Department of Ophthalmology, University of California.
Devers Eye Institute, Devers Eye Institute Glaucoma Service.
J Glaucoma. 2019 Sep;28(9):772-776. doi: 10.1097/IJG.0000000000001315.
We found no evidence of an increase in the number of Americans using topical intraocular pressure (IOP) medication or a number of drops used per patient from 1999 to 2014, although there were significant changes in the class of medications used.
The purpose of this study was to determine changes in topical IOP-lowering medication use in the United States from 1999 to 2014.
A series of 8 nationally representative, weighted cross-sectional surveys of United States residents were performed every 2 years from 1999 to 2014. On 2-year cycles, professional interviewers performed in-home interviews of a representative sample of the nation as part of the National Health and Nutrition Examination Survey study. Participants were asked, "In the past month, have you used or taken medication for which a prescription is needed?" Adults over age 40 who responded to this question were included in the analysis. The primary outcome was number of US adults using topical IOP-lowering medication. Secondary outcomes included the number and types of medications used.
There was no change in the number of adults using topical IOP-lowering medications over the time period studied (P=0.74) with 1.4% (95% confidence interval: 0.9%-1.8%) of US residents on IOP-lowering medications in 1999 to 2000 and 1.4% of US residents (95% confidence interval: 1.1%-1.8%) on topical medications in 2013 to 2014. There was no change in the number of medications per patient over the period of the study (P=0.14). There was a significant increase in the use of prostaglandin analogs and combination medications and a decrease in the use of β-blockers (all P<0.01).
In contrast to the increase in glaucoma medication use seen in several other developed nations, use in the United States remained stable from 1999 to 2014. This may be due to differential use of other procedures. Future studies of IOP-lowering medications incorporating the effect of new agents and minimally invasive surgeries are warranted.
我们发现，从 1999 年到 2014 年，使用局部眼内压（IOP）药物的美国人数量或每位患者使用的药物滴数并没有增加，尽管药物种类发生了显著变化。
本研究旨在确定 1999 年至 2014 年期间美国局部降低眼内压药物使用的变化。
从 1999 年到 2014 年，每隔两年进行了一系列 8 项全国代表性的、加权的横断面调查。在每两年一次的周期中，专业采访人员作为国家健康和营养检查调查研究的一部分，对全国代表性样本进行了入户访谈。受访者被问到，“在过去一个月里，您是否使用或服用过需要处方的药物？”回答了这个问题的 40 岁以上成年人被纳入分析。主要结果是使用局部降低眼内压药物的美国成年人数量。次要结果包括使用的药物数量和类型。
在研究期间，使用局部降低眼内压药物的成年人数量没有变化（P=0.74），1999 年至 2000 年有 1.4%（95%置信区间：0.9%-1.8%）的美国居民使用降眼压药物，2013 年至 2014 年有 1.4%（95%置信区间：1.1%-1.8%）的美国居民使用局部药物。在研究期间，每位患者使用的药物数量没有变化（P=0.14）。前列腺素类似物和联合药物的使用显著增加，β-受体阻滞剂的使用减少（均 P<0.01）。
与其他几个发达国家青光眼药物使用增加形成对比的是，从 1999 年到 2014 年，美国的药物使用保持稳定。这可能是由于其他治疗方法的不同使用。未来需要对包含新药物和微创手术影响的降眼压药物进行研究。
