Tsumura Toyoaki, Kashiwagi Kenji, Suzuki Yasuyuki, Yoshikawa Keiji, Suzumura Hirotaka, Maeda Toshine, Takeda Ryuji, Saito Hitomi, Araie Makoto
Fussa Hospital, Tokyo, Japan.
Department of Ophthalmology, Faculty of Medicine, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi, Japan.
Int Ophthalmol. 2019 Feb;39(2):375-383. doi: 10.1007/s10792-018-0820-7. Epub 2018 Jan 12.
Few reports have investigated the status of adherence in Japan on a large scale. We aimed to investigate the status of adherence to topical glaucoma treatment and its associated factors.
A nationwide survey was conducted as a prospective fashion. Participants in this survey were subjects with primary open-angle glaucoma, normal-tension glaucoma, or ocular hypertension or pseudoexfoliation glaucoma who had been prescribed anti-glaucoma ophthalmic eyedrops and whose ophthalmologist considered prescribing any fixed combination of ocular hypotensive eyedrops for the first time between 2011 and 2012. Subjects and their attending ophthalmologists independently completed a questionnaire by utilizing a fixed combination of ocular hypotensive eyedrops.
A total of 1358 ophthalmologists from 1071 medical institutions participated in this survey. We registered 4430 subjects (2049 males and 2381 females). In total, data from 3853 subjects (87.6%) were analyzed after inclusion of subjects based on inclusion and exclusion criteria. Good adherence was defined as not forgetting instillation during the past week. Rates of good adherence reported by subjects and ophthalmologists were 72.4 and 78.5%, respectively (P < 0.0001). The consistency of adherence evaluation between subjects and ophthalmologists was moderate [kappa score 0.5025 (95% confidence interval 0.4740-0.5309)]. Significant factors associated with adherence were size of clinic, age, gender, number of types of ocular hypotensive eyedrops, ease of instillation, preferred number of eyedrops, preferred frequency of instillation of eyedrops, and knowledge of glaucoma.
Adherence to ocular hypotensive eyedrops among Japanese subjects was relatively good. Concordance of adherence between subjects' reports and ophthalmologists' responses was moderate. Size of clinic, number of types of ocular hypotensive eyedrops, ease of instillation, preferred number of eyedrops, preferred frequency of instillation of eyedrops, and knowledge of glaucoma were associated with adherence among Japanese glaucoma subjects.
很少有报告大规模调查日本的依从性状况。我们旨在调查局部青光眼治疗的依从性状况及其相关因素。
以前瞻性方式进行了一项全国性调查。本次调查的参与者为原发性开角型青光眼、正常眼压性青光眼、高眼压症或假性剥脱性青光眼患者，他们曾被开具抗青光眼眼药水，且其眼科医生在2011年至2012年期间首次考虑开具任何固定组合的降眼压眼药水。受试者及其主治眼科医生通过使用固定组合的降眼压眼药水独立完成一份问卷。
来自1071家医疗机构的1358名眼科医生参与了本次调查。我们登记了4430名受试者（2049名男性和2381名女性）。根据纳入和排除标准纳入受试者后，总共对3853名受试者（87.6%）的数据进行了分析。良好依从性定义为在过去一周内未忘记滴眼。受试者和眼科医生报告的良好依从率分别为72.4%和78.5%（P<0.0001）。受试者和眼科医生之间依从性评估的一致性为中等[kappa值0.5025（95%置信区间0.4740 - 0.5309）]。与依从性相关的显著因素包括诊所规模、年龄、性别、降眼压眼药水的类型数量、滴眼的难易程度、首选的滴眼次数、首选的滴眼频率以及青光眼知识。
日本受试者对降眼压眼药水的依从性相对较好。受试者报告与眼科医生回答之间的依从性一致性为中等。诊所规模、降眼压眼药水的类型数量、滴眼的难易程度、首选的滴眼次数、首选的滴眼频率以及青光眼知识与日本青光眼受试者的依从性相关。
