June 2015
Volume 56, Issue 7
ARVO Annual Meeting Abstract  |   June 2015
Automated Reminder System to Assess Adherence in Glaucoma Patients
Author Affiliations & Notes
  • Ardalan Aminlari
    Wills Eye Hospital, Philadelphia, PA
  • Ethan Greenberg
    Temple University School of Medicine, Philadelphia, PA
  • Michael Waisbourd
    Wills Eye Hospital, Philadelphia, PA
  • Lisa A Hark
    Wills Eye Hospital, Philadelphia, PA
  • Christopher Williams
    Crozer Keystone Health System, Philadelphia, PA
    Wills Eye Hospital, Philadelphia, PA
  • Jonathan S Myers
    Wills Eye Hospital, Philadelphia, PA
  • Footnotes
    Commercial Relationships Ardalan Aminlari, None; Ethan Greenberg, None; Michael Waisbourd, None; Lisa Hark, None; Christopher Williams, Alan Health and Science Corp (I); Jonathan Myers, Aerie (F), Alcon (C), Alcon (F), Alcon (R), Allergan (C), Allergan (F), Allergan (R), Haag Streit (R), Inotek (C), Inotek (F)
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2015, Vol.56, 5715. doi:
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      Ardalan Aminlari, Ethan Greenberg, Michael Waisbourd, Lisa A Hark, Christopher Williams, Jonathan S Myers; Automated Reminder System to Assess Adherence in Glaucoma Patients. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):5715.

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

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To evaluate adherence rates in a patient population using OnPace Plus, a patient care and management information software system, which creates automated phone and text messages with patient responses indicating drop use. Our aim is to identify modifiable factors that impact glaucoma medication adherence, to analyze self-reported drop use over a 6-month period on the automated reminder system, track and analyze progressive non-compliance with the system, and to evaluate adherence to glaucoma medication dosing, and its relationship to the patients' demographics, ethnicity, age and gender.


Retrospective review of daily patient reported adherence to glaucoma medications over 6-month period in a private practice. Reporting rate was defined as percentage of responses vs contacts. Adherence rate defined as percentage of affirmative responses vs total responses. Results were analyzed to assess relation of adherence to patient characteristics utilizing generalized estimating equation.


The study included 56 participants diagnosed as glaucoma or glaucoma suspect. Average (±SD) age was 75.2 (±10.2) years. The patient population was predominantly African American (n=34, 64.2%). The average (±SD) number of glaucoma medications was 1.71 (±0.78).<br /> Response rate showed no statistical difference between month 1 (63%) vs month 3 (67%), P=0.23, and or month 6 (61%), P=0.59. Adherence rates showed no statistical difference between month 1 (98%) vs month 3 (97%), P=0.81, and or month 6 (96%), P=0.98. The number of medications was inversely correlated to response rate (2 medications, OR=0.35, P=0.0093; 3 medications, OR=0.15, P=<0.0001), but not adherence rate (2 medications, OR=0.5, P=0.46; 3 medications, OR=0.42, P=0.4). Other variables, including age, race, vision and VF indices, did not achieve significance.


The majority of glaucoma patients who used an automated reminder system replied to the reminders by using a text message or an automated phone call confirmation. Self reported adherence exceeded 96% at all time intervals. Patients who used a higher number of medications were less likely to respond. This ongoing study continues to enroll patients and extend monitoring through continued clinical use of this patient centered educational tool.


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