Patterns of adherence behaviour for patients with glaucoma

Cate, Heidi; Bhattacharya, Debi; Clark, Allan; Holland, Richard; Broadway, David C

doi:10.1038/eye.2012.294

Cited by 32 publications

(39 citation statements)

References 36 publications

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“…Pharmacy refill methods 10–12 , electronic monitoring 13–19 , and self-report measures 15,18,20 have all been used to assess the medication adherence of glaucoma patients. Estimates of adherence vary based on the method being used; pharmacy refill records have produced the lowest estimates of glaucoma medication adherence while self-report measures have yielded the highest adherence estimates.…”

Section: Introductionmentioning

confidence: 99%

“…A few studies have examined the validity of self-reported measures against objective measures (e.g., pharmacy records or electronic monitors) in glaucoma patients. 15,18 Both studies found that patients with glaucoma tended to over-estimate their adherence to glaucoma medications. 15,18 Furthermore, Cook et al 15 found that the correlation between MEMS and self-report was only 0.31.…”

Section: Introductionmentioning

confidence: 99%

“…15,18 Both studies found that patients with glaucoma tended to over-estimate their adherence to glaucoma medications. 15,18 Furthermore, Cook et al 15 found that the correlation between MEMS and self-report was only 0.31. These previous examinations of self-report versus objective measures have been limited in several respects.…”

Section: Introductionmentioning

confidence: 99%

“…These previous examinations of self-report versus objective measures have been limited in several respects. The Cate et al study 18 was limited to a single study site, a single medication (travoprost), and only had 88 participants. Cook 15 examined a single type of MEMS-measured adherence (percentage of days with correct adherence) and was also restricted to patients taking a single glaucoma medication.…”

Section: Introductionmentioning

confidence: 99%

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Accuracy of Patient-reported Adherence to Glaucoma Medications on a Visual Analog Scale Compared With Electronic Monitors

Sayner

Carpenter

Blalock

et al. 2015

Clinical Therapeutics

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Purpose Glaucoma medications can reduce intraocular pressure and improve clinical outcomes when patients adhere to their medication regimen. Providers often ask glaucoma patients to self-report their adherence, but the accuracy of this self-report method has received little scientific attention. Our purpose was to compare a self-report medication adherence measure with adherence data collected from Medication Event Monitoring Systems (MEMS) electronic monitors. Additionally, we sought to identify which patient characteristics were associated with over-reporting adherence on the self-reported measure. Methods English-speaking adult glaucoma patients were recruited for this observational cohort study from six ophthalmology practices. Patients were interviewed immediately after a baseline medical visit and were given MEMS containers, which were used to record adherence over a 60-day period. MEMS data were used to calculate percent adherence, which measured the percentage of the prescribed number of doses taken, and timing adherence, which assessed the percent doses taken on time. Patients self-reported adherence to their glaucoma medications on a visual analog scale (VAS) approximately 60 days following the baseline visit. Bivariate analyses and logistic regressions were used to analyze the data. Self-reported medication adherence on the VAS was plotted against MEMS adherence to illustrate the level of discrepancy between self-reported and electronically-monitored adherence. Findings The analyses included 240 patients who returned their MEMS containers and who self-reported medication adherence at the 60-day follow-up visit. When compared with MEMS-measured percent adherence, 31% of patients (n=75) over-estimated their adherence on the VAS. When compared with MEMS-measured timing adherence, 74% (n=177) of patients over-estimated their adherence on the VAS. For the MEMS-measured percent adherence, logistic regression revealed that patients who were newly prescribed glaucoma medications were significantly more likely to over-report adherence on the VAS (OR=3.07, 95% CI: 1.22, 7.75). For the MEMS–measured timing adherence, being male (chi-square=6.78, p=0.009) and being prescribed glaucoma medications dosed multiple times daily (chi-square =4.02, p=0.045) were significantly associated with patients over-reporting adherence on the VAS. However, only male gender remained a significant predictor of over-reporting adherence in the logistic regression, (OR=4.05, 95% CI: 1.73, 9.47). Implications Many glaucoma patients, especially new patients, over-estimated their medication adherence. Because patients were likely to over-report percent doses taken and timing adherence, providers may want to ask patients additional questions about when they take their glaucoma medications in order to potentially detect issues with taking glaucoma medications on time.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Accuracy of Patient-reported Adherence to Glaucoma Medications on a Visual Analog Scale Compared With Electronic Monitors

Sayner

Carpenter

Blalock

et al. 2015

Clinical Therapeutics

View full text Add to dashboard Cite

show abstract

“…Tablets can be transferred into dosing boxes to aid the memory, which could be an important resource for elderly patients [127]. Such visual cues or practical remedies are not possible with a bottle of drops [128]. Unit-dose medications in SundayMonday packs would clearly identify missed medications to patients and/or carers, and has been identified as a potential aide to improve adherence (American Glaucoma Society) [129].…”

Section: Administration Of Topical Antiglaucoma Therapies and Prescrimentioning

confidence: 99%

Pharmacotherapy and Adherence Issues in Treating Elderly Patients with Glaucoma

Broadway

Cate

2015

Drugs Aging

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Glaucoma is a leading cause of visual morbidity throughout the world and is an age-related condition, the prevalence of which rises significantly with increasing age. Glaucoma, a condition affecting the optic nerve, has a variety of subtypes with multiple aetiological factors, the most important of which are intraocular pressure (IOP) and increasing age. Treatment by lowering of IOP is the only current method, for which there is evidence, by which the rate of progressive visual deterioration can be slowed or halted. Although there are surgical and laser treatments that are efficacious in lowering IOP, the most common manner in which patients with glaucoma control their IOP is with administration of daily topical ocular hypotensive drugs (eye drops). The variety of topical drugs utilised in the management of glaucoma all have the potential to have adverse effects and/or interactions with concomitant medications, many of which may be used for other age-related conditions. Adherence with appropriate medicines has a major effect on the outcome of medical conditions and this aspect applies to the management of glaucoma. There are certain specific issues that relate to the administration of topical agents, with respect to both adverse effects and adherence. Although many suspect poor adherence in elderly patients with glaucoma, relative to younger patients, adequate evidence for this is lacking. Furthermore, the manner by which adherence issues could be improved remains inadequately understood and poorly addressed. The aims of this article were to review, from a clinical perspective, the medical therapies currently used for glaucoma and discuss adherence issues with respect to the population of patients with glaucoma, who tend to be relatively elderly.

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