Abstract

BackgroundOne barrier to patient adherence with chronic topical glaucoma treatment is an inadequate amount of medication available between prescription refills. We examined the self-reported prevalence of early exhaustion of glaucoma eye drops prior to a scheduled refill, and associated risk factors.MethodsThis cross-sectional survey was performed at a University-based clinical practice. Glaucoma patients at the University of Washington who were experienced with eye drop application and were on a steady regimen of self-administered glaucoma drops in both eyes took a survey at the time of clinic examination. The main outcome measure was self-reported early eye drop bottle exhaustion.Results236 patients were eligible and chose to participate. In general, patients included were relatively healthy (mean 2.3 comorbid medical conditions). Sixty patients (25.4%) reported any problem with early exhaustion of eye drop bottles, and this was associated with visual acuity ≤ 20/70 in the better eye (P = .049). Twelve patients (5.1%) reported that they “often” (5–7 times per year), “usually” (8–11 times per year) or “always” ran out of eye drops prior to a scheduled refill. Patients affected by this higher level (≥5 times yearly) of eye drop bottle exhaustion were more likely to have poor visual acuity in their worse eye ≤ 20/70 (P = .015) and had significantly lower worse-eye logMAR (P = .043).ConclusionsSelf-reported early glaucoma bottle exhaustion regularly affected 5% of patients in our population and 25% reported early exhaustion at least once; the main risk factor was poor vision in at least one eye. These results may not be generalizable to a broad patient population, or to those inexperienced with eye drop self-administration. However, this pilot study compels further evaluation and consideration of early eye drop bottle exhaustion in glaucoma patients.

Highlights

  • One barrier to patient adherence with chronic topical glaucoma treatment is an inadequate amount of medication available between prescription refills

  • We reviewed the patients’ medical records for additional data, including visual acuity and most recent visual field data, including mean deviation (MD), pattern standard deviation (PSD) and visual field index (VFI)

  • The sole risk factor significantly associated with this level of early bottle exhaustion was poor visual acuity (≤20/70) in the better eye (5/9 vs 55/227; P = .049, Fisher exact test) from any cause

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Summary

Introduction

One barrier to patient adherence with chronic topical glaucoma treatment is an inadequate amount of medication available between prescription refills. We examined the self-reported prevalence of early exhaustion of glaucoma eye drops prior to a scheduled refill, and associated risk factors. Multiple reasons for poor adherence with topical glaucoma treatment have been implicated including situational and environmental factors, medication regimen, patient-related and provider-related factors [8] Another barrier to patient compliance is an inadequate amount of medication available between scheduled prescription refills, because of difficulty in eye drop administration with resultant wastage. This is an issue in the United States (and may be in other developed nations) where prescription drug benefits ensure access to medication for most of the population, and control the time interval before a refill may be obtained. The present study was based on patient recall over the year prior to institution of the CMS changes in a state without such legislation

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