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Lyne Racette, Sampson Listowell Abu, Shervonne Poleon, Tracy Thomas, Nouran Sabbagh, Christopher A Girkin; Racial disparity in the impact of the COVID-19 pandemic on adherence to ocular hypotensive medication among patients of African and European descent. Invest. Ophthalmol. Vis. Sci. 2021;62(8):1979.
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Emerging evidence suggests that the COVID-19 pandemic, which has disproportionately affected people of African descent (AD), is disrupting health behaviors such as medication adherence. Studies have not yet assessed, however, whether medication adherence is differentially affected in people of AD, a population shown to have poorer adherence prior to the pandemic. We examined whether racial disparities exist in the impact of the COVID-19 pandemic on medication adherence in people of AD and European descent (ED).
We used a controlled interrupted time series design in which the interruption was the declaration of the COVID-19 pandemic in the United States on March 13, 2020. The 300-day follow-up period, which bracketed this declaration, started on October 16, 2019 and ended on August 10, 2020. Patients were selected from an ongoing longitudinal NIH-funded study initiated prior to the onset of the pandemic, if they had primary open-angle glaucoma, were prescribed ocular hypotensive medication and had adherence data spanning the 300 days of the study. The primary outcome was daliy adherence defined as the number of doses taken divided by the number of doses prescribed, expressed as a percentage. Adherence was measured objectively using Medication Event Monitoring System (MEMS). Segmented regression analysis using the “slope change following a lag” impact model was performed and the Davies test was used to compare the slopes in the periods preceding and following the pandemic.
72 patients (35 of AD and 37 of ED) were included. Prior to the pandemic, mean adherence was 75 ± 25% in patients of AD and 91 ± 15% in people of ED (p = 0.001). In patients of AD, the slopes in the periods preceding (0.0% / day) and following (-0.07% / day) the pandemic were significantly different (p < 0.001). In patients of ED, the slopes in the periods preceding (0.01% / day) and following (-0.02 / day) the pandemic were similar (p = 0.05).
Medication adherence, a health behavior critical in the management of chronic diseases, was adversely affected by the COVID-19 pandemic in patients of African descent with glaucoma. The vulnerabilities exposed by the COVID-19 pandemic should be used to inform the development of interventions that will ensure continued use of medication during crisis periods, particularly in high-risk populations.
This is a 2021 ARVO Annual Meeting abstract.
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