title: Impact of AREDS in a developing country 5 years after publication of the study.
abstract: OBJECTIVE
  The Age-Related Eye Disease Study (AREDS) is the only large-scale study to demonstrate a reduction in the risk of progression to end-stage age-related macular degeneration (AMD) when vitamin supplementation was given to patients with advanced forms of the disease. Our study assesses the impact of this study on vitamin supplementation in patients with advanced AMD from 5 years before publication of the AREDS results until 5 years after.
  
  
  METHODS
  Medical records of patients with AMD presenting between September 1996 and October 2006 were reviewed. Patients were subclassified according to AREDS categories. The proportion of advanced cases on vitamin replacement before October 2001 was compared to that after October 2001. Since October 2001, the different reasons for abstinence were investigated and analyzed.
  
  
  RESULTS
  Only 2403 patients of the 40,000 medical records reviewed met the AREDS AMD criteria. Of these, 137 patients verifying categories 3 and 4 were diagnosed prior to October 2001. Fourteen were on supplements then. Fifty-three patients complied with the represcribed vitamins during subsequent visits after October 2001, raising the percentage significantly to 48.9% (p<0.001). Also, from October 2001 until October 2006, an additional 76 patients verified categories 3 and 4. Fifty-three (69.7%) of them were on vitamins (p=0.001). Financial burden was the principal reason for abstinence in 67.7% of patients prescribed vitamins after October 2001.
  
  
  CONCLUSIONS
  The results of AREDS had an impressive impact on prescribing supplements in AREDS category 3 and 4 patients in Lebanon. The main reason for noncompliance is financial.
authors.affiliation: Department of Ophthalmology, American University of Beirut Medical Center, Beirut, Lebanon.
authors.forename: Daoud C
authors.initials: DC
authors.lastname: Fahed
authors.forename: Nicola G
authors.initials: NG
authors.lastname: Ghazi
authors.forename: Nabil M
authors.initials: NM
authors.lastname: Jabbour
authors.forename: Charbel D
authors.initials: CD
authors.lastname: Fahed
authors.forename: John C
authors.initials: JC
authors.lastname: Fahed
authors.forename: Haytham I
authors.initials: HI
authors.lastname: Salti
mesh_terms: D000368:Aged; D000975:Antioxidants / Q000008:administration & dosage*; D003906:Developing Countries; D019587:Dietary Supplements; D018450:Disease Progression; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007861:Lebanon; D008268:Macular Degeneration / Q000453:epidemiology* / Q000517:prevention & control*; D008297:Male; D055118:Medication Adherence; D011634:Public Health; D040242:Risk Reduction Behavior; D018434:Sickness Impact Profile; D014786:Vision Disorders / Q000517:prevention & control; D014810:Vitamin E / Q000008:administration & dosage; D015032:Zinc / Q000008:administration & dosage; D019207:beta Carotene / Q000008:administration & dosage
chemical_list: D000975:Antioxidants; D019207:beta Carotene; D014810:Vitamin E; D015032:Zinc