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Treatment for glaucoma: adherence by the elderly

J H Gurwitz1, R J Glynn, M Monane

  • 1Department of Medicine, Brigham and Women's Hospital, Boston, MA.

American Journal of Public Health
|May 1, 1993
PubMed
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Many elderly patients with glaucoma do not adhere to their prescribed topical treatments, leading to significant periods without medication. Addressing this nonadherence is crucial for preserving vision.

Area of Science:

  • Ophthalmology
  • Geriatric Medicine
  • Pharmacoeconomics

Background:

  • Glaucoma is a leading cause of irreversible blindness worldwide.
  • Adherence to topical glaucoma medications is critical for disease management and vision preservation.
  • Nonadherence to medication regimens is a common challenge in managing chronic diseases, particularly among the elderly.

Purpose of the Study:

  • To quantify the extent of nonadherence to topical glaucoma treatment in elderly patients.
  • To identify factors associated with treatment nonadherence in this population.

Main Methods:

  • Retrospective cohort study of 2440 elderly patients (age > 65) in New Jersey Medicaid Program.
  • Initiation of topical glaucoma therapy was the index event.
  • Nonadherence assessed by (1) no filled prescription within 12 months and (2) days without therapy during the 12-month period.

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Main Results:

  • 23% of patients (569) were nonadherent based on no filled prescription.
  • The average patient experienced 112 days without glaucoma therapy annually.
  • Nonadherence was linked to medications requiring >2 daily administrations and polypharmacy; multiple glaucoma agents improved adherence.

Conclusions:

  • Significant nonadherence to glaucoma treatment is prevalent among elderly patients.
  • Targeted interventions addressing medication complexity and administration frequency are needed.
  • Improving adherence can lead to better visual outcomes and sight preservation.