June 2022
Volume 63, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2022
Patient factors determine acceptability of topical immunosuppressives in dry eye
Author Affiliations & Notes
  • Louis Tong
    Cornea and external eye disease, Singapore National Eye Centre, Singapore, Singapore, Singapore
    Ocular Surface Research Group, Singapore Eye Research Institute, Singapore, Singapore
  • Semra Ozdemir
    Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
    Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
  • Jia Jia Lee
    Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
  • Adithya Bhaskar
    Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
  • Eric Finkelstein
    Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
    Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
  • Footnotes
    Commercial Relationships   Louis Tong Alcon, Santen, Vivavision Biotech, Code C (Consultant/Contractor), Alcon, Santen, Code F (Financial Support), Alcon, Santen, Bausch and Lomb, Code R (Recipient); Semra Ozdemir None; Jia Jia Lee None; Adithya Bhaskar None; Eric Finkelstein None
  • Footnotes
    Support  NMRC\CSA\017\2017
Investigative Ophthalmology & Visual Science June 2022, Vol.63, 3944 – A0224. doi:
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    • Get Citation

      Louis Tong, Semra Ozdemir, Jia Jia Lee, Adithya Bhaskar, Eric Finkelstein; Patient factors determine acceptability of topical immunosuppressives in dry eye. Invest. Ophthalmol. Vis. Sci. 2022;63(7):3944 – A0224.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Medications can result in side effects which may lead to medication non-adherence and, eventually, to poor outcomes. This study aimed to quantify to what extent the side effects of dry eye disease (DED) medications (burning/stinging sensation and blurring) are important to patients as opposed to medication benefits or costs.

Methods : Patients who were diagnosed with DED were recruited at a referral eye centre in Singapore (n=139). This study utilized a Discrete Choice Experiment where patients were presented with 10 choice tasks where they were asked to choose between their current medication (or no medication), and two hypothetical medications that varied based on five attributes: duration of burning/stinging, duration of blurring, time to medication effectiveness, medication frequency, and out-of-pocket cost. The main outcomes were relative attribute importance and predicted uptake.

Results : Latent class logistic regressions found two groups with distinct preferences. Classes 1 and 2 constituted 62.5% and 37.5% of the sample. For both classes, duration of burning/stinging (Class1=12%, Class2=20%) and cost (Class1=12%, Class2=19%) were the most important attributes while duration of blurring (Class1=8%, Class2=6%) was the least important. The predicted uptake of a medication increased 18 percentage-points when burning/stinging duration decreased from 2 hours to a few minutes. The increase was 41 percentage-points for Class 2 who were more likely to report neutral/poor control of their dry eye symptoms.

Conclusions : This study showed that side effects should be considered, in parallel with therapeutic efficacy, when choosing anti-inflammatory medications in DED. Incorporating patient preferences in treatment decisions could potentially improve patient acceptance of a treatment regimen.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.

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