Medical management of glaucoma: Principles and practice

Singh, Kuldev; Shrivastava, Anurag

doi:10.4103/0301-4738.73691

Cited by 38 publications

(21 citation statements)

References 25 publications

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“…Five general groups of drugs, Parasympathomimetics, carbonic anhydrase inhibitors (CAI's), α-agonists, βblockers and prostaglandin analogs are useful in the reduction of intraocular pressure. 4,5 POAG is a chronic optic neuropathy often requiring lifelong treatment.…”

Section: Discussionmentioning

confidence: 99%

“…7,12 Prostaglandin analogues have been found to be superior in efficacy to all other topical classes of glaucoma medications. 4 However, a study reporting trends in Australia and New Zealand in 2006 has shown that although prostaglandin analogues were the first choice drugs, ophthalmologists favored β blockers because of cost, government restrictions and familiarity. 13 Similarly, higher cost and non-inclusion in hospital formulary may be the reason for lower usage of prostaglandin analogues in a public hospital like ours.…”

Section: Brand 43% 57% Yes Nomentioning

confidence: 99%

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Study of prescription pattern of antiglaucoma drugs used in treatment of primary open angle glaucoma in ophthalmology outpatient department of a tertiary care hospital

Advani

Jadhao

2018

Int J Basic Clin Pharmacol

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Background: In view of the high prevalence rates and the fact that medication is the primary line of treatment in POAG, an understanding of prescribing patterns can provide an insight into rational use of antiglaucoma drugs.Methods: This prospective, cross-sectional study was conducted in the glaucoma clinic of a tertiary care teaching hospital over a period of 12 months. Data from prescriptions of patients with POAG was recorded to study the prescribing pattern of antiglaucoma medications, completeness of the prescription and analysis of the prescriber’s influence.Results: Total of 103 prescriptions were included in which all the 141 anti-glaucoma drugs were prescribed as eye drops. Average number of drugs prescribed in present study was 1.36. β blockers, particularly Timolol (58%) was the most frequently prescribed drug. Timolol with dorzolamide (15%) was the only prescribed fixed dose combination. Prostaglandin analogues (5%) were least commonly prescribed. 53% drugs were prescribed by generic names and 43% were prescribed from hospital formulary. Instructions regarding the route and frequency of drug administration with duration of treatment were present in all prescriptions; however, instructions regarding method of instillation of eye drops were missing. Authors observed prescriber’s influence in present study.Conclusions: Overall prescribing pattern in our set up is satisfactory. There is a need to sensitize the prescribers regarding the importance of writing method of instillation in prescription as this could improve efficacy reduce side effects, prevent drug wastage and reduce cost. To encourage the physicians for rational prescribing such type of studies should be done more often for periodic auditing of prescriptions.

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Section: Discussionmentioning

confidence: 99%

Section: Brand 43% 57% Yes Nomentioning

confidence: 99%

Study of prescription pattern of antiglaucoma drugs used in treatment of primary open angle glaucoma in ophthalmology outpatient department of a tertiary care hospital

Advani

Jadhao

2018

Int J Basic Clin Pharmacol

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“…PGAs have been found to be superior in efficacy to all other topical classes of glaucoma medications. [10] However, a study reporting trends in Australia and New Zealand in 2006 has shown that although PGAs were the first choice drugs, New Zealand ophthalmologists favored β-blockers because of cost, government restrictions and familiarity. [11] Acetazolamide was prescribed in 26.66% of prescriptions which is higher than reported earlier studies for POAG.…”

Section: Discussionmentioning

confidence: 99%

“…[13] The topical carbonic anhydrase inhibitors have been shown to be beneficial adjuncts to PGAs both during the day and night. [10] However, only one prescription contained this combination because of higher cost.…”

Section: Discussionmentioning

confidence: 99%

Drug use in primary open angle glaucoma: A prospective study at a tertiary care teaching hospital

Yadav

Patel

2013

Indian J Pharmacol

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Objective:To study drug use pattern in patients of primary open angle glaucoma (POAG) and to analyze the cost of different anti-glaucoma medications.Materials and Methods:This prospective study was carried in the glaucoma clinic of a tertiary care teaching hospital over a period of 9 months. The data collected for patients with POAG included the patient's demographic details and the drugs prescribed. Data were analyzed for drug use pattern and cost drugs used.Results:In a total 180 prescriptions (297 drugs) analyzed, most drugs (83.83%) were prescribed by topical route as eye drops. β blockers (93.88%) were found to be the most frequently prescribed for POAG. Timolol (82.22%) was the most frequently prescribed drug and timolol with acetazolamide (17.22%) was the most commonly prescribed drug combination. Fixed dose combinations constituted 26.66% of prescriptions. β blockers were found to be cheaper than other anti-glaucoma drugs while prostaglandins analogs were the costliest. Instructions about the route, frequency and duration of treatment were present in all prescriptions. However, instructions regarding instillation of eye drops were missing in all prescriptions.

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“…1,2 Since 1983, topical ophthalmic medications of the same class have generally been manufactured with uniformly colored bottle caps (e.g. all miotic medications are green-topped).…”

Section: Introductionmentioning

confidence: 99%

Ability of Bottle Cap Color to Facilitate Accurate Patient–Physician Communication Regarding Medication Identity in Patients with Glaucoma

et al. 2015

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Objective To determine the accuracy of patient-physician communication regarding topical ophthalmic medication use based on bottle cap color, particularly amongst individuals who may have acquired color vision deficiency from glaucoma. Design Cross-sectional, clinical study. Participants Patients ≥ 18 years old with primary open-angle, primary angle-closure, pseudoexfoliation, or pigment dispersion glaucoma, bilateral visual acuity of 20/400 or better, and no concurrent conditions that may affect color vision. Methods One hundred patients provided color descriptions of 11 distinct medication bottle caps. Patient-produced color descriptors were then presented to three physicians. Each physician matched each color descriptor to the medication they thought the descriptor was describing. Main Outcome Measures Frequency of patient-physician agreement, occurring when all three physicians accurately matched the patient-produced color descriptor to the correct medication. Multivariate regression models evaluated whether patient-physician agreement decreased with degree of better-eye visual field (VF) damage, color descriptor heterogeneity, and/or color vision deficiency, as determined by Hardy-Rand-Rittler (HRR) score and the Lanthony D15 testing index (D15 CCI). Results Subjects had a mean age of 69 (±11) years, with mean VF mean deviation of −4.7 (±6.0) and −10.9 (±8.4) dB in the better- and worse-seeing eyes, respectively. Patients produced 102 unique color descriptors to describe the colors of the 11 tested bottle caps. Among individual patients, the mean number of medications demonstrating patient-physician agreement was 6.1/11 (55.5%). Agreement was less than 15% for 4 medications (prednisolone acetate [generic], betaxolol HCl [Betoptic], brinzolamide/brimonidine [Simbrinza], and latanoprost [Xalatan]). Lower HRR scores and higher D15 CCI (both indicating worse color vision) were associated with greater VF damage (p<0.001). Extent of color vision deficiency and color descriptor heterogeneity were the only significant predictors of patient-physician agreement in multivariate models (odds of agreement = 0.90 per 1 point decrement in HRR score, p<0.001; odds of agreement = 0.30 for medications exhibiting high heterogeneity [≥ 11 descriptors], p=0.007). Conclusions Physician understanding of patient medication usage based solely on bottle cap color is frequently incorrect, particularly in glaucoma patients who may have color vision deficiency. Errors based on communication using bottle cap color alone may be common and could lead to confusion and harm.

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Medical management of glaucoma: Principles and practice

Cited by 38 publications

References 25 publications

Study of prescription pattern of antiglaucoma drugs used in treatment of primary open angle glaucoma in ophthalmology outpatient department of a tertiary care hospital

Study of prescription pattern of antiglaucoma drugs used in treatment of primary open angle glaucoma in ophthalmology outpatient department of a tertiary care hospital

Drug use in primary open angle glaucoma: A prospective study at a tertiary care teaching hospital

Ability of Bottle Cap Color to Facilitate Accurate Patient–Physician Communication Regarding Medication Identity in Patients with Glaucoma

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