Original articleInterventions Improve Poor Adherence with Once Daily Glaucoma Medications in Electronically Monitored Patients
Section snippets
Study Design
Patients were recruited from the Glaucoma Services of the Wilmer Eye Institute and the Scheie Eye Institute. Institutional review boards at both centers approved the study protocol, and written informed consent was obtained from all study patients.
The study had 2 phases. Phase 1 was a prospective, observational cohort study of patient adherence to travoprost therapy for a 3-month interval.14 Because no other bottles for glaucoma medications fit within the Dosing Aid (DA), it can provide data on
Results
Study recruitment for the phase 2 randomized trial began in November of 2006 and ended in June of 2007. Of the 66 patients who were adherent less than 75% of the time, 35 (53%) were randomized to the intervention group and 31 (47%) were randomized to the control group. The intervention and control groups were similar in mean age, race, sex, education level, and income based on zip code (P>0.05 for all; Table 1). The 2 groups also had generally similar ocular characteristics, although the
Discussion
We found that a multifaceted program for enhancing glaucoma eyedrop use improved the adherence rate from 54% to 73% (P<0.001) in persons whose baseline drop-taking was less than 75%. The intervention was administered completely by study staff and did not include physician input with the patient. The intervention was designed to maximize the chance that the adherence with medication use would improve. Our findings suggest that using several approaches at once likely increased the probability
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Manuscript no. 2009-53.
Available online: October 7, 2009.
Financial Disclosure(s): Supported in part by the National Institutes of Health, Bethesda, Maryland (Clinician—Scientist Training award K12 EY015398 [Dr Okeke]); a grant from The Paul and Evanina Bell Mackall Foundation Trust, New York, New York (Drs Okeke and Ying); the Glaucoma Division, Wilmer Institute research program, Baltimore, Maryland; and unrestricted funds and material support from Alcon, Inc., Fort Worth, Texas.
Conflict of interest: Drs. Friedman and Quigley are paid consultants for and have received honoraria or research support from Alcon. No conflicting relationship exists for any other authors.