title: Do adherence rates and glaucomatous visual field progression correlate?
abstract: OBJECTIVE
  To assess the relation between visual field progression and adherence rate in patients with glaucoma using Travatan Dosing Aid® (TDA).
  
  
  METHODS
  In this 36-month retrospective study, 35 patients with primary open-angle glaucoma on travoprost or travoprost/timolol fixed combination monotherapy were submitted to ophthalmic examination and to visual field (VF) test from 2007 to 2009. Adherence was recorded with TDA. The association between VF progression (from 2007 to the end of the follow-up period) and a number of predictors (adherence rates at 12 months) was tested by means of chi-square test (or Fisher exact test) or Mann-Whitney test as appropriate.
  
  
  RESULTS
  The mean (±SD) adherence rates were 71.9%±27.8% after 1 month of follow-up and 76.8%±20.9% at 12 months. A total of 25 (71.4%) patients with stable VF had a median adherence rate (IQR) of 85% (75%-97%); patients who worsened (n=10; 28.6%) recorded a median (IQR) adherence of 21% (9%-45%) (p<0.001). No association was found between VF progression and any of the other variables (age, sex, schooling, visual acuity, intraocular pressure (IOP) at baseline and over time, other ocular diseases, time since diagnosis and actual therapy, number of concomitant systemic therapies). Patients who were at least 90% adherent did not progress, while 43.5% of the patients with lower adherence worsened (p=0.01).
  
  
  CONCLUSIONS
  Our data suggest that adherence rate may play a role in glaucomatous damage and/or progression; the target IOP therefore should be adjusted by adherence rates. Monitoring tools, educational programs, use of videos, a better doctor-patient relationship, or other means to improve adherence are desirable and necessary to preserve visual function.
authors.affiliation: University Eye Clinic, IRCCS Policlinico San Matteo Foundation, Pavia, Italy. gemma.rossi.md@gmail.com
authors.forename: Gemma C M
authors.initials: GC
authors.lastname: Rossi
authors.forename: Gian Maria
authors.initials: GM
authors.lastname: Pasinetti
authors.forename: Luigia
authors.initials: L
authors.lastname: Scudeller
authors.forename: Rosella
authors.initials: R
authors.lastname: Radaelli
authors.forename: Paolo Emilio
authors.initials: PE
authors.lastname: Bianchi
mesh_terms: D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D003008:Cloprostenol / Q000031:analogs & derivatives / Q000627:therapeutic use; D018450:Disease Progression; D004338:Drug Combinations; D005500:Follow-Up Studies; D005902:Glaucoma, Open-Angle / Q000188:drug therapy* / Q000503:physiopathology*; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects; D055118:Medication Adherence; D008875:Middle Aged; D012189:Retrospective Studies; D013999:Timolol / Q000627:therapeutic use; D000069557:Travoprost; D014786:Vision Disorders / Q000503:physiopathology*; D014792:Visual Acuity / Q000502:physiology; D014794:Visual Fields / Q000502:physiology*
chemical_list: D000959:Antihypertensive Agents; D004338:Drug Combinations; D003008:Cloprostenol; D013999:Timolol; D000069557:Travoprost