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Hani Levkovitch-Verbin, Varda Shalev, Nir Zigman, Gabriel Chodick, Inbal Goldschtein; THE MACCABI GLAUCOMA STUDY- TREATMENT PATTERNS AND PERSISTENCE WITH GLAUCOMA THERAPY IN A LARGE ISRAELI HEALTH MAINTENANCE ORGANIZATION. Invest. Ophthalmol. Vis. Sci. 2014;55(13):4318.
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© ARVO (1962-2015); The Authors (2016-present)
To characterize adherence and persistence to glaucoma medications among glaucoma patients in Israel
This is a population-based retrospective cohort study, conducted using the electronic medical databases of Maccabi Healthcare Services (MHS), a 2 million member health maintenance organization in Israel. All MHS newly diagnosed glaucoma patients who purchased at least one anti-glaucoma medication were included. Collected data included demographics, baseline intraocular pressure, diagnosis, prescribed and dispensed anti-glaucoma medications, and caregiver characteristics. Adherence was analyzed by proportion of days covered by drugs during follow up time, ignoring overlaps due to overuse and simultaneous combination of several types of eye drops.
We identified a total of 5,934 incident definite glaucoma patients, who were diagnosed between 2003 and 2010 and purchased at least one anti-glaucoma medication. The mean medical coverage was 58%. Thirteen percent were non-adherent with therapy (covered less than 20% of the follow up time), and only 25% exhibited high adherence (covered at least 80% of the follow-up period). Medical coverage was affected significantly by patient age, gender, socioeconomic status, diagnosis and IOP at baseline. Patients with angle closure and low tension glaucoma were less persistent than those with open angle and exfoliation glaucoma. Medical coverage was also affected by class of drug.
Every Israeli citizen is covered by a governmental supported health insurance. Nevertheless, this study confirms that adherence and persistence with ocular hypotensive medications is less than ideal among Israeli glaucoma patients. Both patients and caregiver characteristics affect adherence.
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