Glaucoma Medication Adherence

Muir, Kelly W.; Lee, Paul P.

doi:10.1001/archophthalmol.2010.351

Cited by 42 publications

(28 citation statements)

References 17 publications

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“…Regardless of number of medications, patient adherence to treatment regimens has long been documented to be low 20, 21. Thus, the study's measurement of preoperative and postoperative unmedicated IOP is clinically very valuable, as it reflects the effect of iStent inject alone, in the absence of medications or cataract surgery.…”

Section: Discussionmentioning

confidence: 99%

Implantation of two second‐generation trabecular micro‐bypass stents and topical travoprost in open‐angle glaucoma not controlled on two preoperative medications: 18‐month follow‐up

Berdahl

Voskanyan

Myers

et al. 2017

Clinical Exper Ophthalmology

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ImportanceAdditional data are sought regarding treatment options for glaucoma, a major cause of global blindness.BackgroundThe study assessed outcomes following standalone implantation of two second‐generation trabecular micro‐bypass stents and postoperative topical prostaglandin in eyes with open‐angle glaucoma not controlled on two preoperative medications.DesignThe study design is a prospective, nonrandomized, open‐label study at a tertiary‐care ophthalmology centre.ParticipantsSubjects had open‐angle glaucoma with preoperative intraocular pressure of 18–30 mmHg on two medications, a medication washout phase, and post‐washout intraocular pressure of 22–38 mmHg. All subjects (N = 53) have been followed for 18 months.MethodsOne day following implantation of two second‐generation trabecular micro‐bypass stents, subjects started topical travoprost. Medication washout was repeated at month 12.Main Outcome MeasuresThe main outcome measure was the proportion of eyes with intraocular pressure reduction ≥ 20% versus medicated baseline intraocular pressure with reduction of one medication at 12 months.ResultsAt 12 months, 91% of eyes achieved intraocular pressure reduction ≥ 20% with reduction of one medication. All eyes had intraocular pressure ≤ 18 mmHg with reduction of one medication, and 87% had intraocular pressure ≤ 15 mmHg. Mean intraocular pressure on one medication was ≤ 13.0 mmHg (≥ 34% reduction) through 18 months. Mean post‐washout intraocular pressure at month 13 was 33% lower than preoperative unmedicated intraocular pressure. No adverse events occurred through 18 months.Conclusions and RelevanceIn open‐angle glaucoma eyes on two preoperative medications, treatment with two second‐generation trabecular stents and one postoperative prostaglandin resulted in mean intraocular pressure ≤ 13 mmHg with reduction of one medication, with favourable safety. These findings show the utility of second‐generation trabecular bypass with postoperative prostaglandin in patients with open‐angle glaucoma.

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Section: Discussionmentioning

confidence: 99%

Implantation of two second‐generation trabecular micro‐bypass stents and topical travoprost in open‐angle glaucoma not controlled on two preoperative medications: 18‐month follow‐up

Berdahl

Voskanyan

Myers

et al. 2017

Clinical Exper Ophthalmology

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“…28 Some studies have quantified adherence using self-reported measures. Kass and colleagues compared patient self-reported glaucoma medication adherence with an electronic eye drop monitor and found that patients reported they were 97% adherent with their medications while the monitor revealed only a 76% rate of adherence.…”

Section: Introductionmentioning

confidence: 99%

“…Furthermore, the MEMS cap is subject to observation bias as subjects often improve their adherence when they are aware that their behavior is being recorded. 28 Despite the known limitations of using MEMS to quantify adherence, this measure is often viewed as the gold standard relative to other measures.…”

Section: Introductionmentioning

confidence: 99%

“…32 Pharmacy data can also be used to calculate persistence or the amount of time before a patient has a gap in recommended treatment, with Days Without Medication (DWM) quantifying this gap. 28 There are several limitations for using pharmacy data to measure adherence, including the uncertainty whether a medication was prescribed to be used in one eye or both eyes. The assumption is often made that the medication was prescribed for both eyes, but that would underestimate the MPR if the medication was prescribed for monocular use.…”

Section: Introductionmentioning

confidence: 99%

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Systematic Review of Educational Interventions to Improve Glaucoma Medication Adherence

Newman-Casey¹,

Weizer²,

Heisler³

et al. 2013

Seminars in Ophthalmology

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Adherence to prescribed glaucoma medications is often poor, and proper adherence can be challenging for patients. We systematically reviewed the literature and identified eight studies using educational interventions to improve glaucoma medication adherence. Overall, five of the eight studies found that educational interventions lead to a significant improvement in medication adherence, and the remaining studies found a trend towards improvement. Using information from this systematic review and Health Behavior Theory, we constructed a conceptual framework to illustrate how counseling and education can improve glaucoma medication adherence. More rigorous studies grounded in Health Behavior Theory with adequately powered samples and longer follow-up are needed.

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“…3–6 Methods of measuring adherence include self-report, pharmacy refill records, electronic monitors, and direct observation of eye drop instillation. 7–9 Although no one measure captures every aspect of adherence to the prescribed treatment regimen, electronic medication monitors record the date and time that the medication is accessed by the patient, allowing for estimates of time-appropriate dosing and overall medication use. 6 Previously, electronic medication monitors have been used to evaluate adherence to ophthalmic medications for children undergoing treatment for myopia 10,11 but not for management of glaucoma.…”

mentioning

confidence: 99%

Influence of Parental Health Literacy and Dosing Responsibility on Pediatric Glaucoma Medication Adherence

Freedman¹

2012

Arch Ophthalmol

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Objective To assess glaucoma medication adherence in children, hypothesizing that poor parental health literacy and eye drop instillation by the child are associated with worse adherence. Methods This prospective, observational study enrolled pediatric patients with glaucoma who were prescribed eye drops. Parent(s) reported who was responsible for eye drop instillation (parent vs child), took the Rapid Estimate of Adult Literacy in Medicine, and were instructed on the use and purpose of the Medication Event Monitoring System. Calculations included average adherence (proportion of prescribed doses taken), dosing errors (number of overdosing or underdosing events in 24 hours), and proportion of doses taken on schedule (doses taken within 2 hours of prescribed dosing interval). Results are reported as mean (SD) or median. Results The study included 46 of the 50 enrolled children who used the Medication Event Monitoring System for 30 days or more. Adherence ranged from 43% to 107% (93%[12%]) and was not associated with age (slope, 0.09 [0.52]; P = .86) but decreased with the parent’s lower health literacy (slope, 0.62 [0.24]; P = .01).The mean number of dosing errors for medications prescribed daily vs twice daily was similar (3.3 vs 2.9; P = .66). The proportion of doses taken on schedule (within 2 hours of prescribed dosing interval) ranged from 3% to 97% (median, 34%; mean, 41% [24%]) and was better when the parent vs the child instilled eye drops (46% [26%] vs 23% [19%]; P < .001). Conclusions Time-dependent glaucoma medication adherence was better when the parent was responsible for eye drop instillation. Overall decreased adherence was associated with decreased parental health literacy. Children of parents with poor health literacy are vulnerable to poor medication adherence; efforts to address poor health literacy may improve outcomes.

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Glaucoma Medication Adherence

Cited by 42 publications

References 17 publications

Implantation of two second‐generation trabecular micro‐bypass stents and topical travoprost in open‐angle glaucoma not controlled on two preoperative medications: 18‐month follow‐up

Implantation of two second‐generation trabecular micro‐bypass stents and topical travoprost in open‐angle glaucoma not controlled on two preoperative medications: 18‐month follow‐up

Systematic Review of Educational Interventions to Improve Glaucoma Medication Adherence

Influence of Parental Health Literacy and Dosing Responsibility on Pediatric Glaucoma Medication Adherence

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