Abstract | PURPOSE: To assess patient adherence and behaviors with topical once-daily therapy for glaucoma. DESIGN: Prospective, observational cohort study. PARTICIPANTS: One hundred ninety-six patients with glaucoma who were being treated with a prostaglandin analog in 1 or both eyes at the Scheie or Wilmer Eye Institutes between August 2006 and June 2007. METHODS: Detailed medical history was obtained from each patient. All subjects used the Travatan Dosing Aid (DA; Alcon, Fort Worth, TX) to administer travoprost as prescribed. Devices were collected at 3 months and the data of drop usage was downloaded using software provided with the dosing aid. Data were analyzed for the 8-week period starting 2 weeks after the enrollment visit and ending 2 weeks before the 3-month visit. MAIN OUTCOME MEASURES: Assessment of adherence and patterns of drop usage as indicated by the DA. RESULTS: A total of 282 subjects consented to be in the study and 86 (30%) withdrew before study completion or had device errors, leaving 196 subjects (70%) with evaluable data at 3 months. The overall mean (+/-standard deviation) adherence rate was 0.71 (+/-0.24), ranging from 0.02 to 0.97. One hundred nine of these patients (55.6%) took greater than 75% of the expected doses. Those with adherence of less than 50% of expected doses showed substantially increased dose taking immediately after the office visit and just before the return visit at 3 months (P = 0.03). The mean adherence rate estimates of the physician and patient self-report were 0.77 and 0.95, respectively. The agreement between the physician assessment and DA-recorded adherence rate showed poor correlation for individual cases (intraclass correlation coefficient, 0.09; 95% confidence interval, 0.00-0.19). CONCLUSIONS: Nearly 45% of patients using an electronic monitoring device who knew they were being monitored and were provided free medication used their drops less than 75% of the time. Patients reported far higher medication use than their actual behavior. The ability of the physician to identify which persons are poorly adherent from their self-report or from other subjective clues is poor. FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found after the references.
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Authors | Constance O Okeke, Harry A Quigley, Henry D Jampel, Gui-shuang Ying, Ryan J Plyler, Yuzhen Jiang, David S Friedman |
Journal | Ophthalmology
(Ophthalmology)
Vol. 116
Issue 2
Pg. 191-9
(Feb 2009)
ISSN: 1549-4713 [Electronic] United States |
PMID | 19084273
(Publication Type: Journal Article, Multicenter Study, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
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Chemical References |
- Antihypertensive Agents
- Ophthalmic Solutions
- Cloprostenol
- Travoprost
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Topics |
- Administration, Topical
- Adult
- Aged
- Aged, 80 and over
- Antihypertensive Agents
(administration & dosage)
- Attitude to Health
- Cloprostenol
(administration & dosage, analogs & derivatives)
- Cohort Studies
- Drug Monitoring
(instrumentation)
- Female
- Follow-Up Studies
- Glaucoma, Angle-Closure
(drug therapy)
- Glaucoma, Open-Angle
(drug therapy)
- Humans
- Intraocular Pressure
(drug effects)
- Male
- Middle Aged
- Ocular Hypertension
(drug therapy)
- Ophthalmic Solutions
(administration & dosage)
- Patient Compliance
(statistics & numerical data)
- Prospective Studies
- Surveys and Questionnaires
- Travoprost
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