Adherence improvement in Dutch glaucoma patients: a randomized controlled trial

Area of Science:

• Ophthalmology
• Clinical Trials
• Patient Adherence

Background:

• Primary open-angle glaucoma (POAG) and ocular hypertension (OHT) require consistent treatment to manage intraocular pressure (IOP).
• Adherence to topical glaucoma medication is crucial for effective IOP control.
• Assistive devices and patient education are potential strategies to improve treatment adherence.

Purpose of the Study:

• To evaluate the impact of patient education and a drop guider device on IOP and medication adherence in POAG and OHT patients.
• To compare four intervention groups: dosing aid alone, dosing aid with drop guider, dosing aid with patient education, and dosing aid with both interventions.
• To assess the influence of specific patient factors on IOP and adherence.

Main Methods:

• A multicenter, randomized controlled trial involving 18 Dutch hospitals.
• Patients were assigned to one of four arms utilizing the TravAlert(®) dosing aid with varying combinations of a drop guider and patient education.
• Intraocular pressure (IOP) was measured at baseline and at 3 and 6 months; adherence data were collected via the dosing aid.

Main Results:

• Mean IOP decreased significantly from baseline across all groups after 6 months (approx. 16.3-16.4 mmHg).
• The overall mean adherence rate was high (0.91 ± 0.1).
• No statistically significant differences in IOP or adherence were found between the study arms. However, patients with 'drug holidays' had higher IOP, drop guider use correlated with lower adherence, and lower patient knowledge was linked to reduced adherence.

Conclusions:

• Patient education is particularly beneficial for newly diagnosed glaucoma patients.
• The use of a drop guider did not enhance medication adherence.
• Patients who intermittently stop their medication ('drug holidays') are at a higher risk of elevated IOP.