Abstract
Purpose :
Medications to lower intraocular pressure (IOP) and reduce the risk of glaucomatous progression are only effective if a patient can take them as prescribed and successfully administer the eye drops. This can often be challenging, especially for patients with medical comorbidities that can affect fine motor skills. Little is known the extent by which patients with glaucoma have medical comorbidities that can limit self-administration of topical glaucoma medications.
Methods :
We identified all patients age ≥18 years old receiving care at 6 health systems participating in the Sight Outcomes Research Collaborative (SOURCE) repository. SOURCE captures EHR data on all eye care recipients at these institutions. We identified patients in SOURCE with glaucoma based on ICD billing codes, clinical exam findings consistent with glaucoma, and receipt of interventions for glaucoma. We assessed which patients had ≥1 medical comorbidities such as rheumatoid arthritis, Parkinson’s disease, cerebrovascular disease, etc, that may make it difficult to self-administer glaucoma medications. Logistic regression assessed for potential associations between glaucoma and impairments, adjusting for patient demographics and other factors.
Results :
Of the 1446229 eligible patients in SOURCE, 247890 (17.1%) had evidence of glaucoma and among these, 106407 (42.9%) had ≥1 medical comorbidities that can make it difficult to administer glaucoma medications. The proportion of patients with glaucoma with 1, 2, 3, 4+ impairments was 18.0%, 15.7%%, 6.1%, and 3.1%, respectively. After adjusting for sociodemographic factors, patients with ≥1 impairment that can limit eye drop instillation had 16% increased odds of glaucoma (adjusted odds ratio (aOR): 1.16 (1.15, 1.17)) compared to those with no impairments. Patients with 2 (aOR: 1.25 (1.24, 1.27), 3 (aOR: 1.39 (1.36, 1.42), 4+ (aOR: 1.54 (1.49, 1.58) impairments had a 25%, 39%, and 54% increased odds of glaucoma, respectively, compared to those with no impairments.
Conclusions :
A sizable percentage of patients with glaucoma (43%) also have ≥1 medical comorbidity that can make it difficult to successfully self-administer topical glaucoma medications. These patients may benefit from alternative treatment modalities for lowering IOP.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.