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Published on: February 15, 2022
Combination therapy as initial treatment in glaucoma and suspected glaucoma
Frederick S Mikelberg1, Mahyar Etminan
1Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, BC. fsm@mail.ubc.ca
Summary
Initial combination eye drops for glaucoma treatment increased significantly from 12.29% to 18.63% between 2004 and 2007. This suggests potential overuse of combination therapy in glaucoma patients and suspects.
Area of Science:
- Ophthalmology
- Pharmacology
- Health Services Research
Background:
- Glaucoma management often involves ocular hypotensive eye drops.
- Initial therapy choice significantly impacts long-term treatment efficacy and patient adherence.
- Combination therapy, using multiple active ingredients in one bottle, is an option for glaucoma treatment.
Purpose of the Study:
- To investigate the frequency of initial combination eye drop prescriptions for glaucoma patients and glaucoma suspects.
- To determine if there is an inappropriate overuse of initial combination therapy in this patient population.
Main Methods:
- A retrospective cohort study was conducted using the British Columbia Population DataBase (POP Data BC).
- The study included individuals who visited an ophthalmologist between 2004 and 2007.
- Newly prescribed ocular hypotensive eye drops within 60 days of glaucoma diagnosis (ICD-9 code 365) were identified.
Main Results:
- The percentage of initial ocular hypotensive prescriptions that were combination therapy increased from 12.29% in 2004 to 18.63% in 2007.
- This represents a substantial rise in the use of combination eye drops as first-line treatment.
Conclusions:
- The observed increase in initial combination therapy suggests a potential overuse.
- Ophthalmologists may need further education on pharmacologic therapy principles or could be influenced by pharmaceutical industry marketing.
- Further research into prescribing patterns and educational needs is warranted.
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