Medical management of primary open-angle glaucoma: Best practices associated with enhanced patient compliance and persistency

Kulkarni, Sadhana V.; Damji, Karim F.; Buys, Yvonne M.

doi:10.2147/ppa.s4163

Cited by 39 publications

(35 citation statements)

References 45 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…To be clinically relevant, an 'acceptable' adherence level should be determined by its impact on clinical outcome. 10 Such evidence is lacking for ocular hypotensives due to the requirement for long-term follow-up and known inaccuracies in determining IOP control, 12 visual field defects, or optic nerve damage. However, a recent cross-sectional glaucoma study in the United States found that participants with adherence rates o80%, according to a medication event monitoring system (MEMS), had worse visual field defects than those with adherence rates Z80%.…”

Section: Introductionmentioning

confidence: 99%

Patterns of adherence behaviour for patients with glaucoma

Cate

Bhattacharya

Clark

et al. 2013

Eye

View full text Add to dashboard Cite

Aims and purpose Adherence to long-term treatment regimens for primary open-angle glaucoma holds a challenge for both clinicians and patients. The study aims were to (i) establish the magnitude of travoprost non-adherence using an Electronic Adherence Monitor (EAM), (ii) compare electronic with patient self-reported adherence, and (iii) explore the application of a previously reported method of graphically presenting adherence data to a larger cohort over a longer monitoring period. Methods A cohort study of patients using travoprost for glaucoma or ocular hypertension was conducted. All participants used an EAM and adherence data were collected prospectively for 2 months. Selfreported adherence was obtained using the Morisky Medication Adherence Scale (MMAS); patients also reported frequency of missed doses. Potential predictors of adherence were collected via a structured interview. EAM-recorded interdose intervals were plotted graphically. Results Of 100 patients invited to participate, 98 consented and EAM data were collected successfully from 88 participants. The median EAM adherence score for the cohort was 88.9% (interquartile range: 71.2, 92.2). When dichotomised (Z80%: adherent; o80%: non-adherent), EAM identified 36.7% as non-adherent and MMAS 12.2%. EAM data were used to classify five types of adherence behaviour including a category representing levels of Z97% maintained by 21% of participants. Conclusion EAM revealed good adherence to glaucoma monotherapy but poor agreement with patient self-reported adherence. An adherence category of persistent and exceptionally high adherence to travoprost over a 2-month period was identified.

show abstract

Section: Introductionmentioning

confidence: 99%

Patterns of adherence behaviour for patients with glaucoma

Cate

Bhattacharya

Clark

et al. 2013

Eye

View full text Add to dashboard Cite

show abstract

“…Unfortunately, the preservatives present in these medications cause the development of, or exacerbates, OSD. Preservative-induced OSD causes ocular discomfort and dryness and may account for non-compliance to glaucoma treatment 53 (up to 64% in one study). 54 The development of preservative-free topical anti-glaucoma medications such as Timabak (Théa, Paris, France) and Zioptan (Merck, Whitehouse Station, NJ, USA) has provided a solution to avoid the adverse effects of preservatives.…”

Section: Discussionmentioning

confidence: 99%

Effect of chronic anti-glaucoma medications and trabeculectomy on tear osmolarity

Lee

Wong

Chua

et al. 2013

Eye

View full text Add to dashboard Cite

Purpose To evaluate the tear film osmolarity (TFO) and ocular surface clinical signs and symptoms in chronically medicated glaucoma patients and post-trabeculectomy patients. Methods This is a single-center, prospective case-controlled study. One-hundred and thirty eyes of 130 participants aged Z45 years were included (49 normal controls, 50 glaucoma patients on chronic preserved antiglaucoma medication Z6 months, and 31 post-trabeculectomy patients not on medication Z6 months). TFO, tear break-up time (TBUT), Schirmer's test I and dry eye symptoms were evaluated. Data from both groups of glaucoma patients were compared with age and sex-matched controls. Logistic regression was performed to calculate the odds ratios. Results Mean TFO in the three groups were 301.4 ± 7.7, 307.0 ± 9.3, and 307.4 ± 11.6 mOsm/l, respectively. Compared with normal controls, chronically medicated glaucoma patients and post-trabeculectomy patients were more likely to have a raised TFO, with odds ratios (95% CI) of 4.43 (1.74-11.32) and 2.76 (1.02-7.94), respectively. Both groups of glaucoma patients were also more likely to experience dry eye symptoms, with ORs of 4.72 (1.92-11.59) and 4.24 (1.54-11.72). There was no significant difference in TFO and symptoms between both groups of glaucoma patients, and in TBUT and Schirmer's test across all three groups. Conclusions Patients on chronic topical antiglaucoma medication and posttrabeculectomy patients were more likely to have raised TFO and dry eye symptoms, suggesting significant ocular surface disease. Glaucoma practitioners should be aware that dry eye symptoms and raised TFO may occur in the absence of TBUT and Schirmer's test abnormality.

show abstract

“…How this may occur is unknown. As to clinical relevance, studies reveal that patients are highly complaint to tailored exercise regimens (mean age of 70 [39][40][41][42][43] ) and that RD patients are nearly 100% compliant in following tailored prescriptions from retina specialists. 41 This suggests that RD patients may benefit more from exercise than other patient groups as they may adhere to exercise "prescriptions.…”

Section: Exercise May Be Beneficial To Retina and Visionmentioning

confidence: 99%