title: Patterns of adherence behaviour for patients with glaucoma.
abstract: OBJECTIVE
  Adherence to long-term treatment regimens for primary open-angle glaucoma holds a challenge for both clinicians and patients. The study aims were to (i) establish the magnitude of travoprost non-adherence using an Electronic Adherence Monitor (EAM), (ii) compare electronic with patient self-reported adherence, and (iii) explore the application of a previously reported method of graphically presenting adherence data to a larger cohort over a longer monitoring period.
  
  
  METHODS
  A cohort study of patients using travoprost for glaucoma or ocular hypertension was conducted. All participants used an EAM and adherence data were collected prospectively for 2 months. Self-reported adherence was obtained using the Morisky Medication Adherence Scale (MMAS); patients also reported frequency of missed doses. Potential predictors of adherence were collected via a structured interview. EAM-recorded interdose intervals were plotted graphically.
  
  
  RESULTS
  Of 100 patients invited to participate, 98 consented and EAM data were collected successfully from 88 participants. The median EAM adherence score for the cohort was 88.9% (interquartile range: 71.2, 92.2). When dichotomised (≥80%: adherent; <80%: non-adherent), EAM identified 36.7% as non-adherent and MMAS 12.2%. EAM data were used to classify five types of adherence behaviour including a category representing levels of ≥97% maintained by 21% of participants.
  
  
  CONCLUSIONS
  EAM revealed good adherence to glaucoma monotherapy but poor agreement with patient self-reported adherence. An adherence category of persistent and exceptionally high adherence to travoprost over a 2-month period was identified.
authors: Eye Department, Norfolk and Norwich University Hospital, NHS Foundation Trust, Norwich, UK. heidi.cate@nnuh.nhs.uk
authors: H
authors: H
authors: Cate
authors: D
authors: D
authors: Bhattacharya
authors: A
authors: A
authors: Clark
authors: R
authors: R
authors: Holland
authors: D C
authors: DC
authors: Broadway
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D003008:Cloprostenol / Q000031:analogs & derivatives* / Q000627:therapeutic use; D015331:Cohort Studies; D005260:Female; D005901:Glaucoma / Q000188:drug therapy*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D057566:Self Report; D000069557:Travoprost; D016903:Drug Monitoring
chemical_list: D000959:Antihypertensive Agents; D003008:Cloprostenol; D000069557:Travoprost