Purpose:
Topical medication is the mainstay of treatment for most patients with glaucoma. However non-adherence remains a critical issue. Novel methods of ocular drug delivery are increasingly being considered although little is known about the associated patients’ attitudes and perceptions of such techniques. We examined the patients’ acceptance towards a subconjunctival injectable implant as a possible alternative to topical anti-glaucoma medication and identified a subgroup willing to accept this alternate form of drug delivery.
Methods:
Patients with primary open angle or angle closure glaucoma and currently on topical anti-glaucoma medication for a minimum of six months, from specialist glaucoma clinics were recruited. Socio-demographic data and information about patients’ general and ocular health were collected from medical records. Beliefs about medicines, glaucoma, eye-drops and self-reported adherence were assessed by trained interviewers using various validated questionnaires.
Results:
Of the 344 patients enrolled, 216 (62.8%) would accept the implant as a replacement for their current eye drops. Regarding the cost of this alternate delivery system, 162 (47.1%) were willing to accept it provided it was similar to the cost of their current medication. 53 (15.4%) and 30 (8.7%) patients were willing to pay one-and-a-half and twice the cost of their present medication, respectively. Patients who accepted the implant tended to have more severe glaucoma (P = 0.015) and rated the implant’s helpfulness more highly (P < 0.001). There was also a trend suggesting that a shorter duration of diagnosis of glaucoma was associated with greater implant acceptance (P = 0.054). Beliefs towards medicines, glaucoma, eye-drops, self-reported adherence and socio-demographic factors did not have a significant impact on the patients’ decisions.
Conclusions:
A commercially available ocular drug implant would be an acceptable alternative to topical eye-drops for a clearly defined subgroup of glaucoma patients.
Keywords: intraocular pressure • injection • clinical (human) or epidemiologic studies: health care delivery/economics/manpower