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Toyoaki Tsumura, Yasuyuki Suzuki, Kenji Kashiwagi, Keiji Yoshikawa, Hirotaka Suzumura, Toshine Maeda, Ryuji Takeda, Hitomi Saito, Makoto Araie, ; Glaucoma Research on Adeherence to Fixed Combination Eye drops in Japan (GRACE study) : A First Report. Invest. Ophthalmol. Vis. Sci. 2014;55(13):539.
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To analyze factors affecting glaucoma treatment adherence in Japanese glaucoma patients.
GRACE study was conducted in over 1000 institutions across Japan during June 2011 and July 2012. Subjects were primary open angle glaucoma (POAG), normal tension glaucoma (NTG), ocular hypertension (OH) and pseudoexfoliation glaucoma (PEG) patients already undergoing eye drop treatment who received an additional prescription of fixed combination glaucoma eye drop for the first time. The treating physician and the patient were both requested to reply to a questionnaire on treatment adherence before, 1 month after and 6 months after prescription of fixed combination medication. Factors related to glaucoma treatment adherence at the time of the enrollment were identified using logistic regression analysis.
Questionnaires were retrieved from 4592 patients (2122 males and 2470 females). One thousand and seventy-two institutions and 1372 physicians participated in the study. Valid replies were obtained from 3853 (83.9%), 3786 (82.4%) and 3054 (66.5%) patients before, 1 month and 6 months after prescription respectively. The mean age and male/female ratio of the 3853 patients included in the study was 68.5±12.2 years and 1794/2059, and 1991 were POAG, 1465 were NTG, 239 were OH and 158 were PEG patients. The number of prescribed eye drops was reduced after prescription of fixed combination medication (1.93±0.78 vs. 1.34±0.54, (P<0.0001). Factors related to glaucoma treatment adherence at the time of the enrollment were older age (Odds ratio (OR) 0.9848, p<0.0001), female gender (OR 0.1084, P=0.0055), fewer numbers of prescribed eye drops (OR:0.7561, p=0.0151). Agreement of adherence evaluation between the treating physician and the patient was 82.8%, and gender (P<0.0001) was the only factor related to the degree of agreement.
Questionnaire results on glaucoma treatment adherence revealed a higher rate of adherence in Japanese glaucoma patients compared to previous reports from other countries. Age, gender and number of prescribed eye drops had a significant effect on glaucoma treatment adherence at the time of the enrollment and gender was related to agreement of adherence evaluation between the treating physician and the patient.
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