Persistence with topical glaucoma therapy among newly diagnosed Japanese patients

Abstract

To investigate persistence with glaucoma medication use and factors associated with it among newly diagnosed Japanese patients. The subjects of this study were Japanese patients entered in the Japan Health Insurance Society database who were newly diagnosed as having glaucoma and who had been prescribed antiglaucoma medication. Newly diagnosed was defined as having no history of glaucoma diagnosis, antiglaucoma medication use, or glaucoma surgery, including laser treatment, during at least 6 months prior to enrollment. Discontinuation of glaucoma medication was defined as no record of an antiglaucoma medication prescription or monthly claims for medical expenses for 6 months or longer. Patients who met the following criteria were eliminated from the analysis: those who changed insurance systems, those without records in the Japan Health Insurance Society database, or those whose glaucoma diagnosis was retracted. A total of 2799 patients (age 47.3 ± 13.9 years) were defined as patients with newly diagnosed glaucoma. They comprised 1494 male (46.9 ± 13.6 years) and 1305 female (47.8 ± 14.1 years) patients. Soon after starting to take the antiglaucoma medication, many patients discontinued it. The persistence rates at 3 months, 6 months, 12 months, and 3 years after the initiation of medication were 73.2, 68.1, 60.9, and 52.5 %, respectively. Younger age, the number of medications, and the hospital size were significantly associated with the patients' persistence with medication use. One-quarter of the newly diagnosed glaucoma patients discontinued glaucoma medication within the first 3 months of being prescribed it, and some factors were significantly associated with persistence with medication use.