Surveillance of glaucoma medical therapy in a Glasgow teaching hospital: 26 years' experience.
OBJECTIVE
To report the initial findings of a unique database of 956 patients with ocular hypertension (OHT), normal tension glaucoma (NTG) and primary open angle glaucoma (POAG) attending the Glaucoma Clinic at Glasgow Royal Infirmary, Glasgow, UK.


METHODS
The database contains retrospective data from 1981 and prospective data from 1999. Analyses have been carried out using specially written queries to generate reports relating to prescription trends and reasons for treatment discontinuation.


RESULTS
The database included the following numbers of patients: POAG 580; OHT 242; NTG 134. Of 2928 treatment-change episodes recorded, failure to reach or maintain a target intraocular pressure (IOP) accounted for 51.9%, while adverse effects accounted for 22.1%. Use of latanoprost has increased sharply since 1996, and that of brimonidine, betaxolol and dorzolamide has declined significantly. Bimatoprost had a higher rate of discontinuation due to adverse effects (25%) than travoprost (16.3%) or latanoprost (12.4%), but this was only statistically significant between latanoprost and bimatoprost (p = 0.0038). In 2000 the database informed the introduction of a new treatment protocol that resulted in a fall in discontinuations due to adverse effects by almost two-thirds.


CONCLUSIONS
A large and unique treatment database has been established at the Glaucoma Clinic of Glasgow Royal Infirmary. Containing data spanning a 26-year period, it promises to be an invaluable resource for audit and research. It has already demonstrated its worth by informing changes in prescribing practice that have resulted in direct patient benefit.
Rahman
M Q
MQ
Department of Ophthalmology, Glasgow Royal Infirmary, 16 Alexandra Parade, Glasgow G312ER, UK. Donald.Montgomery@ggc.scot.nhs.uk
Montgomery
D M I
DM
Lazaridou
M N
MN
D000368:Aged; D000465:Algorithms; D000959:Antihypertensive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002985:Clinical Protocols; D016208:Databases, Factual; D004363:Drug Utilization / Q000706:statistics & numerical data / Q000639:trends; D005260:Female; D005901:Glaucoma / Q000188:drug therapy*; D005902:Glaucoma, Open-Angle / Q000188:drug therapy; D006801:Humans; D008297:Male; D009798:Ocular Hypertension / Q000188:drug therapy; D010044:Outpatient Clinics, Hospital; D012606:Scotland
D000959:Antihypertensive Agents