Medication Refill Adherence in Patients with Chronic Inflammatory Eye Disease

Area of Science:

• Ophthalmology
• Pharmacology
• Immunology

Background:

• Noninfectious inflammatory eye diseases (IED) require long-term immunosuppressive therapy (IMT).
• Assessing patient adherence to IMT is crucial for effective disease management and preventing complications.
• Pharmacy dispenses offer a potential objective measure for tracking IMT adherence.

Purpose of the Study:

• To evaluate adherence rates to IMT using pharmacy dispense data in patients with IED.
• To determine the impact of adherence on ocular disease control.
• To identify factors associated with nonadherence and compare adherence data between medical records and pharmacy records.

Main Methods:

• Retrospective chart review of patients with IED followed for at least two years.
• Adherence assessed via medical record review (appointment/lab attendance, provider notes) and pharmacy refill data.
• Disease control evaluated by clinical examination findings.

Main Results:

• A cohort of 63 patients was studied, with a mean adherence rate of 63.9% based on pharmacy data.
• Over two-thirds of patients (67.2%) had an average adherence rate below 85%, indicating nonadherence.
• Nonadherence was significantly higher (4.72 times) in patients on more than one IMT.
• Ocular inflammation control was achieved in the majority of patients (86.2%).
• Adherence data from medical records and pharmacy records showed congruence in 71.6% of cases.

Conclusions:

• Adherence to IMT in IED patients, assessed via pharmacy data, is often suboptimal, especially for those on multiple medications.
• Despite adherence challenges, most patients achieve good ocular disease control.
• Pharmacy dispense data serves as a reliable correlate for assessing adherence compared to medical record information.