Approximately half of patients who had filled a glaucoma prescription discontinued therapy within six months. Also, only 37% of patients refilled their initial medication at three years. These are the findings of a new study in Octobers American Journal of Ophthalmology.

Epidemiology researchers used health insurance claims data of 5,300 glaucoma patients and suspects to calculate the duration of continuous treatment with the initially prescribed glaucoma medication (i.e., persistence) and the prevalence of use of the initial medication at various time points (i.e., adherence).

Patients were treated with beta-blockers, alpha-agonists, carbonic anhydrase inhibitors or prostaglandin analogs. Prostaglandins were associated with better persistence and adherence than any other class of medication. Also, patients with diagnosed glaucoma were more likely to adhere to treatment than glaucoma suspects.

We can make the best diagnoses, but if patients do not take their medications, what good did we do? says optometrist Murray Fingeret, of St. Albans, N.Y.

There are many reasons why patients do not take their medications, he says. These include cost, side effects, forgetfulness and lack of understanding about why a drug is prescribed.

The best tool optometrists currently have to address the dismal results of this study is patient education, says Dr. Fingeret. Tell patients why they require medication, what the medication will do, and how we will follow their glaucoma. Also, try to keep treatment regimens as simple as possible, and look for and ask the patient about side effects, he says. Until we fully understand why compliance is a problem, the best we can do is recognize the issue and talk about it with our patients.

Nordstrom BL, Friedman DS, Mozaffari E, et al. Persistence and adherence with topical glaucoma therapy. Am J Ophthalmol 2005 Oct;140(4):598-606.

Vol. No: 142:12Issue: 12/15/2005