Medication adherence in patients with ocular hypertension or glaucoma

Abstract

Introduction: Nonadherence to medication is a challenge to effective treatment of many chronic diseases, including glaucoma, and persists even with interventions aimed at improving adherence. The reported rates of nonadherence to topical glaucoma medication vary widely from 16% to 67%, and it is estimated that less than a third of patients remained on their initial therapy after 12 months. Nonadherence can lead to disease progression and increased economic burden. Areas covered: This review examines factors that contribute to nonadherence in patients with glaucoma, including the severity of the disease, complexity of treatment, lack of knowledge in patients, poor communications between physician and patient, difficulty with self-administration of drops, sideeffects, and medication costs. We discuss the unique challenges in identifying nonadherence in glaucoma patients and investigate the current approaches to improving adherence. Expert opinion: Strategies for improving adherence should combine new treatment methods with enhanced patient education. New pharmaceuticals may comprise multiple medications in a single bottle, making dosing regimens simpler. Novel drug delivery systems are in development, such as injectable products and implants releasing IOP-lowering medication without the need for self-administration. A comprehensive approach involving these new methods and more effective patient-physician communication may lead to improved adherence.

Comparison of adherence between fixed and unfixed topical combination glaucoma therapies using Japanese healthcare/pharmacy claims database: a retrospective non-interventional cohort study

“…Moreover, other common risk factors were previously identified [ 12 – 14 ]. All of these risk factors need to be solved by education, communication with patients, and patient training in improving proficiency of self-administration of eye drops [ 42 ].…”

“…Risk factors for nonadherence to glaucoma therapies include patients’ problems (financial concern, poor understanding of the disease, and frequent eye drop application), healthcare providers’ issues (insufficient instruction/explanation and assessment of each patient’s conditions), and the relationship between patients and physicians (lack of communication and trust) [ 12 – 14 ]. A previous study reported that a fixed-combination therapy improved the long-term adherence of patients with glaucoma compared with the unfixed therapy [ 15 ].…”

Comparison of adherence and persistence between fixed and unfixed topical combination glaucoma therapies using Japanese healthcare/pharmacy claims database: a retrospective non-interventional cohort study

“…Moreover, other common risk factors were previously identi ed. [12][13][14] All of these risk factors need to be solved by education, communication with patients, and patient training in improving pro ciency of self-administration of eye drops. 42 Speci c reasons on why physicians prescribed un xed combinations for certain patients would be interesting to identify.…”

“…10,11 Risk factors for nonadherence to glaucoma therapies include patients' problems ( nancial concern, poor understanding of the disease, and frequent eye drop application), healthcare providers' issues (insu cient instruction/explanation and assessment of each patient's conditions), and the relationship between patients and physicians (lack of communication and trust). [12][13][14] A previous study reported that a xed-combination therapy improved the long-term adherence of patients with glaucoma compared with the un xed therapy. 15 According to a nationwide survey performed in 2011-2012 in Japan using a questionnaire, good adherence to IOP-lowering eye drops was observed in 72.4% of patients.…”

Comparison of adherence between fixed and unfixed topical combination glaucoma therapies using Japanese healthcare/pharmacy claims database: A retrospective non-interventional cohort study

“…10,11 Risk factors for nonadherence to glaucoma therapies include patients' problems ( nancial concern, poor understanding of the disease, and frequent eye drop application), healthcare providers' issues (insu cient instruction/explanation and assessment of each patient's conditions), and the relationship between patients and physicians (lack of communication and trust). [12][13][14] A previous study reported that a…”