Abstract
Purpose:
We investigated medication persistency and its related factors among newly medicated Japanese glaucoma patients using a health insurance database to clarify how many glaucoma patients were dropped out from the glaucoma medication.
Methods:
Patients who were covered their medical expense by a social health insurance for same or more than three years during the period between 2005 and 2011 were subject to this study. All analyses were performed based on Japan medical Data Center Claim Data Base. Including criteria were; no history of glaucoma diagnosis, anti-glaucoma medication, and glaucoma surgeries; newly diagnosed glaucoma and started anti-glaucoma medication during the follow up period. Exclusion criteria were; having any type of glaucoma surgeries, change of their health insurance to the others; missing of registered record in the social health insurance during the follow up period. The definition of discontinuation of medication persistency was no health insurance records regarding glaucoma care for same or more than six months, and medication persistency was defined the period between the start of glaucoma medication and the last visit. The medication persistency related factors were also investigated.
Results:
A total number of registered subjects was 1,181,102 and 2799 subjects were judged as newly diagnosed and medicated glaucoma patients. Mean (SD) age was 47.3 (13.9) years and there were 1,494 male and 1,305 female patients. Many patients were dropped out during the early period since the start of glaucoma medication. The dropout rates at three months, six months, and twelve months since the start of glaucoma medication were 26.8%, 31.9%, and 39.1%, respectively. Comparison between patients who quit glaucoma mediation within six month from the start and those who continued glaucoma medication for more than two years showed younger, less number of anti-glaucoma medications, and cared by large scale hospitals were risk factors of dropout from the glaucoma medication.
Conclusions:
More than one third of newly medicated glaucoma patients were dropped out from glaucoma medication within one year from the start and some risk factors of dropout were revealed. It is important to support glaucoma patients for preventing from dropout especially at early period since start of glaucoma medication.
Keywords: 466 clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials