University Eye Clinic, IRCCS Policlinico San Matteo Foundation, Pavia, 27100, Italy.
Expert Opin Pharmacother. 2010 Mar;11(4):499-504. doi: 10.1517/14656561003601994.
To assess adherence in glaucoma patients using the Travatan Dosing Aid (TDA); to record differences in adherence by age, sex, therapy, systemic therapies, years from diagnosis, type of therapy and intraocular pressure (IOP).
Sixth-month cohort study; fifty-six Caucasian, primary open-angle glaucoma patients on travoprost (T) or travoprost/timolol fixed combination (TTFC) monotherapy were submitted to four visits: at baseline and months 1, 3 and 6 (M1, M3, M6). Adherence was recorded with TDA and classified as 'high' if greater than 90%. Self-reported and physician-presumed adherence data were collected. Kruskall-Wallis and Fisher's exact tests were applied.
Thirty-two patients (54.2%) were treated with T. Age, sex, level of schooling, presence of systemic comorbidities, duration of current therapy and IOP were similar between T and TTFC. Seventeen subjects (30.3%) recorded high adherence at every visit, 13 (23.2%) at two visits, 26 (46.4%) otherwise. Adherence was maintained over time with a slight decrease from month 1 to month 6 without statistical differences within and between groups. Adherence was statistically influenced by age (p = 0.007) and duration of therapy (p = 0.004).
The typical nonadherent patient is elderly. TDA records indicate that only a minority of patients are really adherent: predictive models to screen for poor adherence are needed.
使用 Travatan 给药辅助器(TDA)评估青光眼患者的依从性;记录年龄、性别、治疗方法、全身治疗、从诊断到现在的时间、治疗类型和眼内压(IOP)等因素对依从性的差异。
这是一项为期 6 个月的队列研究;56 名高加索原发性开角型青光眼患者接受 travoprost(T)或 travoprost/timolol 固定联合(TTFC)单药治疗,共进行了 4 次就诊:基线和 1、3、6 个月(M1、M3、M6)。使用 TDA 记录依从性,并将大于 90%的患者归类为“高依从性”。收集了自我报告和医生假定的依从性数据。应用 Kruskal-Wallis 和 Fisher 精确检验进行分析。
32 名患者(54.2%)接受 T 治疗。T 和 TTFC 组在年龄、性别、受教育程度、全身合并症、当前治疗持续时间和 IOP 方面相似。17 名患者(30.3%)在每次就诊时均记录到高依从性,13 名患者(23.2%)在两次就诊时记录到高依从性,26 名患者(46.4%)在其他就诊时记录到高依从性。依从性随时间保持稳定,从第 1 个月到第 6 个月略有下降,但组内和组间均无统计学差异。依从性受到年龄(p=0.007)和治疗持续时间(p=0.004)的统计学影响。
典型的不依从患者是老年人。TDA 记录表明,只有少数患者真正依从:需要建立预测模型来筛选出依从性差的患者。