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

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

Abstract

Primary open angle glaucoma is a chronic optic neuropathy often requiring lifelong treatment. Patient compliance, adherence and persistence with therapy play a vital role in improved outcomes by reducing morbidity and the economic consequences that are associated with disease progression. A literature review including searches of The Cochrane Library, MEDLINE, PubMed, conference proceedings, and bibliographies of identified articles reveals the enormous public health burden in various populations due to the impact of glaucoma associated visual impairment on the overall quality of life eg, fear of blindness, inability to work in certain occupations, driving restrictions, motor vehicle accidents, falls, and general health status. Providing specific definitions for the frequently misunderstood terms "compliance, persistence and adherence" with reference to medication use is central not only for monitoring patients' drug dosing histories and clinical outcomes but also for subsequent research. In this review article, a summary of the advantages/disadvantages including cost-effectiveness of various medical approaches to glaucoma treatment, techniques employed for measuring patient compliance and actual patient preferences for therapy are outlined. We conclude by identifying the key barriers to ongoing treatment and suggest some best practices to enhance compliance and persistence.

Keywords: compliance; glaucoma; medication therapy management; persistence.

Figures

Figure 1
Figure 1
Definition of compliance and persistence. Copyright © 2008. Adapted with permission from Joyce AC, Ahuja R, Anita B, et al 2008. Medication compliance and persistence: terminology and definitions. Value Health, 11:44–7.
Figure 2
Figure 2
Percentage distributions of adherence barriers. Copyright © 2003, Lippincott Williams and Wilkins. Reproduced with permission from Tsai JC, McClure CA, Ramos SE, et al 2003. Compliance barriers in glaucoma: a systematic classification. J Glaucoma, 12:393–8.
Figure 3
Figure 3
Reasons given by glaucoma patients for missing eye drop medication. Copyright © 2008. Reproduced with permission from Kholdebarin R, Jin Y, Campbell RJ, et al 2008. Multicenter study of compliance and drop administration in glaucoma. Can J Ophthalmol, 43:454–61.
Figure 4
Figure 4
Medication scheduler and reminder sheet (Courtesy University of Ottawa Eye Institute, Ottawa, Canada).

References

    1. [AAO] American Academy of Ophthalmology. Preferred Practice Pattern: Primary Open Angle Glaucoma. San Francisco, CA: American Academy of Ophthalmology; 2005.
    1. [CNTG] Collaborative Normal-Tension Glaucoma Study Group. The effectiveness of intraocular pressure reduction in the treatment of normal-tension glaucoma. Collaborative Normal-Tension Glaucoma Study Group. Am J Ophthalmol. 1998;126:498–505.
    1. Aspinall PA, Johnson ZK, Azuara-Blanco A, et al. Evaluation of quality of life and priorities of patients with glaucoma. Invest Ophthalmol Vis Sci. 2008;49:1907–15.
    1. Best SJ. Does persistency truly equate to compliance? Clin Exper Ophthalmol. 2007;35:593.
    1. Bhargava JS, Patel B, Foss AJ, et al. Views of glaucoma patients on aspects of their treatment: an assessment of patient preference by conjoint analysis. Invest Ophthalmol Vis Sci. 2006;47:2885–8.
    1. Blondeau P, Esper P, Mazerolle E. An information session for glaucoma patients. Can J Ophthalmol. 2007;42:816–20.
    1. Bour T, Blanchard F, Segal A. [Therapeutic observance and life of patients with primary open-angle glaucoma. Apropos of 341 cases in the department of Marne.] J Fr Ophtalmol. 1993;16(6–7):380–91.
    1. Buller AJ, Morgan LH, Hercules BL. Patients prefer once-daily glaucoma drops. Graefes Arch Clin Exper Ophthalmol. 2007;245:293–4.
    1. Damji KF, Behki R, Wang L Target IOP Workshop. Canadian perspectives in glaucoma management: setting target intraocular pressure range. Can J Ophthalmol. 2003;38:189–97.
    1. Danesh-Meyer HV, Deva NC, Slight C, et al. What do people with glaucoma know about their condition? A comparative cross-sectional incidence and prevalence survey. Clin Exper Ophthalmol. 2008;36:13–8.
    1. Detry-Morel M. [Compliance and persistence.] J Fr Ophtalmol. 2006;29:216–25.
    1. Friedman DS, Hahn SR, Gelb L, et al. Doctor-patient communication, health-related beliefs, and adherence in glaucoma results from the Glaucoma Adherence and Persistency Study. Ophthalmology. 2008;115:1320–7.
    1. Friedman DS, Jampel HD, Munoz B, et al. The prevalence of open-angle glaucoma among blacks and whites 73 years and older: the Salisbury Eye Evaluation Glaucoma Study. Arch Ophthalmol. 2006;124:1625–30.
    1. Friedman DS, Wolfs RC, O’Colmain BJ, et al. Eye Diseases Prevalence Research Group. Prevalence of open-angle glaucoma among adults in the United States. Arch Ophthalmol. 2004;122:532–8.
    1. Girma T, Courtright P, Mengistu F, et al. A placebo controlled double blind clinical trial of mitomycin C in primary trabeculectomy in Ethiopian patients. Ethiop Med J. 2006;44:253–6.
    1. Goldberg LD, Walt J. Cost considerations in the medical management of glaucoma in the US: estimated yearly costs and cost effectiveness of bimatoprost compared with other medications. Pharmacoeconomics. 2006;24:251–64.
    1. Grol R, Grimshaw J. Evidence-based implementation of evidence-based medicine. Jt Comm J Qual Improv. 1999;25:503–13.
    1. Haymes SA, LeBlanc RP, Nicolela MT, et al. Risk of falls and motor vehicle collisions in glaucoma. Invest Ophthalmol Vis Sci. 2007;48:1149–55.
    1. Jampel HD, Parekh P, Johnson E, et al. Chart documentation by general physicians of the glaucoma medications taken by their patients. Am J Ophthalmol. 2005;140:344–5.
    1. Janz NK, Wren PA, Lichter PR, et al. CIGTS Study Group. The Collaborative Initial Glaucoma Treatment Study: interim quality of life findings after initial medical or surgical treatment of glaucoma. Ophthalmology. 2001;108:1954–65.
    1. Joyce AC, Ahuja R, Anita B, et al. Medication compliance and persistence: terminology and definitions. Value Health. 2008;11:44–7.
    1. Juzych MS, Randhawa S, Shukairy A, et al. Functional health literacy in patients with glaucoma in urban settings. Arch Ophthalmol. 2008;126:718–24.
    1. Kass MA, Heuer DK, Higginbotham EJ, et al. The Ocular Hypertension Treatment Study: a randomized trial determines that topical ocular hypotensive medication delays or prevents the onset of primary open-angle glaucoma. Arch Ophthalmol. 2002;120:701–13.
    1. Kharod BV, Johnson PB, Nesti HA, et al. Effect of written instructions on accuracy of self-reporting medication regimen in glaucoma patients. J Glaucoma. 2006;15:244–7.
    1. Kholdebarin R, Jin Y, Campbell RJ, et al. Multicenter study of compliance and drop administration in glaucoma. Can J Ophthalmol. 2008;43:454–61.
    1. Lacey J, Cate H, Broadway DC. Barriers to adherence with glaucoma medications: a qualitative research study. Eye. 2008 Apr 25; [Epub ahead of print]
    1. Lachaine J, Hodge WG, Steffensen I, et al. Prostaglandin analogues for ophthalmic use: a cost-effectiveness analysis. Can J Ophthalmol. 2008;43:33–41.
    1. LeBlanc RP Canadian Glaucoma Strategy Forum. A Canadian glaucoma strategy. Can J Ophthalmol. 2007;42:60–5.
    1. Leske MC, Connell AM, Schachat AP, et al. The Barbados Eye Study. Prevalence of open angle glaucoma. Arch Ophthalmol. 1994;112:821–9.
    1. Leske MC, Heijl A, Hussein M, et al. Early Manifest Glaucoma Trial Group. Factors for glaucoma progression and the effect of treatment: the early manifest glaucoma trial. Arch Ophthalmol. 2003;121:48–56.
    1. Mansberger SL, Hughes BA, Gordon MO, et al. Ocular Hypertension Treatment Study Group. Comparison of initial intraocular pressure response with topical beta-adrenergic antagonists and prostaglandin analogues in African American and white individuals in the Ocular Hypertension Treatment Study. Arch Ophthalmol. 2007;125:454–9.
    1. Muir KW, Santiago-Turla C, Stinnett SS, et al. Health literacy and adherence to glaucoma therapy. Am J Ophthalmol. 2006;142:223–6.
    1. Nemesure B, Honkanen R, Hennis A, et al. Barbados Eye Studies Group. Incident open-angle glaucoma and intraocular pressure. Ophthalmology. 2007;114:1810–15.
    1. [NIH] US National Institutes of Health. Clinical Trials Search [online] 2008. [Accessed on Sept 29, 2008]. URL: .
    1. Nordstrom BL, Friedman DS, Mozaffari E, et al. Persistence and adherence with topical glaucoma therapy. Am J Ophthalmol. 2005;140:598–606.
    1. Obstbaum SA, Cioffi GA, Krieglstein GK, et al. Gold standard medical therapy for glaucoma: defining the criteria identifying measures for an evidence-based analysis. Clin Ther. 2004;26:2102–20.
    1. Parikh RS, Parikh SR, Navin S, et al. Practical approach to medical management of glaucoma. Indian J Ophthalmol. 2008;56:223–30.
    1. Quigley HA. Number of people with glaucoma worldwide. Br J Ophthalmol. 1996;80:389–93.
    1. Quigley HA, Friedman DS, Hahn SR. Evaluation of practice patterns for the care of open-angle glaucoma compared with claims data: the Glaucoma Adherence and Persistency Study. Ophthalmology. 2007;114:1599–606.
    1. Quigley HA, Vitale S. Models of open-angle glaucoma prevalence and incidence in the United States. Invest Ophthalmol Vis Sci. 1997;38:83–91.
    1. Robin AL, Novack GD, Covert DW, et al. Adherence in glaucoma: objective measurements of once-daily and adjunctive medication use. Am J Ophthalmol. 2007;144:533–40.
    1. Rouland JF, Berdeaux G, Lafuma A. The economic burden of glaucoma and ocular hypertension: implications for patient management: a review. Drugs Aging. 2005a;22:315–21.
    1. Rouland JF, Le Pen C, Benhaddi H, et al. Glaucoma Study Group. Naturalistic, prospective study of glaucoma and ocular hypertension treatment in France: Strategies, clinical outcomes, and costs at 2 years. Eur J Ophthalmol. 2005b;15:562–80.
    1. Salyani A, Birt C. Evaluation of an eye drop guide to aid self-administration by patients experienced with topical use of glaucoma medication. Can J Ophthalmol. 2005;40:170–4.
    1. Schmier JK, Halpern MT, Jones ML. The economic implications of glaucoma: a literature review. Pharmacoeconomics. 2007;25:287–308.
    1. Schwartz GF, Platt R. Measuring persistency and intraocular pressure-controlled days in patients receiving topical glaucoma medications. Am J Manage Care. 2002;8(10 Suppl):S278–80.
    1. Shaw ME. Increasing compliance with glaucoma therapy: “so, convince me I have something wrong with my eyes”. Insight. 2005;30:7–9.
    1. Shibuya T, Kashiwagi K, Tsukahara S. Comparison of efficacy and tolerability between two gel-forming timolol maleate ophthalmic solutions in patients with glaucoma or ocular hypertension. Ophthalmologica. 2003;217:31–8.
    1. Singh K, Lee BL, Wilson MR Glaucoma Modified RAND-Like Methodology Group. A panel assessment of glaucoma management: modification of existing RAND-like methodology for consensus in ophthalmology. Part II: Results and interpretation. Am J Ophthalmol. 2008;145:575–81.
    1. Sood NN, Kumar H, Patil ND, et al. Medical and socio-economic aspects of long term therapy of open angle glaucoma. Indian J Ophthalmol. 1991;39:91–3.
    1. Thomas R, Sekhar GC, Kumar RS. Glaucoma management in developing countries: medical, laser, and surgical options for glaucoma management in countries with limited resources. Curr Opin Ophthalmol. 2004;15:127–31.
    1. Tingey D, Bernard LM, Grima DT, et al. Intraocular pressure control and persistence on treatment in glaucoma and ocular hypertension. Can J Ophthalmol. 2005;40:161–9.
    1. Tsai JC, McClure CA, Ramos SE, et al. Compliance barriers in glaucoma: a systematic classification. J Glaucoma. 2003;12:393–8.
    1. Vicente C, Walker J, Buys Y, et al. Association between mean intraocular pressure, disease stability and cost of treating glaucoma in Canada. Curr Med Res Opin. 2004;20:1245–51.

Source: PubMed

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