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March 10, 2020
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Poor medication adherence linked to faster rate of visual field decline

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Donald S. Fong

WASHINGTON — Patients who better adhered to topical glaucoma medications over time experienced a slower rate of visual field decline compared with patients with poor adherence to their medications, according to a speaker here.

“Improving patient adherence to topical glaucoma medications may delay visual field progression. Strategies to improve adherence include sustained-release products that minimize the need for daily patient compliance and allow the patients to preserve vision for longer,” Donald S. Fong, MD, said at the American Glaucoma Society annual meeting.

In the first study to quantify the effect of greater medication adherence to the rate of glaucoma progression measured by visual field loss in a real-world population, Fong and colleagues evaluated 6,343 glaucoma patients from Kaiser Permanente Southern California. Researchers evaluated baseline visual fields to classify disease severity; mild severity was defined as a mean deviation of up to –2 dB, moderate severity as greater than –2 dB to –6 dB, severe severity as greater than –6 dB to –12 dB, and very severe severity as greater than –12 dB, Fong said.

Visual fields were assessed over the follow-up period, and progression was defined as loss in mean deviation from baseline.

In an unadjusted descriptive analysis, the greater baseline disease severity correlated with higher medication adherence (P < .001), Fong said. Also, in a multivariate conditional growth model of mean deviations, the interaction between time and adherence was positive and statistically significant (P = .02), demonstrating a slower rate of progression in patients with greater medication adherence over time.

“We looked at the interaction between time and medication. What you see is the interaction is positive, meaning that if you increase adherence, you decrease the progression of disease. That is a key takeaway of this model,” Fong said. – by Robert Linnehan

 

Reference:

Fong DS. Adherence to topical glaucoma medications decreases rate of visual field progression over time. Presented at: American Glaucoma Society annual meeting; Feb. 27-March 1, 2020; Washington.

Disclosure: Fong reports he receives grant support from Allergan.