Monitoring adherence rates in glaucoma patients using the Travatan Dosing Aid. A 6-month study comparing patients on travoprost 0.004% and patients on travoprost 0.004%/timolol 0.5% fixed combination

Rossi, Gemma Caterina Maria; Pasinetti, Giulio Maria; Scudeller, Luigia; Tinelli, Carmine; Milano, Giovanni; Bianchi, Paolo Emilio

doi:10.1517/14656561003601994

Cited by 17 publications

(7 citation statements)

References 29 publications

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“…A number of factors, such as inadequate patient education, complexity of treatment regimens, side effects of medications, and challenges with regular and correct instillation of eye drops, have been identified as possible barriers to optimal adherence. 40 – 43 Studies have suggested that persistence with glaucoma medications is also low when multiple medications are required. 44 – 46 Fixed-combination therapies, including BBFC, can potentially alleviate a number of these issues.…”

Section: Discussionmentioning

confidence: 99%

Clinical effectiveness of brinzolamide 1%–brimonidine 0.2% fixed combination for primary open-angle glaucoma and ocular hypertension

Trikha¹,

Perera²,

Aung³

2015

OPTH

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The main first-line treatment strategy for glaucoma is to reduce intraocular pressure (IOP) by topical ocular hypotensive medications, but many patients require multiple medications for adequate IOP control. Fixed-combination therapies provide several benefits, including simplified treatment regimens, theoretical improved treatment adherence, elimination of the potential for washout of the first drug by the second, and the reduction in ocular exposure to preservatives. β-Adrenoceptor antagonists (particularly 0.5% timolol) are the most commonly used agents in combination with other classes of drugs as fixed-combination eyedrops, but they are contraindicated in many patients, owing to local allergy or systemic side effects. A fixed-combination preparation without a β-blocker is therefore warranted. This paper reviews the clinical effectiveness of brinzolamide 1% and brimonidine 0.2% fixed combination (BBFC) for use in patients with primary open-angle glaucoma and ocular hypertension. We searched PubMed and the ClinicalTrials.gov registry, and identified three randomized controlled trials comparing BBFC vs its constituents (brimonidine vs brinzolamide), and one comparing BBFC with unfixed brimonidine and brinzolamide. All of the studies demonstrated mean diurnal IOP to be statistically significantly lower in the BBFC group compared with constituent groups and noninferior to that with the concomitant group using two separate bottles. The safety profile of BBFC was consistent with that of its individual components, the most common ocular adverse events being ocular hyperemia, visual disturbances, and ocular allergic reactions. Common systemic adverse effects included altered taste sensation, oral dryness, fatigue, somnolence, and decreased alertness. BBFC seems to be a promising new fixed combination for use in glaucoma patients. However, long-term effects of BBFC on IOP, treatment adherence, and safety need to be determined.

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Section: Discussionmentioning

confidence: 99%

Clinical effectiveness of brinzolamide 1%–brimonidine 0.2% fixed combination for primary open-angle glaucoma and ocular hypertension

Trikha¹,

Perera²,

Aung³

2015

OPTH

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“…Rossi et al. (2010) monitored prostaglandin therapy using the same dosing aid and qualified 46.4% of 56 patients to have ‘poor adherence’.…”

Section: Discussionmentioning

confidence: 99%

Adherence with brimonidine in patients with glaucoma aware and not aware of electronic monitoring

Hermann

Papaconstantinou²,

Muether

et al. 2010

Acta Ophthalmologica

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ABSTRACT.Purpose: To assess the impact of open versus masked adherence monitoring on adherence with topical brimonidine using two different dosing schedules. Methods: Thirty-seven patients with glaucoma or ocular hypertension were enroled in a prospective, observational cohort study. Patients were randomly assigned to open or masked adherence monitoring and to brimonidine twice daily (BID) or three times daily (TID). Patients received conventional brimonidine eye drops with attached electronic monitoring devices for 4 weeks with weekly intraocular pressure measurements. Adherence calculations comprised dosing intervals, adherence rate and time covered. Subgroup analysis with anova included the factors masking, regimen, diagnosis and age. Results: Among 36 individually analysed patients, 12 (33%) had adherence rates above 75%, therein two (5%)>90%. The mean adherence rate in 19 patients aware of adherence measurements was 70 ± 17% for brimonidine BID and 65 ± 14% for TID, not significantly different to the rates of 17 patients not informed about adherence measurements (77 ± 6% BID, 62 ± 9% TID, p = 0.24). On average, patients with brimonidine TID achieved significantly lower adherence rates (64 ± 12%) than patients on BID (73 ± 13%, p = 0.02). Still, patients on TID applied brimonidine more often (TID 1.9 ± 0.3, BID 1.5 ± 0.1 mean applications per day). The median coverage was 70% and showed no statistically significant difference between patients on BID and TID (p = 0.36). Conclusion: The study findings suggest that adherence measurements are not significantly altered by open adherence monitoring, which may simplify future adherence studies. Adherence with brimonidine eye drops was insufficient for most patients. These results demonstrate the necessity to develop new strategies to improve compliance in glaucoma therapy.

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“…5,6 Patient adherence with IOP-lowering treatment is crucial for the successful medical management of glaucoma; however, adherence with glaucoma medications is typically low and decreases with time. [8][9][10] Adherence is influenced by many patient-and treatment-related variables, and treatment complexity (ie, number of individual medications and daily doses) is one of the only modifiable factors associated with suboptimal treatment adherence. For example, compared with combination medications, treatment regimens using multiple individual medications are associated with lower treatment adherence.…”

mentioning

confidence: 99%

Adherence to Fixed-Combination Versus Unfixed Travoprost 0.004%/Timolol 0.5% for Glaucoma or Ocular Hypertension: A Randomized Trial

Barnebey¹,

Robin

2017

American Journal of Ophthalmology

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Monitoring adherence rates in glaucoma patients using the Travatan Dosing Aid. A 6-month study comparing patients on travoprost 0.004% and patients on travoprost 0.004%/timolol 0.5% fixed combination

Abstract: The typical nonadherent patient is elderly. TDA records indicate that only a minority of patients are really adherent: predictive models to screen for poor adherence are needed.

Cited by 17 publications

References 29 publications

Clinical effectiveness of brinzolamide 1%–brimonidine 0.2% fixed combination for primary open-angle glaucoma and ocular hypertension

Clinical effectiveness of brinzolamide 1%–brimonidine 0.2% fixed combination for primary open-angle glaucoma and ocular hypertension

Adherence with brimonidine in patients with glaucoma aware and not aware of electronic monitoring

Adherence to Fixed-Combination Versus Unfixed Travoprost 0.004%/Timolol 0.5% for Glaucoma or Ocular Hypertension: A Randomized Trial

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Monitoring adherence rates in glaucoma patients using the Travatan Dosing Aid. A 6-month study comparing patients on travoprost 0.004% and patients on travoprost 0.004%/timolol 0.5% fixed combination

Abstract: The typical nonadherent patient is elderly. TDA records indicate that only a minority of patients are really adherent: predictive models to screen for poor adherence are needed.

Cited by 17 publications

References 29 publications

Clinical effectiveness of brinzolamide 1%&ndash;brimonidine 0.2% fixed combination for primary open-angle glaucoma and ocular hypertension

Clinical effectiveness of brinzolamide 1%&ndash;brimonidine 0.2% fixed combination for primary open-angle glaucoma and ocular hypertension

Adherence with brimonidine in patients with glaucoma aware and not aware of electronic monitoring

Adherence to Fixed-Combination Versus Unfixed Travoprost 0.004%/Timolol 0.5% for Glaucoma or Ocular Hypertension: A Randomized Trial

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Clinical effectiveness of brinzolamide 1%–brimonidine 0.2% fixed combination for primary open-angle glaucoma and ocular hypertension

Clinical effectiveness of brinzolamide 1%–brimonidine 0.2% fixed combination for primary open-angle glaucoma and ocular hypertension