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S. Kline, J. Walt, A. Carlson, G. Trygstad; Patients’ Persistence and Adherence with Glaucoma Therapy: A Longitudinal Retrospective Database Analysis of Opthalmic Lipids . Invest. Ophthalmol. Vis. Sci. 2004;45(13):4509.
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Purpose: There are varying reported rates of persistence and adherence with prostaglandin and prostamide glaucoma therapies. Results depend on how rigorously these outcomes are evaluated. This study examined the persistence and adherence for patients using latanoprost, travoprost, and bimatoprost across multiple health plans calculating the percent of adherent patients over 12 months. Methods: Glaucoma patients were identified from an employer–based database covering about 1.8 million lives in 40 different health plans with a large patient sample 65 years old and older. Patients with a glaucoma medical claim and a pharmacy claim for latanoprost, travoprost, or bimatoprost from 9/1/01 through 3/31/02 were eligible for study entry. The date of the first prescription claim for an ophthalmic drug of interest was defined as the index date. Continuous eligibility was required for 180 days prior to the index date with no evidence of ophthalmic drug use during that time. These patients were defined as "new therapy starts". Persistence at 12 months and number of days of adherence was determined for all new starts with at least 3 months of therapy following the index date. Due to potential inconsistencies with days supply reporting at the pharmacy level, a clinical algorithm was developed to compute days on therapy. Results: A total of 3,822 patients were identified with glaucoma and at least one claim for latanoprost, travoprost, or bimatoprost. Patients mean age was 73.1 years (SD=10.1, range=15 – 88 years) and 53.1% were female. Of these glaucoma patients taking a drug of interest 2,666 (69.8%) completed the first three months post the index prescription on the same therapy. A total of 70.1% were persistent with therapy at 12 months and on average were adherent for 83.1% of the time. Using the quantity dispensed and the number of days between refills yielded an average of 8 days of therapy per 1 mL of ophthalmic solution. The mean number of days on therapy for bimatoprost was significantly greater than latanoprost (p<0.05). Conclusions: This retrospective database analysis assessed persistence and adherence for patients using latanoprost, travoprost, and bimatoprost to treat their glaucoma for a 12 month study period. Although most patients were persistent and adherent to their therapy regimen for at least three months and then at 12 months there may still be opportunities to improve persistence and adherence with these important ophthalmic therapies.
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