PharmIdeas Research and Consulting Inc., Oakville, Ontario, Canada.
Patient. 2011;4(2):133-41. doi: 10.2165/11539460-000000000-00000.
Glaucoma is one of the leading causes of blindness and visual disability. Few studies have examined persistence and adherence with topical medications in glaucoma patients.
The objective of this study was to compare patient persistence with prostaglandin agonist (PA) monotherapy versus with concomitant adjunctive therapy (AT) in Canada.
Data were obtained from the Québec prescription claims database. Persistence rates were determined for previously treated naive glaucoma patients at 1 year after their index date for use of any of the three available PAs (bimatoprost, latanoprost, and travoprost). Patients who had at least 334 days on their index PA were defined as being persistent during the analysis timeframe. Patient baseline demographics and persistence rates were reported. A logistic regression was used for comparing the PA and PA + AT groups, which incorporated baseline cofounders, such as age and sex, in the analyses.
From an initial cohort of 28 534 patients, 14 893 were identified as naive to glaucoma therapy and had a PA as their index therapy. Of these, 11 197 (75.2%) continued to receive monotherapy and 3696 (24.8%) had an AT added to the PA; 59.0% were females, and the average age was 70.5 ± 11.3 years. Overall, at the end of the first year of therapy, 57.4% of patients were persistent on their index PA; however, a statistically significant difference was observed between the two subgroups, with 54.6% for those receiving PA monotherapy and 65.8% for those receiving PA + AT (p < 0.01) persistent with therapy. On average, 10.5 prescriptions per year were dispensed to persistent patients.
In this Canadian population, persistence rates fall to approximately 60% at the end of the first year of therapy, with patients taking AT being more persistent. Similar persistence analyses are warranted on other populations, and would yield helpful data for conducting economic evaluations of non-persistence.
青光眼是导致失明和视力障碍的主要原因之一。很少有研究调查青光眼患者对局部药物的坚持和依从性。
本研究旨在比较加拿大前列腺素激动剂（prostaglandin agonist，PA）单药治疗与联合辅助治疗（concomitant adjunctive therapy，AT）的患者坚持治疗情况。
数据来自魁北克处方数据库。在索引日期使用三种可用的前列腺素之一（贝美前列素、拉坦前列素和曲伏前列素）后 1 年，对之前接受过治疗的原发性青光眼患者进行了坚持治疗率的评估。将至少有 334 天使用索引 PA 的患者定义为在分析时间段内坚持治疗。报告了患者的基线人口统计学和坚持治疗率。使用逻辑回归比较了 PA 和 PA+AT 组，分析中纳入了年龄和性别等基线混杂因素。
从最初的 28534 例患者中，确定了 14893 例对青光眼治疗无经验且以 PA 为索引治疗的患者。其中，11197 例（75.2%）继续接受单药治疗，3696 例（24.8%）在 PA 基础上加用 AT；59.0%为女性，平均年龄为 70.5±11.3 岁。总体而言，在治疗的第一年结束时，57.4%的患者坚持使用其索引 PA；然而，两个亚组之间存在统计学显著差异，接受 PA 单药治疗的患者中有 54.6%坚持治疗，接受 PA+AT 治疗的患者中有 65.8%坚持治疗（p<0.01）。坚持治疗的患者平均每年配药 10.5 次。
在加拿大人群中，第一年结束时的坚持治疗率约为 60%，接受 AT 的患者坚持治疗的可能性更高。需要在其他人群中进行类似的坚持治疗分析，这将为非坚持治疗的经济评估提供有用的数据。
