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Compliance, education keys to better glaucoma management

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LONDON — Ophthalmologists must educate patients with glaucoma and simplify their medical regimens in order to improve long-term compliance, according to the International Glaucoma Association. The IGA’s recommendations, released yesterday, are based on results of a recent survey of 250 physicians and 243 patients on multiple glaucoma medications in France, Germany, Italy, Spain and the United Kingdom.

Almost one-third of the patients on multiple glaucoma medications reported challenges in following their medication regimen. The two most common difficulties: missing regular dosing periods and not waiting a sufficient amount of time between applications of different medications.

About a third of the patients surveyed reported missing a scheduled dosing within the previous month. And, according to the study, 17% of patients applying multiple medications wait 2 minutes or less between doses, even though physicians recommend a 5- to 10-minute wait.

“The survey very clearly shows that many glaucoma patients are not fully compliant with their eye drop medicines,” said David Wright, chief executive of the IGA. “The results speak to the need for more patient education.” Mr. Wright also said that effective fixed combination drugs would help patients become more compliant.

Physicians also deemed patient compliance an issue: 93% reported “at least some” of their patients do not comply with instructions about treatment. Effective once-daily dosing of glaucoma medication might lead to better compliance than eye drops taken twice or three times daily, according to 90% of the physicians surveyed.

“The survey clearly shows that ophthalmologists across Europe need to listen and respond to the needs of their glaucoma patients — 40% of whom require more than monotherapy according to physicians participating in the survey,” said Prof. Roger Hitchings, president of the European Glaucoma Society. “Communication and education are the keys to successfully managing glaucoma and, together with effective treatment options, can help improve compliance and vision outcomes.”

Survey results indicated that 35% of physicians currently prefer latanoprost plus timolol as their No. 1 choice of unfixed combinations, and 12% prefer dorzolamide plus timolol.