Uchino Miki, Yokoi Norihiko, Kawashima Motoko, Ryutaro Yamanishi, Uchino Yuichi, Tsubota Kazuo
Department of Ophthalmology, Keio University School of Medicine, Tokyo 160-8582 Japan.
Department of Ophthalmology, Kyoto, Prefectural University of Medicine, Kyoto 606-8566, Japan.
J Clin Med. 2019 Jul 28;8(8):1120. doi: 10.3390/jcm8081120.
Despite the importance of dry eye disease (DED) treatment, the rate of DED treatment discontinuation, especially discontinuation of ophthalmic follow-up, remains unknown. This study aimed to assess the prevalence and risk factors of ophthalmic follow-up discontinuation for DED. A cross-sectional survey of 1030 participants was conducted using a self-administered web-survey instrument. We collected lifestyle information, history of DED diagnosis, types of treatment, frequency of eye-drop usage, symptoms, and the reasons for discontinuing treatment. Statistical analyses including logistic regression were used to evaluate the risk factors of discontinuing ophthalmic follow-up for DED. A past history of clinical DED diagnosis was reported by 155 (15.0%) subjects. Of those, 130 had persistent DED, and 88 (67.7%) of the subjects reported discontinuation of ophthalmic follow-up for DED. The most prevalent reasons for ophthalmic follow-up discontinuation were time restrictions, followed by dissatisfaction with the DED treatment. Duration after DED diagnosis was the only significant risk factor for discontinuing ophthalmic follow-up after adjusting for age and sex (odds ratio = 1.09, 95% confidence interval = 1.02-1.17, 0.009). In conclusion, longer DED duration after diagnosis was a significant risk factor for discontinuing ophthalmic follow-up for DED. This study showed that DED ophthalmic follow-up discontinuation involves both medical and non-medical reasons. Clinicians need to be aware of them, and preventative effort is needed to avoid discontinuation.
尽管干眼症(DED)治疗很重要,但DED治疗中断率,尤其是眼科随访的中断率仍然未知。本研究旨在评估DED眼科随访中断的患病率及危险因素。使用自行管理的网络调查问卷对1030名参与者进行了横断面调查。我们收集了生活方式信息、DED诊断史、治疗类型、眼药水使用频率、症状以及治疗中断的原因。采用包括逻辑回归在内的统计分析方法来评估DED眼科随访中断的危险因素。155名(15.0%)受试者报告有临床DED诊断史。其中,130人患有持续性DED,88名(67.7%)受试者报告中断了DED的眼科随访。眼科随访中断最常见的原因是时间限制,其次是对DED治疗不满意。在对年龄和性别进行调整后,DED诊断后的持续时间是中断眼科随访的唯一显著危险因素(比值比=1.09,95%置信区间=1.02-1.17,P=0.009)。总之,诊断后DED持续时间较长是DED眼科随访中断的一个显著危险因素。本研究表明,DED眼科随访中断涉及医学和非医学原因。临床医生需要对此有所了解,并且需要采取预防措施以避免中断。