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Whitecoat Adherence in Patients With Primary Open-Angle Glaucoma.

Shervonne Poleon1, Nouran Sabbagh2, Lyne Racette3

  • 1Department of Optometry and Vision Science, School of Optometry, University of Alabama at Birmingham, Birmingham, AL, United States.

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|June 6, 2022
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Summary

Whitecoat adherence, improved medication compliance near clinic visits, was observed in glaucoma patients. This phenomenon was not seen in patients with suboptimal adherence, highlighting its clinical relevance.

Keywords:
adherenceglaucomaimplementation phasemedicationwhitecoat

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Area of Science:

  • Ophthalmology
  • Pharmacology
  • Clinical Research

Background:

  • Whitecoat adherence describes enhanced medication compliance around medical appointments.
  • This adherence pattern can skew clinical measurements, potentially misrepresenting a patient's typical condition.
  • In glaucoma management, whitecoat adherence to hypotensive eyedrops may falsely indicate treatment efficacy.

Purpose of the Study:

  • To quantify the prevalence of whitecoat adherence in primary open-angle glaucoma patients.
  • To identify factors associated with this adherence phenomenon.
  • To understand the impact of whitecoat adherence on clinical decision-making in glaucoma.

Main Methods:

  • A cohort study included primary open-angle glaucoma patients using hypotensive eyedrops.
  • Medication adherence was measured using Medication Event Monitoring System (MEMS) caps over 28 days bracketing clinic visits.
  • Wilcoxon tests compared adherence rates in periods before and after clinic visits, analyzing optimal vs. suboptimal adherence groups.

Main Results:

  • Sixty-six patients (51.5% female, mean age 70.8 years) were analyzed.
  • Overall mean adherence increased significantly in the days immediately preceding clinic visits (Pre14-4 to Pre3-1, p=0.01).
  • Whitecoat adherence was evident in patients with optimal adherence (≥80%) but not in those with suboptimal adherence (<80%).

Conclusions:

  • The study confirmed the presence of whitecoat adherence in glaucoma patients.
  • This adherence pattern may influence intraocular pressure readings and subsequent treatment decisions.
  • Clinicians should be aware of whitecoat adherence and discuss its implications with patients.