Researchers delve into prescribing habits and comfort, cost of anti-allergy agents

Studies presented at AAO meeting represent newest research on ocular allergy.

Issue: February 2015

Two studies presented at the recent American Academy of Optometry meeting investigate optometrists’ involvement in prescription writing and several formulations of ketotifen.

Agustin L. Gonzalez, OD, FAAO, and Jennifer Snyder, OD, presented their study results as posters at the meeting.

Analyzing allergy prescriptions

Gonzalez and colleagues investigated the prescribing habits of both optometrists and ophthalmologists when treating ocular allergies.

The study, conducted over 52 weeks, analyzed 2,218,422 prescriptions. As detailed in the abstract provided by researchers, 1,181,221 prescriptions were written by ophthalmologists while 1,037,201 were written by optometrists. The researchers reported that they found no significant statistical difference in prescription writing between optometrists and ophthalmologists.

Gonzalez, a member of the Primary Care Optometry News Editorial Board, told PCON that both the data and the study are important for several reasons.

“This poster creates a metric of optometry’s involvement in medical eye care, specifically management of allergy using topical medications,” he said. “This data creates a measure that can be tracked over time to quantify optometry’s involvement in one of the more often encountered eye disease states of a population and optometrist involvement in the management of patients with allergies.”

Gonzalez continued: “We realize we, as optometrists, are taking care of patient’s eyes but without clear measurements. We do not know how involved optometry as a profession is in managing ocular allergies via the use of topical pharmaceuticals. This data allows us to measure and compare how much allergy care optometry delivers.

Agustin L. Gonzalez

“A clear conclusion is that when we look at just volume, the 44,000 optometrists are much less involved in therapeutic management of allergies than the 13,000 practicing ophthalmologists by a 3-to-1 ratio,” he continued. “It could possibly indicate that ODs are less eager to seek pharmacological intervention and seek other forms of palliative care or over-the-counter therapies.

Gonzalez also noted that pharmacological audits may be helpful measurements in assessing skill in disease management.

“The data measured suggest that the seasonal prescribing patterns are similar between both professions, showing no measurable statistical difference in the management style of allergies via topical medications between optometry and ophthalmology,” he stated. “This then creates a valid argument that in the instance when optometrists are prescribing medications, there is no difference in the seasonal way they manage this when compared to their ophthalmological peers.”

Comparing ketotifen drops

Snyder and colleagues focused on three formulations of over-the-counter ketotifen fumarate (0.025%) and how they compare in terms of both comfort and cost.

Jennifer
Snyder

Researchers evaluated the anti-allergy ophthalmic solutions by conducting a double-masked study at the Southern College of Optometry, according to an abstract provided by the authors.

Participants rated the drops based on a survey scale of 1 to 10. Researchers instilled a drop of TheraTears (Advanced Vision Research) lubricating eye drops to serve as a reference point of comfort. Following the reference eye drop, the three formulations were instilled in participants’ eyes at random in 5-minute intervals in order for every participant to grade each drop. Participants compared TheraTears Allergy Eye Itch Relief, Zaditor (Alcon) and Alaway (Bausch + Lomb).

Results showed a similarity in comfort levels between TheraTears Allergy Eye Itch Relief and Zaditor; Alaway was ranked by participants to be significantly less comfortable.

Researchers also reported that both Alaway and TheraTears Allergy Eye Itch Relief are available in 10-mL bottles, but Zaditor is only available in 5-mL bottles. In terms of cost, TheraTears Allergy Eye Itch Relief was found to be less than half the cost of Zaditor.

“Comfort and cost are some of the factors that will impact patient compliance with ophthalmic medications,” Snyder told PCON. “The brand differences demonstrated in this study will allow clinicians to better balance comfort and cost factors when prescribing a specific OTC mast cell stabilizer-antihistamine eye drop for an individual patient.” – by Chelsea Frajerman

References:

Gonzalez AL, et al. A 52-week analysis of allergy medication prescription writing by optometry and ophthalmology. Poster presented at: American Academy of Optometry meeting; November 12, 2014; Denver, CO.

Snyder J, et al. Comfort and cost comparisons of ketotifen anti-allergy drops. Poster presented at: American Academy of Optometry meeting; November 12, 2014; Denver, CO.

For more information:

Agustin L. Gonzalez, OD, FAAO, is in private practice in Dallas, serves as adjunct faculty at InterAmerican University and is a member of the Primary Care Optometry News Editorial Board. He can be reached at AG@TXEyeDr.com.

Jennifer Snyder, OD, is an instructor in primary care at the Southern College of Optometry. She can be reached at jsnyder@sco.edu.

Disclosures: Gonzalez has no relevant financial disclosures. The research reported in Snyder’s study was partially supported by Advanced Vision Research Inc.