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Claudia P. Castiblanco, John J. Huang; Impact of Medication Compliance in the Frequency of Flares in Patients with Uveitis. Invest. Ophthalmol. Vis. Sci. 2012;53(14):1439.
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Impact of Medication Compliance in the Frequency of Flares in Patients with Uveitis
A 5-page survey was administered to eligible patients diagnosed with uveitis currently undergoing topical, peri-ocular, intravitreal and/or systemic treatment evaluated at the Yale Eye Center during a 5-month period from March 2011 to August 2011. The survey included questions such as age, gender, ethnicity, type of uveitis, duration, laterality, associated ocular and/or systemic conditions, current therapies, surgical history and smoking status. Patients were asked about medication non-compliance and associated reasons. Medical records were reviewed to confirm diagnosis, current therapy, degree of inflammation and to obtain baseline visual acuity and IOP. The patients will be followed for the next 6 months and monitored for flares.
Twenty-nine females and 22 males were enrolled with a mean age of 51.3 years. Twenty-four patients were diagnosed with anterior uveitis, 14 patients with panuveitis, 8 patients with posterior uveitis, 4 patients with scleritis and 1 patient with intermediate uveitis. Etiologies ranged from idiopathic, infectious, and autoimmune. Seventy-one percent had inactive uveitis at the time of survey completion compared to 29% of patients who had evidence of inflammation. Baseline mean visual acuity was 20/63 OD and 20/60 OS. Sixty-five percent of patients were on topical therapy, 16% were receiving sub-tenons injections, 10% had intravitreal injections, 8% had intravitreal implants, 24% were taking oral prednisone, and 33% were on immunomodulators. Forty-nine percent of patients had undergone a surgical intervention. In regards to compliance, 68% reported being compliant with their medications compared to 24% reporting non-compliance and 8 % not responding this particular survey question. Adverse effects were cited as the main reason for non-compliance followed by lack of insurance, cost and difficulty with dosing schedule.
Medication compliance plays a significant role in disease activity in patients with uveitis. Identifying factors limiting adherence such as side effect profiles and insurance coverage are essential in optimizing therapy.
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