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L. A. Nelson, B. Kruft, J. A. Stewart, W. C. Stewart; Physician Attitudes Regarding Prostaglandin Treatment for Glaucoma in the United States and Europe. Invest. Ophthalmol. Vis. Sci. 2007;48(13):1572.
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To evaluate physician use of prostaglandins (latanoprost, travoprost and bimatoprost) in the United States and Europe.
A physician survey distributed in the United States and Europe in which physicians were randomly chosen to receive a multiple-choice survey by e-mail (and fax in some cases). The survey was resent twice if no response was received. In total, 1000 surveys were distributed, 500 each in the United States and Europe.
We received 71 responses (United States 40 [8%] and Europe 31 [6%]). Physicians in both continents preferred prostaglandin monotherapy (United States 39 [98%] and Europe 22 [71%], P = 0.003), usually latanoprost (United States 32 [80%] and Europe 22 [71%], P = 0.45). In both continents 45% of respondents stated bimatoprost was more efficacious whereas a similar percent said all three were equally effective. When more efficacy was required physicians in the United States would typically switch (23 [58%]) and physicians in Europe add therapy (22 [71%], P = 0.007). Physicians in both continents noted greater conjunctival hyperemia with bimatoprost. Physicians in the United States generally believed bimatoprost caused greater: itching, ocular pain or periocular pigmentation and that hyperemia adversely affected: cosmetic appearance, number of office visits, compliance or ocular symptoms. Most physicians in the United States and half of physicians in Europe (United States 32 [80%] and Europe 16 [52%], P = 0.01) continued a prostaglandin with cataract surgery.
This study suggested that physicians in the United States and Europe prefer prostaglandin monotherapy, most commonly latanoprost. However, bimatoprost is perceived often as more effective, but having a higher incidence of conjunctival hyperemia. Further, physicians in the United States more often believe bimatoprost contributes to hyperemia related problems and demonstrates additional side effects of itching, ocular pain or periocular pigmentation.
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