title: Cost of the medical management and prescription pattern for primary open angle glaucoma (POAG) in Ghana-a retrospective cross-sectional study from three referral facilities.
abstract: Glaucoma is the leading cause of irreversible blindness globally, and treatment involves considerable cost to stakeholders in healthcare. However, there is infrequent availability of cost information and patterns of management, especially in developing countries. This study determined the cost of the medical management of POAG, adherence, and pattern of medication prescription in Ghana.
  
  
  
  A retrospective cross-sectional study involving 891 Primary Open Angle Glaucoma (POAG) cases seen in the year 2012 at three referral facilities. Demographics, ocular history, resource consumption, medication, test, surgery and other related cost were extracted from 84 patients who had fully complied with their treatment to calculate total cost (TC) based on 2012 estimates. Glaucoma drugs prescribed to patients who had adhered to all their review visits within the period evident from case folders were recorded and analysed for the prescription pattern.
  
  
  
  Out of 891 POAG cases seen in 2012, 351(39.4 %) attended all the required review visits, but only 84 (9.4) had fully and continually adhered to all their treatment regimes. They comprised 41(48.8 %) males and 43(51.2 %) females with a mean age of 65 ± 14.8. Majority of the respondents were elderly above 60 year of age (65.5 %). The total estimated cost for the 84 cases in the year was GH¢ 81,237 ($40,619), comprising GH¢ 72,193 ($36,097) direct medication cost and GH¢9,045 ($4,523) direct non-medication cost (surgery and test cost), and an average of GH¢ 967 ($484) for a mean visit of 5.6 ± 1.1 in the year. A total of 673 glaucoma medications had been prescribed for 351 patients for the year, with timolol being the most prescribed (64.19 %) and monotherapy as the most adopted form of therapy (61.06 %). Age and income showed concurrent increase with cost (P ≤ 0.05).
  
  
  
  Cost of managing glaucoma constitutes a substantial financial burden and influenced the pattern of medication prescription.
authors.affiliation: Department of Vision and Hearing Sciences, Faculty of Science and Technology, Anglia Ruskin University, Cambridge, UK. socansey2@ucc.edu.gh.|Department of Optometry, School of Allied Health Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana. socansey2@ucc.edu.gh.
authors.forename: Stephen
authors.initials: S
authors.lastname: Ocansey
authors.affiliation: Department of Optometry, School of Allied Health Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana.
authors.forename: Samuel
authors.initials: S
authors.lastname: Kyei
authors.affiliation: Department of Optometry, School of Allied Health Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana.
authors.forename: Ama
authors.initials: A
authors.lastname: Diafo
authors.affiliation: Department of Economics, Faculty of Social Sciences, College of Humanities and Legal Studies, University of Cape Coast, Cape Coast, Ghana.
authors.forename: Kwabena Nkansah
authors.initials: KN
authors.lastname: Darfor
authors.affiliation: Department of Optometry, School of Allied Health Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana.
authors.forename: Samuel Bert
authors.initials: SB
authors.lastname: Boadi-Kusi
authors.affiliation: Department of Economics, Faculty of Social Sciences, College of Humanities and Legal Studies, University of Cape Coast, Cape Coast, Ghana.
authors.forename: Peter B
authors.initials: PB
authors.lastname: Aglobitse
mesh_terms: D000368:Aged; D001766:Blindness / Q000517:prevention & control; D003365:Costs and Cost Analysis; D003430:Cross-Sectional Studies; D016527:Drug Costs; D005260:Female; D005869:Ghana; D005902:Glaucoma, Open-Angle / Q000188:drug therapy*; D006295:Health Resources / Q000706:statistics & numerical data; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D012017:Referral and Consultation; D012189:Retrospective Studies
keywords: Compliance; Cost; Ghana; Glaucoma; Medication