Improved Glaucoma Medication Adherence in a Randomized Controlled Trial

Muir, Kelly W.; Rosdahl, Jullia A; Hein, Aaron; Woolson, Sandra; Olsen, Maren K.; Kirshner, Miriam; Sexton, Malina; Bosworth, Hayden B.

doi:10.1016/j.ogla.2021.04.006

Cited by 18 publications

(8 citation statements)

References 22 publications

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“…Okeke et al3 used an educational video, a compliance meeting with a study coordinator, phone calls, and electronic reminders to increase adherence rates from 54 to 73%. Likewise, a recent study by Muir et al26 found that a multifaceted intervention with glaucoma education, personalized disease management suggestions and a reminder aid was able to significantly improve adherence rates from 62 to 85%. Complex interventions have been found to improve adherence in other chronic medical diseases as well 27.…”

Section: Discussionmentioning

confidence: 95%

Eye Drop Adherence With an Eye Drop Bottle Cap Monitor

Kinast

Sanchez

Rees

et al. 2022

Journal of Glaucoma

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Précis: An eye drop bottle cap monitor with audio and visual alarms measured eye drop adherence in 50 subjects with glaucoma. Baseline adherence rates were too high to test if the alarms could improve adherence.Purpose: To determine if an eye drop bottle cap monitor can measure and improve adherence. Materials and Methods:The Devers Drop Device (D3, Universal Adherence LLC) was designed to measure eye drop adherence by detecting bottle cap removal and replacement, and it can provide text, visual and audio alerts when a medication is due. In Stage 1, we determined baseline adherence for 50 subjects using a nightly eye drop over a 25-day period. Subjects with less than 90% baseline adherence were eligible for Stage 2. In Stage 2, we randomized subjects to receive either no reminder or automated D3 alerts for their nightly eye drop over a subsequent 25-day period. We defined adherence as the proportion of drops administered within 3 hours of the subjects' scheduled dosing time. Subjects completed 3 questions regarding satisfaction with the device and willingness to pay. Results:The D3 monitor remained attached to the eye drop bottle cap for the duration of the study and collected adherence data in all 50 patients. In Stage 1, the mean adherence rate was 90 ± 18% (range 32-100%). Forty (80%) subjects had an adherence rate greater than 90%. Adherence rates were too high in Stage 1 to adequately test the effects of reminders in Stage 2. Ninety-eight percent (49/50) and 96% (48/50) of subjects agreed "the device always stayed attached to the bottle cap" and "I was able to use the device to take the drops", respectively. Patients would pay $61 ± 83 (range $0-400) for a similar device to improve adherence. Conclusions:The D3 can measure eye drop adherence. Research subjects reported high satisfaction and willingness to pay for an eye drop bottle cap monitor. Glaucoma patients have high adherence when they are being monitored, and future studies with research subjects screened for poor adherence may further determine the benefit of electronic monitoring of adherence with and without electronic reminders.

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Section: Discussionmentioning

confidence: 95%

Eye Drop Adherence With an Eye Drop Bottle Cap Monitor

Kinast

Sanchez

Rees

et al. 2022

Journal of Glaucoma

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“…Authorship of patient education materials written at appropriate reading levels can facilitate patient understanding. Personalized coaching and individualized risk discussions were also shown to improve glaucoma medication adherence in the Support, Educate, Empower (SEE) and Medication Adherence in Glaucoma to Improve Care (MAGIC) trials 22,23. Clinicians may consider these strategies particularly for patients with LHL.…”

Section: Discussionmentioning

confidence: 99%

Association of Health Literacy and Health Care Utilization Among Glaucoma Patients

Cheng

Tanna

2022

Journal of Glaucoma

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Précis: Among 7846 adults with self-reported glaucoma, low health literacy (LHL) was associated with fewer outpatient ophthalmological follow-up visits, utilization of a greater number of ocular hypotensive medication classes, and higher costs for glaucoma medications.Purpose: Previous studies found LHL is associated with increased difficulty with treatment adherence among adults with glaucoma, which can lead to poor outcomes. This study examined patterns of glaucoma health care utilization associated with LHL.Methods: We analyzed 7846 adults with self-reported glaucoma enrolled in the 1996-2017 Medical Expenditure Panel Survey. Adult glaucoma patients with LHL (defined by National Assessment of Adult Literacy score <226) were the compared with those with high health literacy. Multivariable regression models were constructed to examine the association of LHL with number of outpatient glaucoma visits, prescription medications, polypharmacy ( ≥ 2 ocular hypotensive classes prescribed), and associated costs.Results: Self-reported glaucoma diagnosis was associated with higher rates of LHL [23.9% vs. 9.7%, odds ratio (95% CI): 2.43 (2.25-2.62), P < 0.0001]. Among those with glaucoma, LHL was associated with fewer glaucoma outpatient visits [risk ratio: 0.94 (0.89-0.99), P = 0.02] and the use of a greater number of ocular hypotensive medications [1.06 (1.01-1.12), P = 0.03]. Moreover, those with LHL had higher health care spending on prescription medications

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“…Furthermore, other studies have not shown the same association between race and medication adherence. [86][87][88] The difference in adherence rates among racial and ethnic minorities may be in part explained by the work of Delavar et. al, which found in their retrospective cross-sectional study that non-Hispanic African American and Hispanic individuals were more likely to report not being able to afford medications than their non-Hispanic White counterparts even when controlling for other social factors, including income.…”

Section: Medication Access and Treatment Adherencementioning

confidence: 99%

Social determinants of health and health disparities in glaucoma: A review

Acuff,

Wu,

Varkhedi

et al. 2024

Clinical Exper Ophthalmology

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Social determinants of health and barriers to care can significantly impact patients' access to glaucoma care and treatment, resulting in disparities within disease presentation, progression, management, and treatment outcomes. The widespread adoption of electronic health record systems has allowed researchers and clinicians to further explore these relationships, identifying factors such as race, ethnicity, and socioeconomic status to be risk factors for more severe disease and lower treatment adherence. These disparities highlight potential targets for interventions to combat these disparities and improve overall patient outcomes. This article provides a summary of the available data on health disparities within glaucoma disease presentation, progression, management, treatment, and outcomes and discusses interventions to improve care delivery and outcomes among patients with glaucoma.

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Improved Glaucoma Medication Adherence in a Randomized Controlled Trial

Cited by 18 publications

References 22 publications

Eye Drop Adherence With an Eye Drop Bottle Cap Monitor

Eye Drop Adherence With an Eye Drop Bottle Cap Monitor

Association of Health Literacy and Health Care Utilization Among Glaucoma Patients

Social determinants of health and health disparities in glaucoma: A review

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