September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Association between Glaucoma Progression and Medication Adherence: 7-Year Study of Veterans Affairs Maryland Health Care System Database
Author Affiliations & Notes
  • Eva DeVience
    Department of Ophthalmology, University of Maryland, Baltimore, Maryland, United States
  • Stephen DeVience
    University of Maryland, Baltimore, Maryland, United States
  • Katherine Williams
    Department of Ophthalmology, University of Maryland, Baltimore, Maryland, United States
  • Michael V Boland
    Wilmer Eye Institute and Health Sciences Informatics, Baltimore, Maryland, United States
  • Lily Im
    Department of Ophthalmology, University of Maryland, Baltimore, Maryland, United States
  • Rex Ballinger
    VA Maryland Health Care System, Baltimore, Maryland, United States
  • David S Friedman
    Wilmer Eye Institute, Baltimore, Maryland, United States
  • Osamah Saeedi
    Department of Ophthalmology, University of Maryland, Baltimore, Maryland, United States
  • Footnotes
    Commercial Relationships   Eva DeVience, None; Stephen DeVience, None; Katherine Williams, None; Michael Boland, None; Lily Im, None; Rex Ballinger, None; David Friedman, None; Osamah Saeedi, None
  • Footnotes
    Support  American Glaucoma Society MAPS Grant to Dr. Osamah Saeedi
Investigative Ophthalmology & Visual Science September 2016, Vol.57, No Pagination Specified. doi:
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to Subscribers Only
      Sign In or Create an Account ×
    • Get Citation

      Eva DeVience, Stephen DeVience, Katherine Williams, Michael V Boland, Lily Im, Rex Ballinger, David S Friedman, Osamah Saeedi; Association between Glaucoma Progression and Medication Adherence: 7-Year Study of Veterans Affairs Maryland Health Care System Database. Invest. Ophthalmol. Vis. Sci. 201657(12):.

      Download citation file:


      © 2017 Association for Research in Vision and Ophthalmology.

      ×
  • Supplements
Abstract

Purpose : To investigate the relationship between adherence to glaucoma medications measured using pharmacy refill data and worsening of visual field loss in patients in the Veterans Affairs Maryland Health Care System (VAMHCS).

Methods : We retrospectively reviewed VAMHCS pharmacy and visual field databases from 2008 to 2015. Glaucoma patients who had received topical glaucoma therapy and had taken ≥3 SITA standard visual field tests were included. A total of 1337 eyes from 722 patients, with median follow-up of 2.2 years (range 6-78 months) met study criteria. The database population was 59.7% African American, and 38.7% Caucasian, with an average age of 72.8 ± 12.1 years. Chart review of 200 patients in the database assessed demographic, clinical, and surgical follow-up over a 10-year period. Perimetric visual field worsening was defined as a statistically significant negative rate of change in MD, calculated with linear regression from three or more visual field measurements over time. Subjects with at least one eye exhibiting visual field worsening were defined as progressors. Glaucoma medication refills within the VA system were used to calculate the medication possession ratio (MPR, total days of medication possessed by the patient divided by total days prescribed), a widely used adherence measure. Patients with MPR > 0.9 were considered adherent.

Results : Visual field worsening was not correlated with MPR (p= 0.55). The mean MPR was 0.74 ± 0.35, with median 0.68. Adherent vs non-adherent patients had similar rates of visual field worsening, when considering both eyes (mean annual MD change =-0.27 vs. -0.33, p=0.50) or the eye with greater rate of worsening (mean annual MD change =-0.56 vs. -0.59, p=0.71) for each patient. Similarly, adherent patients were equally likely to be progressors as non-adherent patients (8% vs. 9%, p=0.68). Age, race, and sex were not found to be associated with visual field worsening in the chart review.

Conclusions : Significant visual field worsening was not found to be associated with patient adherence to topical glaucoma medications; the overall adherence was high in this study with patients having an average MPR of 0.74.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×