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A nationwide survey of factors influencing adherence to ocular hypotensive eyedrops in Japan

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Abstract

Introduction

Few reports have investigated the status of adherence in Japan on a large scale. We aimed to investigate the status of adherence to topical glaucoma treatment and its associated factors.

Methods

A nationwide survey was conducted as a prospective fashion. Participants in this survey were subjects with primary open-angle glaucoma, normal-tension glaucoma, or ocular hypertension or pseudoexfoliation glaucoma who had been prescribed anti-glaucoma ophthalmic eyedrops and whose ophthalmologist considered prescribing any fixed combination of ocular hypotensive eyedrops for the first time between 2011 and 2012. Subjects and their attending ophthalmologists independently completed a questionnaire by utilizing a fixed combination of ocular hypotensive eyedrops.

Results

A total of 1358 ophthalmologists from 1071 medical institutions participated in this survey. We registered 4430 subjects (2049 males and 2381 females). In total, data from 3853 subjects (87.6%) were analyzed after inclusion of subjects based on inclusion and exclusion criteria. Good adherence was defined as not forgetting instillation during the past week. Rates of good adherence reported by subjects and ophthalmologists were 72.4 and 78.5%, respectively (P < 0.0001). The consistency of adherence evaluation between subjects and ophthalmologists was moderate [kappa score 0.5025 (95% confidence interval 0.4740–0.5309)]. Significant factors associated with adherence were size of clinic, age, gender, number of types of ocular hypotensive eyedrops, ease of instillation, preferred number of eyedrops, preferred frequency of instillation of eyedrops, and knowledge of glaucoma.

Conclusion

Adherence to ocular hypotensive eyedrops among Japanese subjects was relatively good. Concordance of adherence between subjects’ reports and ophthalmologists’ responses was moderate. Size of clinic, number of types of ocular hypotensive eyedrops, ease of instillation, preferred number of eyedrops, preferred frequency of instillation of eyedrops, and knowledge of glaucoma were associated with adherence among Japanese glaucoma subjects.

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References

  1. Heijl A, Leske MC, Bengtsson B et al (2002) Reduction of intraocular pressure and glaucoma progression: results from the Early Manifest Glaucoma Trial. Arch Ophthalmol 120(10):1268–1279

    Article  PubMed  Google Scholar 

  2. Kashiwagi K (2010) Changes in trend of newly prescribed anti-glaucoma medications in recent 9 years in a Japanese local community. Open Ophthalmol J 4:7–11

    Article  PubMed  PubMed Central  Google Scholar 

  3. Okeke CO, Quigley HA, Jampel HD et al (2009) Adherence with topical glaucoma medication monitored electronically the Travatan Dosing Aid study. Ophthalmology 116(2):191–199

    Article  PubMed  Google Scholar 

  4. Campbell JH, Schwartz GF, LaBounty B et al (2014) Patient adherence and persistence with topical ocular hypotensive therapy in real-world practice: a comparison of bimatoprost 0.01% and travoprost Z 0.004% ophthalmic solutions. Clin Ophthalmol 8:927–935

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Nordstrom BL, Friedman DS, Mozaffari E et al (2005) Persistence and adherence with topical glaucoma therapy. Am J Ophthalmol 140(4):598–606

    Article  PubMed  Google Scholar 

  6. Park MH, Kang KD, Moon J (2013) Noncompliance with glaucoma medication in Korean patients: a multicenter qualitative study. Jpn J Ophthalmol 57(1):47–56

    Article  PubMed  Google Scholar 

  7. Kashiwagi K, Furuya T (2014) Persistence with topical glaucoma therapy among newly diagnosed Japanese patients. Jpn J Ophthalmol 58(1):68–74

    Article  PubMed  Google Scholar 

  8. Reardon G, Kotak S, Schwartz GF (2011) Objective assessment of compliance and persistence among patients treated for glaucoma and ocular hypertension: a systematic review. Patient Prefer Adherence 5:441–463

    Article  PubMed  PubMed Central  Google Scholar 

  9. Gray TA, Fenerty C, Harper R et al (2012) Individualised patient care as an adjunct to standard care for promoting adherence to ocular hypotensive therapy: an exploratory randomised controlled trial. Eye (London) 26(3):407–417

    Article  CAS  Google Scholar 

  10. Quek DT, Ong GT, Perera SA et al (2011) Persistence of patients receiving topical glaucoma monotherapy in an Asian population. Arch Ophthalmol 129(5):643–648

    Article  PubMed  Google Scholar 

  11. Owen CG, Carey IM, de Wilde S et al (2009) Persistency with medical treatment for glaucoma and ocular hypertension in the United Kingdom: 1994–2005. Eye (London) 23(5):1098–1110

    Article  CAS  Google Scholar 

  12. Djafari F, Lesk MR, Harasymowycz PJ et al (2009) Determinants of adherence to glaucoma medical therapy in a long-term patient population. J Glaucoma 18(3):238–243

    Article  PubMed  Google Scholar 

  13. Gurwitz JH, Glynn RJ, Monane M et al (1993) Treatment for glaucoma: adherence by the elderly. Am J Public Health 83(5):711–716

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Robin AL, Covert D (2005) Does adjunctive glaucoma therapy affect adherence to the initial primary therapy? Ophthalmology 112(5):863–868

    Article  PubMed  Google Scholar 

  15. Robin AL, Novack GD, Covert DW et al (2007) Adherence in glaucoma: objective measurements of once-daily and adjunctive medication use. Am J Ophthalmol 144(4):533–540

    Article  PubMed  Google Scholar 

  16. Aptel F, Denis P (2011) Balancing efficacy and tolerability of prostaglandin analogues and prostaglandin-timolol fixed combinations in primary open-angle glaucoma. Curr Med Res Opin 27(10):1949–1958

    Article  CAS  PubMed  Google Scholar 

  17. Herceg M, Noecker R (2008) Travoprost/timolol fixed combination. Expert Opin Pharmacother 9(6):1059–1065

    Article  CAS  PubMed  Google Scholar 

  18. Higginbotham EJ (2010) Considerations in glaucoma therapy: fixed combinations versus their component medications. Clin Ophthalmol 4:1–9

    PubMed  PubMed Central  Google Scholar 

  19. Sabaté E (2003) Adherence to long-term therapies: evidence for action. World Health Organization, Geneva

    Google Scholar 

  20. Cate H, Bhattacharya D, Clark A et al (2014) Improving adherence to glaucoma medication: a randomised controlled trial of a patient-centred intervention (The Norwich Adherence Glaucoma Study). BMC Ophthalmol 14:32

    Article  PubMed  PubMed Central  Google Scholar 

  21. Dreer LE, Owsley C, Campbell L et al (2016) Feasibility, patient acceptability, and preliminary efficacy of a culturally informed, health promotion program to improve glaucoma medication adherence among African Americans: “Glaucoma Management Optimism for African Americans Living with Glaucoma” (GOAL). Curr Eye Res 41(1):50–58

    Article  PubMed  Google Scholar 

  22. Loon SC, Jin J, Jin Goh M (2015) The relationship between quality of life and adherence to medication in glaucoma patients in Singapore. J Glaucoma 24(5):e36–e42

    Article  PubMed  Google Scholar 

  23. Rosdahl JA, Swamy L, Stinnett S et al (2014) Patient education preferences in ophthalmic care. Patient Prefer Adherence 8:565–574

    Article  PubMed  PubMed Central  Google Scholar 

  24. Kashiwagi K, Tsukahara S (2014) Impact of patient access to Internet health records on glaucoma medication: randomized controlled trial. J Med Internet Res 16(1):e15

    Article  PubMed  PubMed Central  Google Scholar 

  25. Friedman DS, Okeke CO, Jampel HD et al (2009) Risk factors for poor adherence to eyedrops in electronically monitored patients with glaucoma. Ophthalmology 116(6):1097–1105

    Article  PubMed  Google Scholar 

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Acknowledgements

The authors deeply appreciate the cooperation of the participating subjects and ophthalmologists. Kenji Kashiwagi MD, PhD has full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. The authors have no proprietary or commercial interests in any materials discussed in this article. Pfizer Japan Inc. financially supported this study, but Pfizer Japan Inc. had no roles in designing or conducting the study; collecting, managing, analyzing, or interpreting the data; or preparing, reviewing, or approving the manuscript.

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Authors and Affiliations

  1. Fussa Hospital, Tokyo, Japan

    Toyoaki Tsumura

  2. Department of Ophthalmology, Faculty of Medicine, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi, Japan

    Toyoaki Tsumura & Kenji Kashiwagi

  3. Department of Ophthalmology, Tokai University, Hiratsuka, Kanagawa, Japan

    Yasuyuki Suzuki

  4. Yoshikawa Eye Clinic, Tokyo, Japan

    Keiji Yoshikawa

  5. Suzumura Eye Clinic, Tokyo, Japan

    Hirotaka Suzumura

  6. Maeda Eye Clinic, Tokyo, Japan

    Toshine Maeda

  7. Faculty of Agriculture, Kinki University, Nara, Japan

    Ryuji Takeda

  8. Kanto Central Hospital of the Mutual Aid Association of Public School, Tokyo, Japan

    Hitomi Saito & Makoto Araie

Authors
  1. Toyoaki Tsumura
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  2. Kenji Kashiwagi
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  3. Yasuyuki Suzuki
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  4. Keiji Yoshikawa
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  5. Hirotaka Suzumura
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  6. Toshine Maeda
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  9. Makoto Araie
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Corresponding author

Correspondence to Kenji Kashiwagi.

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Tsumura, T., Kashiwagi, K., Suzuki, Y. et al. A nationwide survey of factors influencing adherence to ocular hypotensive eyedrops in Japan. Int Ophthalmol 39, 375–383 (2019). https://doi.org/10.1007/s10792-018-0820-7

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  • DOI: https://doi.org/10.1007/s10792-018-0820-7

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