Patients with glaucoma report higher levels of cost-related nonadherence
Patients with glaucoma are more likely to report cost-related nonadherence compared with patients without glaucoma, according to research published in Ophthalmology Glaucoma.
Researchers included responses from patients aged 40 and older who responded to questions pertaining to eye health and visual function in the cross-sectional study.
In total, 40,380 participants were included in the survey, where 1,930 patients reported having glaucoma and 38,450 reported not having glaucoma. Patients with glaucoma were more likely to be female, Black, have at least one other medical comorbidity, lower levels of education, lower household income and vision impairment (P < .001).
Patients with glaucoma (8.2%) were more likely to report cost-related nonadherence than patients without glaucoma (6.4%) (P = .024). Of all patients with glaucoma, 22.6% reported asking for cheaper medications.
“In our nationally representative study, we found 8.2% of patients with glaucoma reported they could not afford their medications. Patients may also skip, take less or delay refills for prescribed medications,” Divakar Gupta, MD, one of the study co-authors told Healio/OSN.
Gupta and colleagues used the 2016 to 2017 National Health Interview Survey to determine the rates of cost-related nonadherence.
“Eye professionals that take care of patients with glaucoma should be aware that the cost of medications may influence their patients' ability to adhere to therapy,” Gupta said.
Patient responses did not include disease severity or patient perception details, “both of which may influence the value individuals place on their glaucoma medications, which may in turn affect cost-related medication adherence issues,” the authors wrote.
Perspective
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As eye care providers, we inevitably come across this statement from patients: “I’d rather die than go blind.” The fear in patients about losing their vision and the associated reduction in quality of life can’t be denied. Our job as their visual guardians always has to have the final goal in mind — We need to get our patients to the end of their lives with good, functional vision. This article exemplifies that our current strategy, writing more and more prescription glaucoma medications and simply expecting our patients to fill and take them, isn’t a winning plan of attack. At a minimum, we need to be even more thoughtful in the number and types of medications we prescribe. However, what becomes more apparent is that our drop, or patient-centric, approach plants too much burden and responsibility on our patients. The better approach is to consider procedural, or physician-centric, where we deliver the IOP reduction directly for our patients. This change in paradigm would allow us to minimize these issues leading to nonadherence and help our patients get to the finish line with the vision and quality of life they deserve.
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