Abstract
Purpose :
The US population is ageing rapidly, leading to increased prescribing rates to manage chronic conditions and greater risk of polypharmacy. Glaucoma is an age-related eye disease that requires lifetime management, often with multiple medications. The goals of this study were to: 1) assess the impact of topical glaucoma medications on a set of functional outcomes and 2) quantify the additional effects of glaucoma drops on the effects of systemic medications on these functional outcomes.
Methods :
We used baseline demographic, health, and vision data from the Falls in Glaucoma Study (FIGS) in addition to functional outcomes assessments of: vision-related quality of life, fear of falling, daily minutes of moderate to vigorous physical activity, daily step counts, mean reading speed, and falls incidence. Multivariable regression models were used to determine the impact of glaucoma drops on functional outcomes. Separate multivariable regression models were used to assess the relationship between medication load (with or without inclusion of glaucoma drops) and functional outcomes.
Results :
Visual and functional outcome assessments were completed by 245 study participants. About half of participants (47%, n=108) indicated not using any glaucoma drops. Prostaglandin analogues were the most commonly prescribed medication (42%, n=97). Multivariable regression analysis showed that none of the glaucoma medication classes (alpha agonists, beta blockers, carbonic anhydrase inhibitors, prostaglandin analogues) nor number of glaucoma drops were associated with any of the functional outcomes after adjusting for relevant covariates (total integrated visual field sensitivity, age, race, sex, number of comorbidities, non-eyedrop polypharmacy, and number of glaucoma drops) (p>0.05 for all). Other analysis showed the relationship between medication load and functional outcomes was very similar in models which did, or did not, count glaucoma drops as a medication.
Conclusions :
Glaucoma drops do not appear to significantly affect functional outcomes, at least in patients tolerating these medications. Also, consideration of glaucoma drops did not change the relationships between systemic medications and the functional outcomes. Thus, we recommend that topical glaucoma medications need not be considered in polypharmacy assessments within the context of functional outcomes.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.