Treatment for glaucoma: adherence by the elderly

J H Gurwitz, R J Glynn, M Monane, D E Everitt, D Gilden, N Smith, J Avorn, J H Gurwitz, R J Glynn, M Monane, D E Everitt, D Gilden, N Smith, J Avorn

Abstract

Objectives: The purpose of this study was to determine the extent of nonadherence to treatment for glaucoma among elderly patients.

Methods: This was a retrospective cohort study of 2440 patients older than age 65 who were enrolled in the New Jersey Medicaid Program and who were newly initiated on a topical agent for the treatment of glaucoma. Two patient-specific measures of nonadherence were employed: (1) no filled prescription for any glaucoma medication over a 12-month period after the initiation of therapy and (2) number of days without therapy for glaucoma during this 12-month period.

Results: By the first measure, 569 patients (23%) were found to be nonadherent. The mean number of days without therapy during the study year was 112. Factors associated with nonadherence included the use of glaucoma medication requiring more than 2 administrations per day and the presence of multiple other medications in the patient's drug regimen. Patients started on multiple glaucoma medication were more adherent than those started on a single agent. Age and sex were not found to be predictors of nonadherence.

Conclusions: Substantial nonadherence was found to be common in this population. More attention to the issue of nonadherence could result in important benefits in the preservation of sight.

References

    1. Med Care. 1976 Feb;14(2):166-72
    1. Br J Ophthalmol. 1977 Aug;61(8):531-4
    1. Am J Ophthalmol. 1981 Nov;92(5):727-31
    1. Drugs. 1983 Jan;25(1):63-76
    1. N Engl J Med. 1983 Jun 16;308(24):1457-63
    1. Am J Epidemiol. 1983 Aug;118(2):206-12
    1. JAMA. 1983 Oct 7;250(13):1728-32
    1. Ann Intern Med. 1984 Feb;100(2):258-68
    1. Arch Ophthalmol. 1985 Apr;103(4):504
    1. Arch Ophthalmol. 1985 Apr;103(4):529-31
    1. J Am Geriatr Soc. 1986 Jan;34(1):1-4
    1. Am J Ophthalmol. 1986 May 15;101(5):515-23
    1. Am J Med. 1986 Dec 31;81(6C):20-4
    1. Am J Ophthalmol. 1987 Feb 15;103(2):188-93
    1. N Engl J Med. 1987 Aug 27;317(9):550-6
    1. Arch Ophthalmol. 1989 Nov;107(11):1590-8
    1. Ophthalmology. 1989 Oct;96(10):1460-7
    1. Ann Intern Med. 1990 Jan 15;112(2):120-5
    1. Trans Am Ophthalmol Soc. 1989;87:598-618
    1. Arch Intern Med. 1990 Sep;150(9):1881-4
    1. Health Aff (Millwood). 1990 Fall;9(3):6-19
    1. N Engl J Med. 1991 Jun 20;324(25):1825-8
    1. J Chronic Dis. 1962 Nov;15:1025-36

Source: PubMed

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