Sum = 5; Rank 4 Sum = 20; Rank 3 Sum = 6; Rank 2 Sum = 2; Rank 1 Sum = 1	34
Quantity of drops to administer “Getting adjusted to taking more than 1 eye drop” “Quantity”	Rank 5 Sum = 15; Rank 4 Sum = 4; Rank 3 Sum = 0; Rank 2 Sum = 4; Rank 1 Sum = 1	24
Being distracted “Distractions” “When my sugar is up, I forget to put my drops in”	Rank 5 Sum = 5; Rank 4 Sum = 4; Rank 3 Sum = 9; Rank 2 Sum = 2; Rank 1 Sum = 0	20
Lack of availability “Pharmacy does not have drops in stock that day” “Availability” “Being in an inaccessible place” “Having to rely on samples and not knowing if I can get the samples”	Rank 5 Sum = 5; Rank 4 Sum = 12; Rank 3 Sum = 0; Rank 2 Sum = 2; Rank 1 Sum = 0	19
Listening to or observing others’ experiences “Listening to my friends at first made me scared to take my drops” “It made me fearful that my kids had it and it looked like the drops weren’t doing them any good, so I figured they might not work for me either” “I stopped taking my eye drops because a man told me my eye drops were drugs with marijuana in it”	Rank 5 Sum = 0; Rank 4 Sum = 8; Rank 3 Sum = 3; Rank 2 Sum = 2; Rank 1 Sum = 1	14
Communication with doctor “Lack of communication for the doctor” “Doctor told me to stop taking my drops”	Rank 5 Sum = 10; Rank 4 Sum = 4; Rank 3 Sum = 0; Rank 2 Sum = 0; Rank 1 Sum = 0	14
Contamination “Eye drops became contaminated”	Rank 5 Sum = 10; Rank 4 Sum = 0; Rank 3 Sum = 3; Rank 2 Sum = 0; Rank 1 Sum = 0	13
Busy personal schedule “Being real busy at work”	Rank 5 Sum = 5; Rank 4 Sum = 4; Rank 3 Sum = 0; Rank 2 Sum = 0; Rank 1 Sum = 0	9
Other health issues “Being tired and overwhelmed with other health issues”	Rank 5 Sum = 5; Rank 4 Sum = 4; Rank 3 Sum = 0; Rank 2 Sum = 0; Rank 1 Sum = 0	9
Changing eye medications “Getting used to the change of one drug to another”	Rank 5 Sum = 5; Rank 4 Sum = 4; Rank 3 Sum = 0; Rank 2 Sum = 0; Rank 1 Sum = 0	9
Difficulty accepting glaucoma diagnosis “Hard time accepting that I had glaucoma”	Rank 5 Sum = 5; Rank 4 Sum = 0; Rank 3 Sum = 0; Rank 2 Sum = 2; Rank 1 Sum = 0	7
Having to refrigerate drops	Rank 5 Sum = 5; Rank 4 Sum = 0; Rank 3 Sum = 0; Rank 2 Sum = 0; Rank 1 Sum = 1	6
Not feeling any pain	Rank 5 Sum = 5; Rank 4 Sum = 0; Rank 3 Sum = 0; Rank 2 Sum = 0; Rank 1 Sum = 0	5
Difficulty reading print size on label “I have a hard time seeing the print on the label to know how to correctly put drops”	Rank 5 Sum = 5; Rank 4 Sum = 0; Rank 3 Sum = 0; Rank 2 Sum = 0; Rank 1 Sum = 0	5
Managing other eye care issues “I have to take my prosthetic eye out, clean it, and have to put drops in it also, and it makes it harder”	Rank 5 Sum = 5; Rank 4 Sum = 0; Rank 3 Sum = 0; Rank 2 Sum = 0; Rank 1 Sum = 0	5
Poor tracking of prescription “I don’t keep track of my prescriptions and sometimes I run out”	Rank 5 Sum = 0; Rank 4 Sum = 0; Rank 3 Sum = 0; Rank 2 Sum = 4; Rank 1 Sum = 0	4
Eye surgery “It was painful to put my drops in right eye after surgery”	Rank 5 Sum = 0; Rank 4 Sum = 4; Rank 3 Sum = 0; Rank 2 Sum = 0; Rank 1 Sum = 0	4
Problems with insurance coverage “The pharmacist wont’ give the brand name and my insurance only covers the generic not the brand name”	Rank 5 Sum = 0; Rank 4 Sum = 4; Rank 3 Sum = 0; Rank 2 Sum = 0; Rank 1 Sum = 0	4
Taking eye drops too often	Rank 5 Sum = 0; Rank 4 Sum = 4; Rank 3 Sum = 0; Rank 2 Sum = 0; Rank 1 Sum = 0	4
Taking steroids (prednisone)	Rank 5 Sum = 0; Rank 4 Sum = 0; Rank 3 Sum = 0; Rank 2 Sum = 0; Rank 1 Sum = 1	1
Having multiple eye doctors “I was going to several clinics and getting too many drops”	Rank 5 Sum = 0; Rank 4 Sum = 0; Rank 3 Sum = 0; Rank 2 Sum = 0; Rank 1 Sum = 1	1
Thought eye drops were contributing to my headaches	Rank 5 Sum = 0; Rank 4 Sum = 0; Rank 3 Sum = 0; Rank 2 Sum = 0; Rank 1 Sum = 1	1

Note. A maximum of up to 6 examples per theme were listed.