Abstract
Purpose :
Despite the success of intraocular pressure lowering therapy, glaucoma medication persistence - defined as the act of continuing the treatment for the prescribed duration - remain suboptimal. To date, there has been no comprehensive population-based studies examining glaucoma medication persistence rates. We conducted a retrospective population-based study utilizing data from a universal publicly funded system. This is the first study that employs a big-data approach to elucidate treatment persistence patterns for glaucoma eye drops.
Methods :
All individuals diagnosed with glaucoma who initiated ocular hypotensive medication between January 1, 2011, and December 31, 2016 were included in the study. Glaucoma was defined as patients using one or more glaucoma medications, accompanied by at least one visual field test within four months before or up to two years after medication initiation. Medication persistence was defined as maintaining a continuous supply of medications for up to two years. Partial persistence was for patients who intermittently maintained medications within the 2-year period; and transient users had less than 3 refills. We further analyzed potential factors, such as age, sex and socioeconomic status (SES), that influenced medication persistence.
Results :
From the ICES database, we identified 75,055 glaucoma patients. Among them, 13,150 were transient medication users (Group 1). In contrast, 61,905 patients belonged to the consecutive group. Of these, 17,462 (28.2%) achieved full persistence (Group 2); 31,125 (50.3%) patients (Group 3) experienced >90 days of medication interruption but later resumed their medications. The non-persistent group (Group 4, 21.5%) typically discontinued medications after 3 consecutive refills. The average age, average number of comorbidities, SES and sex distribution in each group are outlined in Figure 1. There were significant associations between the persistence group and SES (p<0.01), and with gender (p<0.001). Specifically, the non-persistence group have higher proportion of patients with low SES than the full-persistence group.
Conclusions :
Our study underscores the prevalence of low persistence (28.2%) for glaucoma medications over a 2-year period. This knowledge will facilitate the refinement of both medical practice and social policies, with the aim of providing enhanced support to individuals who are grappling with these challenges.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.