Compliance and persistency in glaucoma follow-up treatment.
OBJECTIVE
To summarize research published between 1980 and October 2004 regarding compliance (the extent to which patients' behaviors correspond with providers' recommendations) and persistency (total time on therapy) in patients diagnosed with open-angle glaucoma or ocular hypertension; to suggest approaches ophthalmologists might consider to improve compliance and persistency; and to identify areas warranting future research.


RESULTS
Medication compliance, the focus of most compliance-related research, has been measured using a variety of methods including patient self-reports, the medication possession ratio, and electronic monitoring. Noncompliance rates of at least 25% commonly have been reported. The primary obstacles to medication compliance appear to be situational/environmental (e.g., being away from home or a change in routine) or related to the medication regimen (e.g., side effects or complexity). Persistency with ocular hypotensive therapies has been found to be poor. Retrospective cohort studies using survival analyses have reported that fewer than 25% of patients are persistent over 12 months.


CONCLUSIONS
Accurately assessing patient compliance and persistency is important to optimizing patient care. Physicians may mistake either medication noncompliance or lack of persistency with poor efficacy. Such errors would likely increase health care costs if they result in unnecessary changes to a patient's therapeutic regimen or in surgery.
Schwartz
Gail F
GF
Glaucoma Consultants, Greater Baltimore Medical Center, Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland 21204, USA. schwartzgf@aol.com
D000959:Antihypertensive Agents / Q000627:therapeutic use*; D003695:Delivery of Health Care / Q000379:methods / Q000592:standards; D005500:Follow-Up Studies; D005901:Glaucoma / Q000188:drug therapy*; D006801:Humans; D010349:Patient Compliance / Q000706:statistics & numerical data; D010352:Patient Dropouts / Q000706:statistics & numerical data; D010817:Physician-Patient Relations; D012189:Retrospective Studies; D016896:Treatment Outcome
D000959:Antihypertensive Agents