Aiding Adherence to Glaucoma Medications: A Systematic Review

Buehne, Kristen L.; Rosdahl, Jullia A; Muir, Kelly W.

doi:10.1080/08820538.2021.1963788

Cited by 7 publications

(5 citation statements)

References 66 publications

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“…The explanation is further supported by the majority negative outcomes of previously published studies, those of which do systematically examine glaucomatous disease progression. As described in a recent review, only 14 of the 42 identified glaucoma adherence studies examined clinical outcomes of the used glaucoma adherence tools [15]. Thirteen of these same 14 studies lasted 12 months or less (the 14th study was 24 months), and only 3 of 14 found positive clinical outcomes [15].…”

Section: Discussionmentioning

confidence: 99%

“…As described in a recent review, only 14 of the 42 identified glaucoma adherence studies examined clinical outcomes of the used glaucoma adherence tools [15]. Thirteen of these same 14 studies lasted 12 months or less (the 14th study was 24 months), and only 3 of 14 found positive clinical outcomes [15]. The results of our analyses do not dispute this trend; instead, they strongly argue that not only does clinical impact need to be addressed in adherence trials but that more time is needed to adequately assess these outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…Alternatively, the 6-month-long intervention may not have been long enough to impact the clinical outcomes, or the intervention’s benefit may have worn off in the following 6 months of time; perhaps a “booster” intervention might be needed to reenforce the previously developed habits. Again, based on the current literature, studies that evaluate clinical outcomes vary widely in time to assess outcomes, with little correlation between time and effectiveness of the intervention [15]. Consequently, a second lesson from this analysis is to consider how a gap between intervention and measured clinical outcomes might affect results, with the goal of minimizing a gap’s size to remove a potential confounding factor.…”

Section: Discussionmentioning

confidence: 99%

“…Ranging from individualized education sessions and reminder phone calls to smartphone apps and visual chart aids, developers try to provide aid for those who struggle to consistently take their eye drops [4, 14]. However, only a few studies have examined the association between their interventions and clinical outcomes (fourteen of 42 in a recent review), with all but one having a follow-up period of 12 months or less [15]. Additionally, these reports do not consistently show positive results [16]; only three of the aforementioned 14 found improvements in intraocular pressure (IOP) [15].…”

Section: Introductionmentioning

confidence: 99%

“…However, only a few studies have examined the association between their interventions and clinical outcomes (fourteen of 42 in a recent review), with all but one having a follow-up period of 12 months or less [15]. Additionally, these reports do not consistently show positive results [16]; only three of the aforementioned 14 found improvements in intraocular pressure (IOP) [15]. This implies that while some interventions do appear to impact adherence, their effect on disease progression has not been consistently shown.…”

Section: Introductionmentioning

confidence: 99%

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How Medication Adherence Affects Disease Management in Veterans with Glaucoma: Lessons Learned from a Clinical Trial

et al. 2023

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Introduction: We conducted a secondary, real-world clinical assessment of a randomized controlled trial to determine how a glaucoma medication adherence intervention impacted the clinical outcomes of participants at 12 months post randomization. Participants included veterans at a VA eye clinic with medically treated glaucoma who reported poor adherence, and their companions if applicable. Methods: The treatment group received a glaucoma education session with drop administration instruction, and virtual reminders from a “smart bottle” (AdhereTech) for their eye drops. The control group received a general eye health class, and the smart bottle with the reminder function turned off. Medical chart extraction determined if participants in each group experienced visual field progression, additional glaucoma medications, or a recommendation for surgery or laser due to inadequate intraocular pressure (IOP) control over the 12 months following randomization. The main outcome measure was disease progression, defined as visual field progression or escalation of glaucoma therapy, in the 12 months following randomization. Results: Thirty-six vs. 32% of the intervention (n=100) vs. control (n=100) group, respectively experienced disease intensification. There was no difference between the intervention and control groups in terms of intensification, [Intervention vs. Control Group Odds Ratio: 1.20, 95% Confidence Interval: (0.67, 2.15)], including when age, race, and disease severity were accounted for in the logistic regression model. Those whose study dates included time during the COVID-19 pandemic were evenly distributed between groups. Conclusions: A multi-faceted intervention that improved medication adherence for glaucoma for 6 months did not affect the clinical outcomes measured at 12 months post randomization. Twelve months may not be long enough to see the clinical effect of this intervention or more than 6 months of intervention are needed.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%