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A. M. Bron, M. M. Hermann, Jr., C. Creuzot-Garcher, M. Diestelhorst; Monitoring Individual Compliance in Glaucoma Patients Used to Topical Therapy. Invest. Ophthalmol. Vis. Sci. 2007;48(13):5580.
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Glaucoma patients constitute the most important group relying on long-term topical therapy. Retrospective cohort studies suggest the rate of non-compliance in glaucoma to be of major importance since non-compliance may lead to blindness. Monitoring individual compliance may improve the understanding of therapy failure and the reasons why certain patients fail with their therapy. Individual compliance with Brimonidine eye drops was studied in glaucoma patients and ocular hypertensives.
Conventional Brimonidine 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, 14 glaucoma and 7 ocular hypertensive patients used to eye drop therapy mean±STD [range] (9.6 ± 7.4 years [1-25]) were randomly assigned to Brimonidine therapy b.i.d or t.i.d daily for 4 weeks. IOP was measured at baseline and after one month.
Twelve males and nine females aged 69.2 ± 10.0 years [50-86] were enrolled in this study, 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 (range: 1.2-2.0) applications per day for patients assigned to Brimonidine 2x daily with a mean treatment interval of 17.2 hours (range: 12.1-21.4 h). Patients on Brimonidine 3x daily showed a mean rate of 2.2 (range: 1.8-2.7) applications per day and a mean treatment interval of 11.8 h (range: 9.1-13.9 h). One patient discontinued therapy after day 7 (12 applications) and one after day 1 (1 application only). No difference was observed between IOP at baseline and after one month (p=0.16).
Individual compliance with conventional Brimonidine eye drops was studied by means of a newly developed compliance monitoring device with a known detection sensitivity for eye drop applications ~ 99% (C. Ustundag, M.M. Hermann and M. Diestelhorst. Reliability of a New Microprocessor-Controlled Compliance Monitor. Invest Ophthalmol Vis Sci 2005;46: E-Abstract 4728). The monitoring devices permit to detect individual non-compliance with regard to missed doses, non-treatment intervals. Our data confirm the need for larger studies on individual compliance with topical ocular therapy in glaucoma.
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