Treatment for glaucoma: adherence by the elderly.

Abstract

OBJECTIVES. The purpose of this study was to determine the extent of nonadherence to treatment for glaucoma among elderly patients. METHODS. This was a retrospective cohort study of 2440 patients older than age 65 who were enrolled in the New Jersey Medicaid Program and who were newly initiated on a topical agent for the treatment of glaucoma. Two patient-specific measures of nonadherence were employed: (1) no filled prescription for any glaucoma medication over a 12-month period after the initiation of therapy and (2) number of days without therapy for glaucoma during this 12-month period. RESULTS. By the first measure, 569 patients (23%) were found to be nonadherent. The mean number of days without therapy during the study year was 112. Factors associated with nonadherence included the use of glaucoma medication requiring more than 2 administrations per day and the presence of multiple other medications in the patient's drug regimen. Patients started on multiple glaucoma medication were more adherent than those started on a single agent. Age and sex were not found to be predictors of nonadherence. CONCLUSIONS. Substantial nonadherence was found to be common in this population. More attention to the issue of nonadherence could result in important benefits in the preservation of sight.

Force requirements in topical medicine use—the squeezability factor

“…Non-compliance in glaucoma and ocular hypertension is common. [1][2][3] The insidious nature of disease progression and necessity for long-term therapy are key issues. In these conditions the ease of topical drop delivery is of paramount importance.…”

Strategies for Coping in a Complex World: Adherence Behavior Among Older Adults with Chronic Illness

“…1,[10][11][12][13] . Increased numbers of medicines increase nonadherence 13,14 because of increased complexity [15][16][17][18][19][20] or cost. 12,[21][22][23][24] Increased age is not associated independently with reduced adherence.…”

Mean deviation fluctuation in eyes with stable Humphrey 24-2 visual fields

“…Multiple medication changes and polypharmacy which may result from a false-positive diagnosis of progression, may itself cause poor medication compliance 24,25 and subsequent disease progression. Conversely, a worsening of a visual field MD within our CI may indicate real progression of the disease and this should be born in mind.…”