Kim Chan Yun, Park Ki Ho, Ahn Jaehong, Ahn Myung-Douk, Cha Soon Cheol, Kim Ho Soong, Kim Joon Mo, Kim Moon Jung, Kim Tae-Woo, Kim Yong Yeon, Lee Ji Woong, Park Sang-Woo, Sohn Yong Ho, Sung Kyung Rim, Yoo Chungkwon, Cha Jinhye, Kim Young-Joo
Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Republic of Korea.
Department of Ophthalmology, Seoul National University Hospital, Seoul, Republic of Korea.
Br J Ophthalmol. 2017 Jun;101(6):801-807. doi: 10.1136/bjophthalmol-2016-308505. Epub 2017 Mar 7.
BACKGROUND/AIMS: This study aimed to investigate treatment patterns and medication adherence of glaucoma. It also identified key factors associated with non-adherence.
It was a cross-sectional, observational study. Patients who use eye-drops for ≤2 years were recruited at 15 eye clinics from March to November 2013. Data were collected through self-administered questionnaires and medical chart review. Medication adherence was evaluated using patients' self-report on pill count and defined as patients' administering drug for ≥80% of prescribed days. Medication adherence rate was calculated by dividing actual number of administration from total prescribed number of administration for 7 days. Patients whose self-reported prescription was different from total daily doses of physicians' prescription were considered as non-adherent.
A total of 1050 patients included, and medication adherence rate was evaluated in 1046 patients whose verification of adherence was available. Of the total, 27.4% were non-adherent, and the medication adherence rates of the total, the adherent, and the non-adherent were 90.6±17.8%, 96.8±5.5% and 56.6±24.7%, respectively. The most commonly used medication was prostaglandin (PGA) alone and the second was combination of two-class (β-blocker and carbonic anhydrase inhibitor (CAI)) and three-class combination of PGA, β-blocker and CAI followed. In multivariate analysis, the risk of non-adherence was 1.466 times greater in males than in females (95% CI 1.106 to 1.943) and 1.328-fold greater as the daily number of administration was increased (95% CI 1.186 to 1.487).
Approximately, one-third of the patients were non-adherent, and males and increased daily number of administration were associated with non-adherence. It highlights that more systematic treatment strategies should be considered for better medication adherence, leading to effective glaucoma management.
背景/目的：本研究旨在调查青光眼的治疗模式和药物依从性。同时确定与不依从相关的关键因素。
这是一项横断面观察性研究。2013年3月至11月期间，在15家眼科诊所招募了使用眼药水≤2年的患者。通过自行填写问卷和查阅病历收集数据。药物依从性通过患者对药丸计数的自我报告进行评估，定义为患者在规定天数的≥80%时间内服药。药物依从率通过7天内实际服药次数除以总规定服药次数来计算。自我报告的处方与医生处方的每日总剂量不同的患者被视为不依从。
共纳入1050例患者，对1046例可进行依从性验证的患者评估了药物依从率。其中，27.4%为不依从，总体、依从和不依从患者的药物依从率分别为90.6±17.8%、96.8±5.5%和56.6±24.7%。最常用的药物是单独使用前列腺素（PGA），其次是两类药物（β受体阻滞剂和碳酸酐酶抑制剂（CAI））联合使用，以及PGA、β受体阻滞剂和CAI三类药物联合使用。多因素分析显示，男性不依从的风险比女性高1.466倍（95%可信区间1.106至1.943），且随着每日服药次数增加，风险高1.328倍（95%可信区间1.186至1.487）。
约三分之一的患者不依从，男性和每日服药次数增加与不依从相关。这突出表明，应考虑更系统的治疗策略以提高药物依从性，从而实现有效的青光眼管理。
