Problem of Adherence in Glaucoma Patients and its Solution

The prices of managing glaucoma actually take out a large chunk of the resources for healthcare but a recent study carried by Joshua Stein, MD, a glaucoma specialist and researcher at theUniversityofMichigan Kellogg Eye CentreinAnn Arborproves that laser trabeculoplasty and tropical prostaglandin analogs can be cost effective options.

To know which of the two options is better in treating patients with newly diagnosed mild open-angle glaucoma (OAG), a Markov mathematical model with a 25- year time horizon was used to compare the cost effectiveness of prostaglandins analogs (PGAs) and laser trabeculoplasty (LTP). According to Dr. Stein, this comparison will not only help guide decision making by eye care providers and their patients but even the health policymakers. The results showed that against no treatment, the incremental cost effectiveness of PGAs was $14,179 per quality-adjusted life year (QALY) while it was $16,824 QALY for trabeculoplasty. According to the researchers trabeculoplasty might be the better option for patients who are at a greater risk for poor adherence.
problem of adherence

Describing the extent and outcomes of improper medication adherence, Dr. Stein said, “Studies have demonstrated that nearly a third of all patients with glaucoma aren’t able to adhere to their medication regimens. And research has also shown that even in patients who start out with good adherence, very few are able to maintain that level of adherence over the long term. However, with the introduction of a less-expensive generic PGA (latanoprost), there is hope that barrier to adherence will be mitigated.”

The vital adherence issues need to be discussed with the patients by their physicians while discussing the treatment methods and they should be made aware with the hurdles related to the poor adherence such as complexity of the drug regimen, medication costs, forgetfulness, problems with eye drop administration, side effects and this will help the patients to choose laser trabeculoplasty if they think they will probably fight with some of these issues since to identify which patients are surly adherent to medication regimens and which are not, is a tedious affair.

With the advancement of the medical sciences, patients have with them abundant choices and that’s the good part. While selective laser trabeculoplasty which was introduced a few years back has helped to cut down energy during the procedure, generic prostaglandin analogs (PGAs) has helped in bringing down the price of the treatment significantly.


Problem of Adherence in Glaucoma Patients and its Solution
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