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Stefanie Frech, Daniel Kreft, Niels Grabow, Rudolf F Guthoff, Gabriele Doblhammer-Reiter; Primary open-angle glaucoma prevalence and adherence - a prospective cohort study based on a health insurance data base. Invest. Ophthalmol. Vis. Sci. 2017;58(8):3707. doi: https://doi.org/.
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Glaucoma is the second leading cause of blindness worldwide. Considering the aging population, prevalence of primary open-angle glaucoma (POAG) rises and the socio-economic impact increases.Understanding the patients environment helps to increase the awareness of the importance of a topical glaucoma medication. In order to assess prevalence and adherence to medical regimens of POAG patients, data from a public health insurance database were evaluated.
Based on a longitudinal data set from 2010-2013 including 250,000 individuals age 50 years and older, inpatient and outpatient details of glaucoma patients of a German public health insurance were analyzed. Quarterly information included general demographic data, medical care parameters, data concerning diagnosis and disease status and medication details, respectively.
The data provided detailed insights into the demographic structure of POAG patients. Estimated point prevalence steadily increased, reaching a maximum of 6.1% for women at the age of 80-84 and 6.6% for men at the age of 85-89.Regarding patients adherence, the percentage of filled prescriptions was assessed for different age-groups. The results demonstrated a substantial non-adherence, as 20-30% of eye drops were even not collected from the pharmacy. Non-adherence of prescription pick-up was independent of gender and age.
The unexpected high percentage of patients not collecting the medication at the pharmacy suggests that the overall adherence including those not using their collected medication as prescribed is much higher.Reasons for glaucoma progression will have to take these results into serious consideration. The most effective strategies to increase patients adherence have to be worked out in the near future.In order to confine the most endangered subgroups we will further investigate the influence of potential cofactors like diabetes, hypertension and polypharmacy using multivariate panel regression models that allow to adjust for gender and age.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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