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January 11, 2023
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Clinical management, medication adherence top concerns in POAG

Fact checked byHeather Biele
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Lack of treatment and poor patient compliance with medication are major concerns in the management of primary open-angle glaucoma, researchers reported in Patient Preference and Adherence.

Perspective from Jessica Steen, OD, FAAO

“Progression of [primary open-angle glaucoma (POAG)] and associated nerve damage can be halted by lowering IOP,” Joseph S. Imperato, MS, MEng, principal at IQVIA and former senior director of global medical analytics and real-world evidence at Viatris Inc., and colleagues wrote. “This makes control of IOP paramount for preventing the major etiology of glaucoma and POAG blindness worldwide.”

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Medical adherence is a top concern in POAG. Source: Adobe Stock

In a cross-sectional, retrospective study of Optum’s de-identified Market Clarity Data collected from July 2013 to December 2019, Imperato and colleagues examined clinical management, health care resource utilization, medication adherence/persistence and procedure use for 232,572 eligible patients aged 18 years or older with POAG in the U.S.

Researchers grouped participants into the following four categories: CH1 group (26.2% of the cohort), who received antiglaucoma treatment only; CH2 group (1.9% of the cohort), who had a glaucoma procedure only; CH3 group (2.6% of the cohort), who received both antiglaucoma medication and a glaucoma procedure; and CH4 group (69.4% of the cohort), who received neither antiglaucoma treatment nor a glaucoma procedure.

Researchers reported that prostaglandin analogs were the most prescribed antiglaucoma medication, with latanoprost as the most common. In addition, both medication persistence (P < .0001) and adherence (P < .0001) were higher in the CH1 group compared with the CH3 group. Further, patients in the CH4 group were least likely to have disease-specific office visits and surgical services visits, according to researchers.

Being a woman or aged 55 years or older, living in the West region of the U.S. and having a history of dyslipidemia or thyroid disease were among the most significant positive predictors of medication adherence (P .0003).

“Pharmacologic management appears to be the major approach to POAG management, with prostaglandins used by more than half of all patients who received antiglaucoma medications,” Imperato and colleagues wrote. “Adherence and persistence with antiglaucoma medication were, however, suboptimal, especially in patients who had previously undergone a procedure for POAG or ocular hypertension. Targeted screening and educational approaches are thus needed to improve POAG management in the U.S.”