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Michael Diestelhorst, Travalert Study Group; Correlation Of Iop And Individual Adherence With The Fixed Travoprost / Timolol Therapy. A Multi-centre Study In Ambulant Glaucoma Patients. Invest. Ophthalmol. Vis. Sci. 2011;52(14):230.
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Forgetfulness is a major reason for non-adherence with glaucoma therapy. Electronic monitoring of individual adherence improves our understanding of treatment failure. The Travalert® reminder device (Alcon, USA) was used to study the correlation of IOP and individual adherence with fixed Travoprost/Timolol therapy.
In a multi-centre study conventional DuoTrav® bottles (Travoprost/Timolol, Alcon GmbH, Germany) were equipped with Travalert® devices capable to remind of treatment via acoustic signalling. Patients were switched from other topical therapy to the fixed combination of travoprost/timolol. After written informed consent 130 glaucoma patients were asked to apply one drop of DuoTrav® each day at 8-10 pm for 4 weeks to designated eyes. The identical treatment was re-evaluated during the following 4 weeks. IOP was measured at inclusion and +30, +60 days. Adherence was defined as % of valid applications within a ±4 hour interval. Dosage intervals, IOP and handling was analyzed based on electronic monitoring protocols, patients’ and Drs.’ questionnaires.
Travalert® devices of 84 patients were included in the ITT analyses. Mean IOP was sign. reduced from baseline 19.4±3.7 to 15.6±3.3 mmHg during weeks 1-4 and 5-8. The mean dose adherence of 38.3±33.3% (wee 1-4) did not change significantly during weeks 5-8. The mean number of eye drops per day was 3.6±3.8. There was no significant correlation of IOP and individual treatment adherence. The mean treatment gap was 56.4±102.5 hours. Adherence was worse in patients with more severe visual field defects.
In a multi-centre study individual adherence with DuoTrav® therapy was studied in 84 ambulant glaucoma patients. The Travalert® reminding system revealed non-adherence of ~60%. There was no correlation of IOP and individual treatment adherence. Adherence was worse in patients with more severe visual field defects. Non-adherence with topical glaucoma therapy is underestimated.
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