Glaucoma medication adherence: Early habits stick

Medication adherence patterns established during the first year of glaucoma treatment, both good and poor, usually remained consistent for the next 3 years, according to this retrospective study.

The authors used group-based trajectory modeling to identify distinctive patterns of behavior among 1,234 patients newly diagnosed with open-angle glaucoma. This type of modeling has been used to capture longer-term medication use in other chronic disease states, such as hyperlipidemia, hypertension, psoriasis and epilepsy.

Most patients were grouped as exhibiting persistently moderate adherence (48.1%) during the first year of follow-up. Patients in this group were more likely to be white, older and earn >$60 000/year (P<0.05 for all comparisons).

Other factors that contributed toward better long-term adherence were increased number of visits with an eye-care provider (P<0.05), which may be due to more frequent counseling and reinforcement. Mail order prescriptions were also associated with maintaining good adherence, though it is possible that automated mail-order refills enabled higher medication possession ratios without necessarily ensuring high actual usage. A higher initial copayment cost was associated with lower adherence rates (P=0.03).

While this study suggests that early physician intervention may have a positive long-term effect on adherence, the durability of this effect is unclear. It’s also unclear if initial adherence patterns persists due to physician intervention.

Still, the authors conclude that helping patients with suboptimal adherence patterns in the first year of treatment may have a large impact on longer-term adherence.