INITIAL ADHERENCE IS ASSOCIATED WITH LONG-TERM COMPLIANCE

 

Studies have shown that patients on anti-glaucoma treatment can be identified for their specific characteristics, regarding long-term adherence and compliance to treatment.

According to a study by Kolko et al, individuals who have high adherence in the first 2 years of treatment have long-term compliance with the medications.

The study also found that adherence is less likely among men (OR first year: 0.78, 95%CI: 0.75 to 0.82), younger individuals, and those with a positive Charlson Comorbidity Index (CCI) score (OR first year/CCI≥3: 0.71, 95%CI: 0.63 to 0.80).

Adherence in the first one and two years of treatment was associated with better adherence in the 5^th and also in the 10^th year of treatment, to some extent.

It was also found that patients with poor adherence prove to be more expensive for hospital contacts in the long run.

Glaucoma patients with diseases of the eye and adnexa, diseases of the musculoskeletal system and connective tissue, and ischemic heart diseases were less likely to be adherent to glaucoma treatment compared with glaucoma patients without the presence of these comorbidities.

A study by Newman-Casey has classified glaucoma patients into 5 groups, based on their adherence to therapy.

These groups were:

1) Never adherent after their index prescription fill (7.5%,15.6% of persons in the one and four-year models, respectively)

2) Persistently very poor adherence (14.9%, 23.4%)

3) Declining adherence (9.5%, 9.1%)

4) Persistently moderate adherence (48.1%, 37.0%)

5) Persistently good adherence (20.0%, 15.0%)

Persons with the best adherence over 4 years were more likely to be white, older age, earn >

$60,000/year, and have more eye care visits (p<0.05 for all comparisons).

CONCLUSION:

These studies indicate that improving adherence in the first two years of treatment has long-term benefits regarding compliance. This can translate into better clinical outcomes.

REFERENCES:

Kolko M, Faergemann Hansen R, G Dal L, Sabelström E, Brandel M, Hoiberg Bentsen A, Falch-Joergensen AC. Predictors and long-term patterns of medication adherence to glaucoma treatment in Denmark-an observational registry study of 30 100 Danish patients with glaucoma. BMJ Open Ophthalmol. 2024 Apr 15;9(1):e001607. doi: 10.1136/bmjophth-2023-001607. PMID: 38626933; PMCID: PMC11029215.

Newman-Casey PA, Blachley T, Lee PP, Heisler M, Farris KB, Stein JD. Patterns of Glaucoma Medication Adherence over Four Years of Follow-Up. Ophthalmology. 2015 Oct;122(10):2010-21. doi: 10.1016/j.ophtha.2015.06.039. Epub 2015 Aug 25. PMID: 26319441; PMCID: PMC4581955.