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M. M. Hermann, D. Papaconstantinou, G. Georgopoulos, M. Diestelhorst; Compliance With Brimonidine Therapy in Patients Aware of Individual Electronic Compliance Monitoring. Invest. Ophthalmol. Vis. Sci. 2007;48(13):5576.
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© ARVO (1962-2015); The Authors (2016-present)
In ophthalmology glaucoma patients constitute the most important group relying on long-term eye drop therapy. Non-compliance may lead to visual loss. Monitoring individual compliance shall permit to improve the understanding of therapy failure and the reasons why certain patients fail. Individual compliance with Brimonidine therapy was studied in glaucoma patients.
Conventional Brimonidine eye drop vials (Alphagan®, AllerganTM) were equipped with a microprocessor-controlled monitoring device capable to record date and time of each eye drop application including ambient temperature. After written informed consent 20 glaucoma and ocular hypertensive patients used to eye drop therapy were randomly assigned to Brimonidine therapy 3x or 2x daily for 4 weeks. All patients were aware of the individual compliance monitoring unit. IOP was measured at baseline and on days 7, 14, 21, 28. The remaining amount of Brimonidine in the returned bottles was compared to the electronic compliance data.
According to the monitoring devices all patients were non-compliant with regard to total dose and coverage. Electronic records revealed a mean of 1.5 applications per day for patients assigned to Brimonidine 2x daily with a mean treatment interval of 17.0 hours. Patients on Brimonidine 3x daily showed a mean rate of 1.8 applications per day and a mean treatment interval of 13.3 hours. One patient (31y; 2x daily) emptied his bottle within 16 days with 173 attempts of application. Adherence was not remarkably influenced by return appointments.
Individual compliance with conventional Brimonidine eye drops was studied using a recently developed compliance monitoring device with known detection sensitivity for eye drop applications of 99% (ARVO 2005). Though all patients were informed about the presence of the monitoring device, a low individual patient compliance with a mean of 25% missed doses in the Brimonidine 2x group and 40% missed doses in the Brimonidine 3x group was observed. Our data underline the importance and necessity for further studies.
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