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The Minimal Clinically Important Difference in Glaucoma Medication Adherence: Interviews of Glaucoma Experts
Ajay Kolli1, Shelby Daniel-Wayman2, Paula Anne Newman-Casey3
1University of Michigan Medical School, Ann Arbor, Michigan, USA.
Ophthalmic Research
|November 10, 2020
Summary
Defining a clinically significant improvement in glaucoma medication adherence is crucial for effective treatment. Experts suggest a minimal clinically important difference (MCID) of 15-20% for adherence, considering intervention costs and physician burden.
Area of Science:
- Ophthalmology
- Pharmacology
- Health Services Research
Background:
- Poor adherence to glaucoma medications is a significant factor in progressive vision loss.
- Interventions to improve adherence exist, but the threshold for clinical significance remains undefined.
Discussion:
- This study aimed to establish a hypothesized minimal clinically important difference (MCID) for glaucoma medication adherence through expert interviews.
- Two definitions of MCID were explored: incremental increase in average patient adherence and incremental increase in population adherence to "good" levels (>80% adherence).
Key Insights:
- Glaucoma experts estimated the MCID for average individual adherence at 17.7% and for population adherence at 18.5%.
- Key themes influencing MCID included intervention cost and the burden on ophthalmologists and practices.
Outlook:
- The hypothesized MCID for glaucoma medication adherence is between 15-20%.
- Future research should objectively determine MCID, factoring in intervention cost and physician burden.
- This hypothesis can guide the design of future studies on glaucoma medication adherence.
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