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Long-Term Effect of Systemic Comorbidity on Glaucoma Medication Adherence
1Department of Ophthalmology (C.H.H.), National Taiwan University Hospital, Taipei, Taiwan; Institute of Public Health, School of Medicine (C.H.H., C.P.), National Yang Ming Chiao Tung University, Taipei, Taiwan.
American Journal of Ophthalmology
|January 26, 2024
Summary
Systemic comorbidity significantly reduces long-term adherence to glaucoma medication, especially with multiple health conditions. This highlights a potential barrier to effective glaucoma management in complex patient cases.
Area of Science:
- Ophthalmology
- Public Health
- Health Services Research
Background:
- Glaucoma medication adherence is crucial for preventing vision loss.
- Systemic comorbidities may impact patients' ability to manage multiple chronic conditions, potentially affecting adherence to glaucoma treatment.
Purpose of the Study:
- To investigate the association between systemic comorbidity and glaucoma medication adherence.
- To determine if the number of comorbidities and time since glaucoma diagnosis influence adherence levels.
Main Methods:
- A population-based cohort study using Taiwan's National Health Insurance claims data.
- Inclusion of 50,408 patients newly diagnosed with glaucoma, followed for 5 years.
- Assessment of comorbidities using the Deyo-Charlson Comorbidity Index and adherence via medication possession ratio (MPR).
Main Results:
- Patients with comorbidities initially showed higher adherence but decreased significantly in years 4 and 5 post-diagnosis.
- Glaucoma medication adherence declined progressively with an increasing number of comorbidities.
- Patients with four or more comorbidities experienced adherence reductions of 6.4% and 11.8% in the fourth and fifth years, respectively.
Conclusions:
- Systemic comorbidity can reduce long-term glaucoma medication adherence by up to 12%.
- The increased burden of managing multiple chronic diseases may lead to lower priority for glaucoma treatment, particularly given its often asymptomatic nature.
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