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Shani Reich, Justin Rome, Jack Manns, Lilly Droll, Joseph Zelefsky; Impact of Educational Intervention on Compliance with Topical Therapy for Glaucoma. Invest. Ophthalmol. Vis. Sci. 2013;54(15):3517.
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Poor compliance with medical therapy is a barrier for effective treatment of disease. Previous studies have shown increased compliance with medical therapy for glaucoma with educational interventions. While these predominantly focused on Caucasian and Black populations, data for the Hispanic community is limited. The goal of this study was to determine if educational intervention can increase compliance in patients on travoprost in the Hispanic population.
Patients with glaucoma or ocular hypertension on travoprost therapy were enrolled. Patients under 18 years of age, unable to self-administer drops, or using any other drops were excluded. Patients were provided with a Travatan Dosing Aid (TDA), an electronic device that records when a drop of travoprost is dispensed. At one-month follow-up the data was downloaded off of the TDA and compliance was calculated. Those with <75% compliance were randomized into either an education or control group. Patients in the education group watched a 10 minute video produced by the AAO, in either English or Spanish, discussing glaucoma and eye drop usage, followed by verbal reinforcement of drop usage. Control group patients were only given verbal reinforcement of drop usage. Compliance was reassessed 2 months later.
A total of 70 patients will be enrolled; 44 patients are enrolled thus far, 10 of which are mid-study. Of the 34 who have completed the study to date (22 Hispanic, 12 Black), baseline compliance was 45% (40% Hispanics, 54% Blacks). Nine patients (4 Hispanic, 5 Black) had >75% compliance (mean 90%, range 78-100%), and 25 patients (18 Hispanic, 7 Black) had <75% compliance (mean 29%, range 4-70%) at one-month follow-up. Thirteen patients were randomized to the educational group, and 12 to the control group. Compliance rates in the education group were increased from 25%→46%, p=0.006, (23%→49%, p=0.009 in Hispanics, and 28%→45%, p=0.03 in Blacks) at the three-month follow-up. There was no statistically significant change in compliance in the control group (34%→36% overall, p=0.7; 37%→37%, p=0.99 in Hispanics, and 23%→32%, p=0.6, in Blacks).
Compliance with glaucoma therapy remains a major problem in glaucoma management. In our Hispanic and Black patient population, compliance increased with educational intervention. This study underscores the importance of education in increasing compliance with glaucoma therapy.
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