Treatment Trends in Dry Eye Disease and Factors Associated with Ophthalmic Follow-up Discontinuation in Japan.

Miki Uchino,Motoko Kawashima,Kazuo Tsubota,Yuichi Uchino,Norihiko Yokoi,Yamanishi Ryutaro

doi:10.3390/jcm8081120

Miki Uchino, Motoko Kawashima + Show 4 more

Open Access

https://doi.org/10.3390/jcm8081120

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Abstract

Despite the importance of dry eye disease (DED) treatment, the rate of DED treatment discontinuation, especially discontinuation of ophthalmic follow-up, remains unknown. This study aimed to assess the prevalence and risk factors of ophthalmic follow-up discontinuation for DED. A cross-sectional survey of 1030 participants was conducted using a self-administered web-survey instrument. We collected lifestyle information, history of DED diagnosis, types of treatment, frequency of eye-drop usage, symptoms, and the reasons for discontinuing treatment. Statistical analyses including logistic regression were used to evaluate the risk factors of discontinuing ophthalmic follow-up for DED. A past history of clinical DED diagnosis was reported by 155 (15.0%) subjects. Of those, 130 had persistent DED, and 88 (67.7%) of the subjects reported discontinuation of ophthalmic follow-up for DED. The most prevalent reasons for ophthalmic follow-up discontinuation were time restrictions, followed by dissatisfaction with the DED treatment. Duration after DED diagnosis was the only significant risk factor for discontinuing ophthalmic follow-up after adjusting for age and sex (odds ratio = 1.09, 95% confidence interval = 1.02–1.17, p = 0.009). In conclusion, longer DED duration after diagnosis was a significant risk factor for discontinuing ophthalmic follow-up for DED. This study showed that DED ophthalmic follow-up discontinuation involves both medical and non-medical reasons. Clinicians need to be aware of them, and preventative effort is needed to avoid discontinuation.

Highlights

The prevalence of dry eye disease (DED) continues to rise due to several psychosocioeconomic factors, including an increasingly digitalized world, an aging society, and stressful social environments [1,2]
After controlling for age and sex, we found that each additional year of DED treatment increased the risk by 9% (OR = 1.09, 95% confidence intervals (CIs), 1.02–1.17)
In this study we found that the prevalence of discontinuing ophthalmic follow-up among patients with DED is high in the Japanese population

Summary

Introduction

The prevalence of dry eye disease (DED) continues to rise due to several psychosocioeconomic factors, including an increasingly digitalized world, an aging society, and stressful social environments [1,2]. The economic burden to the health-care system is related to indirect costs, such as those attributed to reductions in working hours and in effectiveness due to dry eye symptoms [4]. As the population ages, establishing effective treatment strategies and ensuring adherence to the treatment for DED become increasingly important. The treatment options for DED have been rapidly increasing, and treating clinicians as well as patients with DED can select from a variety of methods, including tear drops, gels, ointments, and punctal occlusion [6]. There are marked reported discrepancies in the degree of DED severity and treatment response between patient and clinician assessments, which have been found to result in discontinuation of ophthalmic follow-up among patients with DED [7]

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