Using Pharmacy Claims Data to Study Adherence to Glaucoma Medications: Methodology and Findings of the Glaucoma Adherence and Persistency Study (GAPS)

Friedman, David S.; Quigley, Harry A.; Gelb, Laurie; Tan, Jason; Margolis, Jay; Shah, Sonali; Kim, Elizabeth E.; Zimmerman, T J; Hahn, Steven R.

doi:10.1167/iovs.07-0290

Cited by 255 publications

(200 citation statements)

References 11 publications

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“…Third, patients prescribed an ocular hypotensive medication o6 months before administration of the questionnaire could not, by definition, report the maintenance behaviour; in our patient groups, only 16% of patients were diagnosed with the condition for which they were receiving ocular hypotensive therapy p1 year previously, further limiting response variability. Fourth, patients who participated in the current research (as well as those included in the survey portion of the Glaucoma Adherence and Persistency Study (GAPS)) 34 may not be representative of the wider population of glaucoma patients as all consented to answer questions about their conditions and medication-taking behaviours. Given these limitations, testing of the instrument in larger, more diverse groups of patients seems warranted.…”

Section: Discussionmentioning

confidence: 99%

“…The effectiveness of motivational interviewing has been documented in programmes targeting diet and exercise, 38,39 smoking cessation, 40,41 and medical adherence. 42,43 Although the utility of the current questionnaire and of motivational interviewing in patients prescribed ocular hypotensive therapy requires further testing, others 19,32,34,[44][45][46][47][48][49] have found adherence in this patient population to be problematic and have identified several barriers that parallel the situational issues (eg, forgetting when travelling or when the regular schedule changed 19 ) reported broadly by patients in both the glaucoma and multispecialty practices. Research is needed to further specify health-related beliefs, lapses in or dissatisfaction with doctor-patient communication, and situational obstacles that negatively impact adherence in this patient population.…”

Section: Discussionmentioning

confidence: 99%

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An assessment of readiness for behaviour change in patients prescribed ocular hypotensive therapy

Schwartz

Plake

Mychaskiw

2008

Eye

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Objectives To compare responses in two patient populations with a questionnaire developed to identify those prescribed ocular hypotensive medication whose adherence may need improvement and who may be ready to change. Methods The content/face validity of a 62-item, self-administered questionnaire was confirmed by nine glaucoma specialists. Questions concerned demographics, health and medications, use of/problems with medications, and visual function. The questionnaire was administered anonymously to 102 consecutive patients in a glaucoma referral practice ('glaucoma practice') and 100 from a multispecialty ophthalmology practice ('multispecialty practice'). All participants were prescribed X1 ocular hypotensive medication and had no previous trabeculectomy. Results Patients in the glaucoma practice were more likely to be younger, AfricanAmerican, and better educated (Po0.05 for each). In both, 480% had glaucoma with 460% diagnosed X3 years previously. Most (glaucoma, multispecialty: 87, 93%) reported administering drops every day, but more in the multispecialty practice reported administering drops at the same time every day (79, 92%; Po0.05). Number of adherence problems (mean, 1/patient) and adherence scores (mean, 24; possible scale range, 0-25) were similar. Common adherence barriers were falling asleep and forgetting when the regular schedule changed or when travelling. In the glaucoma practice, the number of adherence problems was correlated with adherence score (r ¼ -0.611; Po0.0001) and number of side effects (r ¼ 0.349; Po0.0001).Conclusions Similarities between patient populations limited our ability to compare responses between groups or to propose adherence counselling tailored to specific demographics. Until such recommendations are possible, physicians should incorporate adherence counselling broadly into their practices.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

An assessment of readiness for behaviour change in patients prescribed ocular hypotensive therapy

Schwartz

Plake

Mychaskiw

2008

Eye

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“…[23,24] This definition was been completed as "the extent to which a patient participates in a treatment regimen after he or she agrees to that regimen. " [25,26] In publication several methods are reported to calculate the adherence to treatment such as Continuous Measure of Medication Acquisition (CMA) [27][28][29]; Medication Possession Ratio (MPR) [30][31][32][33]; Medication Refill Adherence (MRA) [34][35][36]; Proportion of Days Covered (PDC) [37][38][39]; Refill Compliance Rate (RCR) [40][41][42]; Medication Possession Ratio, modified (MPRm) [43][44][45] [46]; and Received Daily Dose/Prescribed Daily Dose [47]. Only the last method consider the Prescribed Dose and not the Defined Dose, approaching most of all to the WHO definition, that take in consideration the treatment regimen prescribed by physician.…”

Section: Medication Adherencementioning

confidence: 99%

Leuprorelin and Triptorelin in the treatment of Prostate Cancer: Medication adherence, Persistence and Economic Evaluation in Five Years of Analysis

Santoleri¹

2014

Int J Pharm Sci Res

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Background: A successful of home treatment is strongly influenced by patient adherence to treatment. Non-adherence represents not only an important issue for the patient, affecting both the clinical efficacy and safety of the medication regimen, but also has economical and social implication for the community. Objective: The aim of this study is to evaluate medication adherence, persistence to treatment and daily cost of therapy in patients with prostate cancer treated with gonadotropin-releasing hormone agonists, comparing Leuprorelin 3.75mg-11.25mg and Triptorelin 3.75mg-11.25mg. Materials and Methods: The study was carried out from 2007 to 2012 in an Italian Hospital in Pescara. This is a General Hospital with 800 beds. Medication adherence was measured as the ratio between the Received Daily Dose (RDD) and the Prescribed Daily Dose (PDD), using software developed ad hoc by the hospital pharmacists. The RDD was calculated dividing the dose of drug dispensed in a pharmacy refill by the sum of days between two consecutive drug refills. PDD was determined in basis of the treatment regimen as prescribed by physician. The non-persistence was calculated like the effective days of treatment, that is the sum of days elapsing between the first and the last pharmacy refill, plus the days of treatment supplied with the last refill, minus the days of non-persistence, and it was graphically represented by the Kaplan Meier curves. The daily cost of treatment was calculated on the basis of the RDD. Results:The patients included in this study were 239 for Leuprorelin and 199 for Triptorelin. The adherence values for all drugs ranged between from 0.92 to 1.00, showing good quality management of treatment at home. The analysis of non-persistence conducted in four years (with patients included until 31 December 2007) showed a decrease by a 21% for Leuprorelin and 38% for Triptorelin, using the Log Rank Test the persistence for two drugs are not significantly different. The cost per RDD was of € 2.24 for Leuprorelin and € 2.84 for Triptorelin. Conclusion: Often health personnel have not a precise idea on behavior of patient in home therapy for chronic disease; calculation of adherence is very important to know what the real pharmacoutilization of drugs is, and our results showed a good profile of medication adherence for both drugs studied. Economic results give a difference of 60 cent per day, one year of therapy with Triptorelin is approximately € 219 more expensive than Leuprorelin per patient; we think that this kind of comparisons would be encouraged, that could be really useful for decisors of National Regulatory Agencies to negotiate the pricing of drugs on the basis of the real utilization in clinical practice, and for clinicians to make a good cost-effectiveness choice.

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“…With COAG patients, the probability of remaining persistent with topical prostanoids over the first year of therapy is typically less than 60%; this is despite the encouraging overall patient persistence with topical prostanoids compared with all other classes of topical ocular hypotensives [5][6][7][8][9][10][11][12][13][14] . Interestingly, it has been reported that patient persistence with prostaglandin analogues is even inferior to that of other chronic therapies, including those for management of hyperlipidaemia (statins), osteoporosis (bisphosphonates), and type II diabetes (oral hypoglycaemic agents) 15 .…”

Section: I a L D I S T R I B U T I O N U N A U T H O R I Z E D U S mentioning

confidence: 99%

Adherence, persistence and cost–consequence comparison of bimatoprost topical ocular formulations

Alany

2013

Current Medical Research and Opinion

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Using Pharmacy Claims Data to Study Adherence to Glaucoma Medications: Methodology and Findings of the Glaucoma Adherence and Persistency Study (GAPS)

Cited by 255 publications

References 11 publications

An assessment of readiness for behaviour change in patients prescribed ocular hypotensive therapy

An assessment of readiness for behaviour change in patients prescribed ocular hypotensive therapy

Leuprorelin and Triptorelin in the treatment of Prostate Cancer: Medication adherence, Persistence and Economic Evaluation in Five Years of Analysis

Adherence, persistence and cost–consequence comparison of bimatoprost topical ocular formulations

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