Topical treatment‐ are we adhering to guidelines?

Abstract

AbstractPurpose To determine if established guidelines for medical treatment are being used in glaucoma clinicsMethods Retrospective case note review of 120 consecutive patients in a glaucoma clinic who had been started on topical treatment within the last 5 years. The prescribing trends were compared to EGS guidelines and local guidelines. first line, second line and combination regimens, was analysed. The persistence of individual classes of drops and combination regimens was studied.Results First line: Prostaglandin analogues (PGA) were prescribed in 70%, Beta‐blockers (BB) in 20% and Carbonic anhydrase inhibitors (CAI) and combination preparations in 10%. Persistence: 25% of PGA group, effect of one PGA lasted > 3 years; 75% of PGA group, effect of one PGA lasted < 3 years. 36% of BB group, effect of one BB lasted > 3years; in 64%, effect of single BB lasted < 3 years. Second line: PGA prescribed in 25%, BB in 9% and combination preparations in 66%. Persistence: 30% of BB+PGA lasted > 3 years; 43% of PGA+BB lasted > 3Conclusion First line drop prescription was in line with EGS and local guidelines. Persistence of effect of BB at > 3 years was better than PGA (36% v 25%). Combination drops were the most popular 2nd line, with Cosopt being the most popular (38%) 2nd line drop. The combination of PGA+combination drop had the best persistence (39%). There was a surprisingly large number of cases with inappropriate combination regimes. Commercial interest