Adherence and Persistence with Glaucoma Therapy

Research output: Contribution to journalArticle

Abstract

Adherence and persistence with chronic therapies is crucial to prevent disease progression, such as in glaucoma. Patients report high rates of adherence, which are not supported by pharmacy claims analysis. This article reviews the literature regarding methods to assess adherence and persistence and the patient behaviors that pose challenges to proper treatment. Rates for persistence are generally below 50% at 1 year. Differentiating efficacy of eyedrops from lack of adherence presently confounds ophthalmic treatment. Additionally, as intraocular pressure (IOP) can appear controlled by short-term adherence, the physician can be fooled into believing the patient's glaucoma is well-controlled. Likewise, when progressive worsening is noted despite good IOP control, it can be problematic whether the patient's target pressure needs to be lowered or adherence needs to be improved. White-coat adherence is common, in which patient adherence rises sharply 1 week before the appointment with the physician, then declines rapidly following the appointment. White-coat adherence may make it difficult to assess IOP control over the longer term; cycling behavior with medication use is well-documented. Adherence and persistence rates differ by class of drug, with higher rates associated with prostaglandin use. We review findings from The Glaucoma Adherence and Persistency Study that identified behaviors associated with poor adherence. Greater physician awareness of adherence and persistence issues is necessary in order to help the patient become more adherent.

Original languageEnglish (US)
JournalSurvey of Ophthalmology
Volume53
Issue number6 SUPPL.
DOIs
StatePublished - Nov 2008

Fingerprint

Glaucoma
Intraocular Pressure
Patient Compliance
Physicians
Appointments and Schedules
Insurance Claim Review
Ophthalmic Solutions
Therapeutics
Prostaglandins
Disease Progression
Pressure
Pharmaceutical Preparations

Keywords

  • adherence
  • compliance
  • glaucoma
  • persistence

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Adherence and Persistence with Glaucoma Therapy. / Schwartz, Gail; Quigley, Harry A.

In: Survey of Ophthalmology, Vol. 53, No. 6 SUPPL., 11.2008.

Research output: Contribution to journalArticle

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