June 2013
Volume 54, Issue 15
ARVO Annual Meeting Abstract  |   June 2013
Impact of supply problems of preservative-free and low preservative glaucoma medications on patients and hospital staff
Author Affiliations & Notes
  • Shima Shah
    Moorfields Eye Hospital, London, United Kingdom
  • Julia Theodossiades
    Moorfields Eye Hospital, London, United Kingdom
  • Footnotes
    Commercial Relationships Shima Shah, None; Julia Theodossiades, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 757. doi:https://doi.org/
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      Shima Shah, Julia Theodossiades; Impact of supply problems of preservative-free and low preservative glaucoma medications on patients and hospital staff. Invest. Ophthalmol. Vis. Sci. 2013;54(15):757. doi: https://doi.org/.

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      © ARVO (1962-2015); The Authors (2016-present)

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Since March 2011 there have been recurring problems with the supply of preservative-free (PF) and low preservative (LP) glaucoma medications in the UK. We report a study investigating the impact of these problems from a patient, administrative and clinical perspective.


The numbers of individuals on PF and LP formulations of glaucoma therapy was determined from the Moorfields Eye Hospital (MEH) pharmaceutical database. Information was sourced from: staff (glaucoma surgeons, secretaries, clerical staff and pharmacists), patients and a notes assessment of the clinical impact on patient management.


A considerable number of patients require LP and PF medication, rising each year, with an 83% increase from April 2009 to April 2013 (extrapolated). Anecdotal staff evidence - The number and difficulty of enquiries varied across the job spectrum. The largest load fell upon the secretaries who reported receiving up to 30 enquiries a day. Each enquiry involved locating patient notes, consultant review of notes, correspondence with GP and patient, and in some cases expediting the patients' next clinic appointment. All staff had noted a measurable impact on their work load. Notes assessment - The consequence on patient management included ineffectivity of alternative drugs, adverse drug reactions and the need for alternative intervention. The most notable impact was increased visits to the medical system, both GP and hospital. Patient experience - Results showed increased anxiety, communication frustrations and inconvenience of disrupted drug supply.


Glaucoma is a chronic disease that requires long-term medical therapy. Our results show a real impact on patients, disease management and hospital services as a result of erratic drug supply. European legislation states that marketing authorisation holders and distributors have ‘an obligation to ensure appropriate and continued supplies of a medicinal product to pharmacies and persons authorised to supply medicinal products'. To the best of our knowledge this represents the first report of the impact of failure to comply with this legislation in the field of glaucoma.

Keywords: 460 clinical (human) or epidemiologic studies: health care delivery/economics/manpower • 503 drug toxicity/drug effects  

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