Abstract
BackgroundGlaucoma is the leading cause of irreversible blindness globally, and treatment involves considerable cost to stakeholders in healthcare. However, there is infrequent availability of cost information and patterns of management, especially in developing countries. This study determined the cost of the medical management of POAG, adherence, and pattern of medication prescription in Ghana.MethodsA retrospective cross-sectional study involving 891 Primary Open Angle Glaucoma (POAG) cases seen in the year 2012 at three referral facilities. Demographics, ocular history, resource consumption, medication, test, surgery and other related cost were extracted from 84 patients who had fully complied with their treatment to calculate total cost (TC) based on 2012 estimates. Glaucoma drugs prescribed to patients who had adhered to all their review visits within the period evident from case folders were recorded and analysed for the prescription pattern.ResultsOut of 891 POAG cases seen in 2012, 351(39.4 %) attended all the required review visits, but only 84 (9.4) had fully and continually adhered to all their treatment regimes. They comprised 41(48.8 %) males and 43(51.2 %) females with a mean age of 65 ± 14.8. Majority of the respondents were elderly above 60 year of age (65.5 %). The total estimated cost for the 84 cases in the year was GH¢ 81,237 ($40,619), comprising GH¢ 72,193 ($36,097) direct medication cost and GH¢9,045 ($4,523) direct non-medication cost (surgery and test cost), and an average of GH¢ 967 ($484) for a mean visit of 5.6 ± 1.1 in the year. A total of 673 glaucoma medications had been prescribed for 351 patients for the year, with timolol being the most prescribed (64.19 %) and monotherapy as the most adopted form of therapy (61.06 %). Age and income showed concurrent increase with cost (P ≤ 0.05).ConclusionsCost of managing glaucoma constitutes a substantial financial burden and influenced the pattern of medication prescription.
Highlights
Glaucoma is the leading cause of irreversible blindness globally, and treatment involves considerable cost to stakeholders in healthcare
To ensure that Primary Open Angle Glaucoma (POAG) cases in the study had been on therapy for a least a year, were diagnosed by an Ophthalmologist according to the International Classification of Diseases (Ninth Revision, Clinical Modification 365.11; 365.12; 365.04), and were always reviewed by an Ophthalmologist on their subsequent visits, only the year 2012 was selected because it was the only year during which Ophthalmologists were concurrently present at the three facilities throughout the year
The cost of medication prescribed and tests done and recorded in the folders of 84 patients who had fully adhered to their treatment was calculated, the pattern of medications prescribed to the 351 patients who had made all the required visits were analysed
Summary
Glaucoma is the leading cause of irreversible blindness globally, and treatment involves considerable cost to stakeholders in healthcare. Estimates based on published data, in conjunction with prevalence studies have shown that glaucoma is the second leading cause of blindness in the world after cataract, and it is given due public health importance globally [3, 4]. As the risk of POAG increases with age, and with the group of those over 40 years of age constituting more than 25 % of Africa’s population and growing, more people could be living with the condition than reported [6]. It is estimated that about 8.5 % of the population aged 40 years and older have glaucoma in Ghana, of whom about 70 % are POAG cases [5, 8, 9]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
