High adherence in first 2 years of glaucoma treatment may predict long term
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Key takeaways:
- High adherence was associated with older age, female sex and lower Charlson Comorbidity Index score.
- High adherence in the first 2 years may be a good predictor of long-term adherence.
Older age, female sex and low comorbidity score were associated with high adherence to glaucoma treatment, as was adherence in the first 2 years of treatment, according to a study conducted in Denmark and published in BMJ Open Ophthalmology.
“As to other chronic diseases, self-treatment with glaucoma medication has been associated with adherence challenges with the therapeutic regimen given the asymptomatic nature of glaucoma and the self-effort needed for treatment,” Miriam Kolko, MD, PhD, professor in translational eye research at the University of Copenhagen, and colleagues wrote. “Although many studies have assessed patient adherence in relation to glaucoma medication, the measures of adherence vary greatly due to inconsistency in the assessment methods, period of interests and criteria of adherence. This has resulted in the proportion of nonadherent patients to range from 5% to 80%.”
In a register-based study of 30,100 Danish patients with glaucoma, researchers assessed predictors of medication adherence, whether adherence to treatment early in the course of disease affects long-term adherence and economic consequences of poor adherence over time. Participants were monitored for 10 years between 2000 and 2018.
According to results, 54.7% of participants were adherent to glaucoma treatment within the first year of diagnosis, and 51.8% were adherent in the first 2 years.
More than 70% of highly adherent patients were older than 60 years and 60.6% of highly adherent patients were women. Lower Charlson Comorbidity Index scores also were associated with higher adherence.
In addition, patients with specific comorbidities, including eye diseases, musculoskeletal and connective tissue diseases, and ischemic heart diseases, were less likely to be adherent compared with those without those comorbidities.
Further, adherence in years 1 and 2 was strongly associated with adherence in years 5 and 10, with poor adherence in the first years of glaucoma treatment linked to higher long-term health care costs related to hospital contacts.
“Future studies exploring the direction of the association between severity and progression of glaucoma disease and poor adherence seem essential for enriching the interpretation of the findings from this study,” Kolko and colleagues wrote. “The understanding of the interplay is likewise highly relevant for enhancing the glaucoma treatment, and thus, seeking to prevent the negative consequences of poor medical adherence to glaucoma treatment.”
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