Adherence with Topical Glaucoma Medication Monitored Electronically

Okeke, Constance; Quigley, Harry A.; Jampel, Henry D.; Ying, Gui Shuang; Plyler, Ryan J.; Jiang, Yuzhen; Friedman, David S.

doi:10.1016/j.ophtha.2008.09.004

Cited by 263 publications

(254 citation statements)

References 37 publications

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“…In some instances patients reported missing no drops when their TDA indicated o40% adherence. Similar disparities between reported and objective measures of adherence have been given by Okeke 10 and Kass 2 and this paper confirms their conclusions, that relying upon patient reports of adherence is prone to error.…”

Section: Discussionsupporting

confidence: 88%

“…This finding is similar to that of other groups reporting on the TDA. 10,11 However, this figure of 480% adherence does not adequately describe adherence within our whole cohort. Of the 34 patients who completed 75 days with the TDA, 3 had adherence rates of less than 40% and there were 3 further patients whose TDA data indicated that they stopped all medication after 3, 37, and 49 days, respectively.…”

Section: Discussionmentioning

confidence: 84%

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Patterns and rate of adherence to glaucoma therapy using an electronic dosing aid

Ajit

Fenerty

Henson

2010

Eye

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Aims and purpose To identify patterns and rates of adherence with travoprost eye drops using the Travatan dosing aid (TDA) and to present a method for graphically presenting adherence data. Methods A prospective observational cohort study of patients on travoprost (prostaglandin) monotherapy. Patients were dispensed a TDA and followed up after approximately 3 months of usage. Data were downloaded from the TDA into a computer for analysis. Analysis used inter-dose intervals (the time between each dosing) to look at adherence between days 4 and 75. Results In all, 100 patients were invited to participate, 53 agreed and complete TDA data sets were obtained from 37. In total 23 of the complete data sets showed good adherence (dosing within ±4 h of the agreed dosing time on 480% of occasions), 3 patients discontinued usage before 75 days, 4 showed frequent drug holidays (no dosing for X8 days) and 7 frequently missed doses with adherence rates of o60%. Of the 16 patients for whom no TDA data was obtained, 5 were lost to follow-up, 4 had faulty/damaged TDAs, 3 changed medication, 3 preferred not to use the TDA, and 1 was hospitalized. Conclusions There were four easily defined patterns of adherence; (1) good adherence; (2) discontinued usage; (3) frequent drug holidays; and (4) frequent missed doses with low adherence rates. A new method for graphically presenting adherence data helps clinicians identify the pattern of usage and is a valuable aid to the overall management of patients on travoprost therapy.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 84%

Patterns and rate of adherence to glaucoma therapy using an electronic dosing aid

Ajit

Fenerty

Henson

2010

Eye

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“…Also, compliance with given medication was not measured. Previous glaucoma studies have shown that compliance with medications is quite low (19), and may be influenced by age (although not a consistent risk factor), cost of medication, and complicated dosing strategies (20). The average age of the patients in our study was 75 years and they were both physically and mentally capable of instilling drops themselves or had caregivers who were able to instill for them.…”

Section: Pattern Of Decrease In Pain Sensation During the First Postimentioning

confidence: 69%

Shortening Ocular Pain Duration following Intravitreal Injections

Rifkin

Schaal

2012

European Journal of Ophthalmology

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Purpose. To determine ocular pain duration after routine in-office intravitreal injection and to determine whether topical eyedrops are beneficial in increasing patient comfort. Methods. Forty injection-naïve patients receiving routine intravitreal injections of bevacizumab for age-related macular degeneration were randomized into 3 groups: group 1 (control, no drops), group 2 (generic artificial tears), and group 3 (ketorolac tromethamine 0.4% eyedrops). Those who received topical medications were given a Visual Analog Pain score survey and asked to record their pain on a scale from 0 (no distress) to 10 (unbearable distress) daily until a score of 0 was achieved, at which point they were instructed to discontinue use of their given drops. Self-reported pain scores were assessed. Results. Pain after routine intravitreal injection lasts on average between 3 and 7 days. Patients receiving topical ketorolac eyedrops reported the fewest average number of pain days (2.25±1.22) vs patients receiving artificial tears (3.54±1.13) or those who received no postprocedure eyedrops (5.13±1.25); p<0.05. At most, patients receiving ketorolac eyedrops reported 3 days of recordable pain. Those who received artificial tears reported at most 5 days of recordable pain, and patients who did not receive any postprocedure eyedrops reported at most 7 days of recordable pain. Conclusions. Pain after intravitreal injection is generally mild, may be reduced by postinjection topical ketorolac eyedrops, and lasts less than 1 week.

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“…It is known that adherence improves with attention, 23 often causing the adherence rate to improve equally in intervention and control groups. 15,24 Education and training in the initial months of commencing therapy helps prevent poor adherence from developing.…”

Section: Discussionmentioning

confidence: 99%

Individualised patient care as an adjunct to standard care for promoting adherence to ocular hypotensive therapy: an exploratory randomised controlled trial

Gray

Fenerty

Harper

et al. 2011

Eye

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Purpose To evaluate the impact of individualised patient care, as an adjunct to standard care, on adherence to ocular hypotensive therapy. Methods A two-arm, single-masked exploratory randomised controlled trial recruited patients newly prescribed ocular hypotensive therapy. The intervention involved an individual assessment of health-care needs and beliefs and a 1-year follow-up period according to need. The primary outcome was refill adherence, measured by collating prescription and dispensing data for 12 months. Secondary outcomes included self-reported adherence, glaucoma knowledge, beliefs about illness and medicines, quality of care, intraocular pressure (IOP) fluctuation, and changes in clinical management assessed at 12 months. The strength of the intervention was measured following withdrawal by reviewing clinical outcomes for a further 12 months. Results In all, 127 patients were recruited (91% response rate). Intervention-arm patients collected significantly more prescriptions than control-arm patients. Self-report adherence was significantly better in the intervention-arm for patients who forgot drops and those who intentionally missed drops. The intervention group demonstrated significantly more glaucoma knowledge, expressed a significantly stronger belief in the necessity of eye drops and believed that they had more personal control over managing their condition. Control-arm patients had more IOP fluctuation and changes in clinical management. However, this finding only reached significance at 24 months. Conclusion Modelling patient care according to health-care needs and beliefs about illness and medicines can have a significant impact on improving adherence to therapy for this patient group, with the potential benefit of improving clinical outcomes.

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Adherence with Topical Glaucoma Medication Monitored Electronically

Cited by 263 publications

References 37 publications

Patterns and rate of adherence to glaucoma therapy using an electronic dosing aid

Patterns and rate of adherence to glaucoma therapy using an electronic dosing aid

Shortening Ocular Pain Duration following Intravitreal Injections

Individualised patient care as an adjunct to standard care for promoting adherence to ocular hypotensive therapy: an exploratory randomised controlled trial

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