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The relationship between sociodemographic factors and persistence with topical glaucoma medications
Victoria C Leung1, Ya-Ping Jin, Wendy Hatch
1*Faculty of Medicine †Department of Ophthalmology and Vision Sciences ‡Dalla Lana School of Public Health, University of Toronto, Toronto, ON §Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, BC, Canada.
Purpose:
To investigate the relationship between sociodemographic factors and nonpersistence with topical glaucoma medication.
Design:
This was a retrospective, observational cohort study.
Patients And Methods:
We invited glaucoma patients on medical therapy from a general ophthalmology practice to complete a standardized questionnaire between November 2011 and April 2012. Nonpersistence was defined as having ≥ 1 gaps (≥ 14 d without medication) in therapy over the last year. Patients' pharmacy records, dating back 1 year from study enrollment, were used to determine the total number of gaps and the cumulative number of days off therapy in the last year. Prevalence ratios (PR) and 95% confidence intervals (CI) were used to assess the relationship between sociodemographic factors and nonpersistence. The relationships between sociodemographic factors and the median number of gaps, as well as the median number of days off, were also assessed.
Results:
Sixty-one patients were included for analysis. The mean age was 72 years; 61% were male patients and 71% were on one medication for glaucoma. Fifty-four percent of patients (n=33) were nonpersistent with glaucoma medications over the 1 year study period. Median numbers of gaps and days off therapy were 1 and 11, respectively. Patients reporting below average income were twice as likely to be nonpersistent (prevalence ratio, 2.02; 95% confidence interval, 1.37-2.96; P<0.01). Below average income also trended toward a greater median number of days off therapy (P=0.07).
Conclusions:
Below average socioeconomic status may negatively impact persistence with topical glaucoma medications, potentially threatening long-term visual outcomes.
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