The impact of ocular adverse effects in patients treated with topical prostaglandin analogs: changes in prescription patterns and patient persistence.
OBJECTIVE
To document patient/physician perceptions of adverse effects and their relationship to medication changes among patients prescribed prostaglandin analogs.


METHODS
Medical/pharmacy claims (private U.S. health network) identified patients filling initial topical ocular hypotensive prescriptions from 2001 to 2004; 300 open-angle glaucoma patients prescribed a prostaglandin analog and 103 ophthalmologists were selected by algorithm for telephone interviews. Medical charts for 225/300 interviewed and 75 non-interviewed patients were abstracted. Medication patterns were assessed in pharmacy claims data. Frequency of adverse effects noted by physicians and associations with medication change decisions were examined in charted data. Patients' experiences with adverse effects were compiled from surveys.


RESULTS
In patients treated with latanoprost (N = 4,071), bimatoprost (N = 1,199), or travoprost (N = 1,001), continuous refill of medication through 1 year was seen in 11%, 9%, and 5% of patients, respectively (P = 0.0001; retrospective pharmacy claims). Adverse effects were the second most common reasons noted by physicians for switching medications after lack of efficacy (19% vs. 43%, respectively). Adverse effects were noted in 65% of patient charts. Hyperemia was the most common adverse effect occurring with at least one other adverse effect in 48% of patients with the condition.


CONCLUSIONS
Ocular adverse effects, particularly hyperemia, negatively affect patient continuation with therapy and switching.
Zimmerman
Thom J
TJ
Department of Ophthalmology and Visual Sciences, University of Louisville, Louisville, Kentucky 40207, USA. tjzimm01@louisville.edu
Hahn
Steven R
SR
Gelb
Laurie
L
Tan
Hiangkiat
H
Kim
Elizabeth E
EE
D000287:Administration, Topical; D000328:Adult; D000577:Amides / Q000009:adverse effects / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D000069580:Bimatoprost; D003008:Cloprostenol / Q000009:adverse effects / Q000031:analogs & derivatives / Q000627:therapeutic use; D016208:Databases, Factual; D005902:Glaucoma, Open-Angle / Q000188:drug therapy; D006801:Humans; D006940:Hyperemia / Q000139:chemically induced; D000077338:Latanoprost; D009883:Ophthalmic Solutions; D010349:Patient Compliance / Q000706:statistics & numerical data*; D010593:Pharmaceutical Services; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D055553:Prescription Drugs; D011461:Prostaglandins F, Synthetic / Q000009:adverse effects / Q000627:therapeutic use; D011465:Prostaglandins, Synthetic / Q000009:adverse effects* / Q000627:therapeutic use; D012189:Retrospective Studies; D000069557:Travoprost
D000577:Amides; D000959:Antihypertensive Agents; D009883:Ophthalmic Solutions; D055553:Prescription Drugs; D011461:Prostaglandins F, Synthetic; D011465:Prostaglandins, Synthetic; D003008:Cloprostenol; D000077338:Latanoprost; D000069580:Bimatoprost; D000069557:Travoprost