A recent study published in American Journal of Ophthalmology investigated the impact of comorbidities on patients’ glaucoma medicine adherence.
Give me some background first.
Poor patient adherence to glaucoma meds is a consistent obstacle for eyecare providers. Previous research identified existing barriers in financial burdens, discomfort, lack of knowledge, and forgetfulness.
In the case of this recent research, investigators evaluated whether systemic comorbidity could be another one of these barriers to adherence, and if there was variation based on time after glaucoma onset and comorbidity number.
Now, talk about the study.
Data from 50,408 patients—all newly diagnosed with glaucoma—was collected from National Health Insurance (NHI) claims in Taiwan, Japan, in a study period from January 1, 2011, to December 31, 2020.
A follow-up period was set for 5 years after onset.
The study details..
Researchers used the Deyo-Charlson Comorbidity Index, a popular age independent score to predict long-term survival, to identify comorbidities among patients, while the medication possession ratio (MPR) was used to measure patient adherence to meds.
MPR was calculated by dividing the number of days a patient had a supply of glaucoma medicine by 365.
Findings?
Patients with at least one comorbidity were found to have a higher MPR (meaning better med compliance) in the first 2 years post-onset compared to those without any comorbidity.
However, specifically in the fourth and fifth years after onset, patients with at least one comorbidity had significantly lower MPR.
Tell me more.
The authors suggested that the high levels of early adherence may be due to the fact that those with comorbidities were more likely to visit healthcare facilities for management of these conditions.
They continued to posit that “in the long term, the burden of managing multiple chronic diseases may become increasingly high.”
As a result, this could potentially contribute to lower levels of medicine adherence.
Go on…
The data also expressed that patient nonadherence increased alongside the increasing number of comorbidities.
After the fifth year, patients with ≥4 comorbidities had a 12% decrease in glaucoma drop adherence.
Expert opinion?
Per the authors of the study: “Managing multiple comorbidities necessitates complex treatment plans and multiple medications, increasing the complexity of the medication regimen.”
They further suggested that other comorbidities with more prominent symptoms or “immediate fatal consequences” may take priority for patients over glaucoma which may lack those characteristics.
Take home.
This study displayed key findings that may be utilized to improve glaucoma patient adherence for those with comorbidities in the future.
The authors of the study speak to “the importance of integrating glaucoma treatment into comprehensive chronic disease management plans.”