title: Rates of glaucoma medication utilization among persons with primary open-angle glaucoma, 1992 to 2002.
abstract: OBJECTIVE
  To determine the percentage of Medicare beneficiaries with primary open-angle glaucoma (POAG) treated medically or surgically, utilization rates for each major class of glaucoma medication, and factors influencing treatment.
  
  
  METHODS
  Longitudinal observational study using data from the Medicare Current Beneficiary Survey (MCBS).
  
  
  METHODS
  Persons age 65 and older with POAG, 1992 to 2002 (N = 6446).
  
  
  METHODS
  By using MCBS data merged with Medicare claims, rates of medical and surgical treatment for participants with POAG were determined. Logistic analysis was used to assess factors associated with use of care.
  
  
  METHODS
  Receipt/nonreceipt of medical or surgical therapy in a year and rates of drug utilization by class and of surgery by type among persons who did not receive medical therapy in a year.
  
  
  RESULTS
  On average from 1992 to 2002, 27.4% of persons diagnosed with POAG received no medical or surgical treatment. Rates of nonuse increased by 3% annually (odds ratio [OR], 1.03; 95% confidence interval [CI], 1.02-1.05). Beneficiaries with Medicaid were 43% more likely not to receive care for POAG in a year (OR, 1.43; 95% CI, 1.20-1.70). Hispanic, Asian, and beneficiaries of other race/ethnicity were less likely to receive treatment than were whites. Use of beta-blockers and miotics decreased, but utilization rates increased substantially for alpha-agonists, combination beta-blocker-carbonic anhydrase inhibitors, and especially prostaglandin analogs.
  
  
  CONCLUSIONS
  Despite availability of more efficacious glaucoma medication classes with few side effects and findings of clinical trials underscoring the importance of intraocular pressure reduction in POAG patients, many patients with POAG continue to go untreated.
authors.affiliation: Kellogg Eye Center, University of Michigan Department of Ophthalmology, Ann Arbor, Michigan, USA.
authors.forename: Joshua D
authors.initials: JD
authors.lastname: Stein
authors.forename: Padmaja
authors.initials: P
authors.lastname: Ayyagari
authors.forename: Frank A
authors.initials: FA
authors.lastname: Sloan
authors.forename: Paul P
authors.initials: PP
authors.lastname: Lee
mesh_terms: D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D004363:Drug Utilization / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D005902:Glaucoma, Open-Angle / Q000188:drug therapy*; D006302:Health Services Research; D006306:Health Surveys; D006801:Humans; D007345:Insurance Claim Review / Q000706:statistics & numerical data; D007429:Intraocular Pressure / Q000187:drug effects; D008297:Male; D006278:Medicare / Q000706:statistics & numerical data; D009885:Ophthalmology / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D014481:United States
chemical_list: D000959:Antihypertensive Agents