Medication Adherence and Persistence of Open-Angle Glaucoma Patients in Korea: A Retrospective Study Using National Health Insurance Claims Data.

Yunjeong Jang,Seungjin Bae,Nam-Kyong Choi,Donghyun Jee,Donghwan Lee

doi:10.3390/ijerph18084106

Abstract

This study aimed to analyze medication adherence and persistence among open-angle glaucoma patients in Korea. A retrospective study was conducted using the Korean National Health Insurance (NHI) claims database from 2016 to 2019. Newly diagnosed open-angle glaucoma patients who were prescribed with the intraocular pressure (IOP)-lowering eyedrops were included. Adherence was measured using the medication possession ratio (MPR), and persistence was measured using the duration of therapy during the 24 month follow-up period. During the study period, 14,648 open-angle glaucoma patients were identified, and 3118 (21.3%) and 4481 patients (30.6%) were adherent to and persistent with their glaucoma treatment, respectively. The mean MPR was 48.8%, and the mean duration of therapy was 357.2 days. Logistic regression analysis showed that patients who are older, female, using prostaglandins as the index medication, and visiting secondary or tertiary hospitals were significantly associated with greater rates of adherence (odds ratio (OR) = 1.21, 1.12, 1.27, and 1.73, respectively) and persistence (OR = 1.11, 1.17, 1.16, 1.17, and 1.36, respectively) during the study period. Patients with open-angle glaucoma in Korea had substandard medication adherence and discontinued their treatment. Ophthalmologists should pay more attention to younger, male patients to improve adherence.

Highlights

Glaucoma is a progressive optic neuropathy disease and one of the major causes of permanent blindness worldwide, affecting more than 70 million people [1,2]
Most glaucoma patients are recommended to be initially treated with topical intraocular pressure (IOP)-lowering eyedrops, including prostaglandin analogs, beta-blockers, carbonic anhydrase inhibitors, and alpha 2-agonists [4]
Patients are required to be adherent and persistent to lower their IOP and prevent vision loss [6,7]

Summary

Introduction

Glaucoma is a progressive optic neuropathy disease and one of the major causes of permanent blindness worldwide, affecting more than 70 million people [1,2]. The goal of glaucoma treatment is to prevent visual field deterioration by lowering the intraocular pressure (IOP). Most glaucoma patients are recommended to be initially treated with topical IOP-lowering eyedrops, including prostaglandin analogs, beta-blockers, carbonic anhydrase inhibitors, and alpha 2-agonists [4]. Prostaglandins and beta-blockers are the drugs most commonly used for initial therapy because they have relatively few adverse effects [5]. Patients are required to be adherent (i.e., the extent to which a person behaves according to the prescribed interval and dosing regimen recommended by the provider) and persistent (i.e., to continue with treatment and use prescribed medications for the specific length of time) to lower their IOP and prevent vision loss [6,7]

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Discussion

Conclusion