Abstract
Abstract: :
Purpose: We sought to examine the effect of adding complexity to a glaucoma medical treatment regimen – specifically, what would occur to refill rate (and by inference, to adherence) when a second medication was added to a currently used once–daily drug. Methods: We obtained prescription data from a large, national, health care provider for patients who had received a prescription for latanoprost. between 1 July 2001 and 30 June 2002. We evaluated patients who continued on latanoprost alone, and those who had a second medication added. Results: The mean age of the population using second–line therapy was 68.3 +/– 14.5 years (Range 4–97) and was 56% female. In this population of 1,784 patients who used two different ocular hypotensive medications, the mean refill interval for latanoprost before the addition of a second drug was 40.6 ± 21.8 days, and after the addition of a second drug was 47.4 ± 24.4 days, with a mean increase of 6.7 +/–25.6 days. For 22.9% (409/1784) of patients, the interval was increased by more than two weeks (p < 0.0001). The mean refill interval was longer than that for the 3,146 patients who continued on latanoprost monotherapy, which was 41 +/– 24 days. Conclusions:This statistically and clinically significant increase in refill intervals may affect long–term visual outcome. We suggest that when adding a second drug, physicians need to consider the possible impact on the patient’s adherence to the first drug.
Keywords: clinical (human) or epidemiologic studies: health care delivery/economics/manpower • clinical (human) or epidemiologic studies: outcomes/complications • clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled