Der Ophthalmologe

, Volume 109, Issue 11, pp 1087–1092 | Cite as

Konservierte Augentropfen und Adhärenz in der augenärztlichen Praxis

Leitthema

Zusammenfassung

Chronische Augenerkrankungen wie das Glaukom oder die Benetzungsstörungen der Augenoberfläche bedürfen einer langfristigen Medikamentenapplikation am Auge. Hierfür ist eine hohe Adhärenz erforderlich. Darunter versteht man das Einbeziehen des Patienten in die therapeutischen Ziele. Der frühere Begriff der Compliance umfasste demgegenüber nur das Befolgen ärztlicher Instruktionen. Die Adhärenz wird durch sozioökonomische, gesundheitssystembezogene, krankheitsbezogene, therapiebezogene und patientenbezogene Faktoren beeinflusst. Sie lässt sich durch aufwendige Verfahren wie elektronisches Monitoring, Selbsteinschätzung, „drop counting“ und laborchemisch über serologische Medikamentenspiegel messen. Nonadhärenz ist ein weltweit zunehmendes Problem. Eine Steigerung der Adhärenz bedeutet für den Patienten ein zunehmendes Maß an Therapiesicherheit und langfristig eine Kostenersparnis für das Individuum und die Gesellschaft. Nebenwirkungsreiche Augentropfen bewirken bei chronischen Erkrankungen wie Glaukom und Benetzungsstörungen eine Nonadhärenz. Vielfach werden diese Nebenwirkungen durch Hilfsstoffe wie das Konservierungsmittel Benzalkoniumchlorid ausgelöst. Für das Erreichen einer guten Adhärenz sind konservierungsmittelfreie Augentropfen angeraten.

Schlüsselwörter

Adhärenz Compliance Benetzungsstörung Glaukom Konservierungsmittel 

Preservative-containing eye drops and adherence in ophthalmological practice

Abstract

Chronic eye diseases, such as glaucoma or dry eye syndrome, require long-term drug application to the eyes. Good adherence is required to achieve the therapeutic goal and patient needs and requirements have to be taken into account. This distinguishes adherence to drug therapy from the former compliance which implies only following medical instructions. Adherence is influenced by socioeconomic, health system-related, disease-related, treatment-related and patient-related factors. It can be measured by tedious procedures, such as electronic monitoring, self-assessment, drop counting and laboratory findings of systemic drug levels. Non-adherence is a growing medical problem worldwide. An increase in adherence means an increased degree of therapeutic safety for the patient and long-term cost savings for the individual as well as society. Non-adherence in chronic diseases, such as glaucoma and dry eye syndrome is increased by eye drops that cause side effects. Often these side effects are caused by agents such as the preservative benzalkonium chloride. To achieve a good adherence preservative-free eye drops are advised.

Keywords

Adherence Compliance Tear film disorder Glaucoma Preservative 

Notes

Interessenkonflikt

Der korrespondierende Autor weist für sich und seinen Koautor auf folgende Beziehungen hin: Berater MSD, Allergan, Alcon, Pfizer.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  1. 1.AugenklinikTU MünchenMünchenDeutschland
  2. 2.AugenärztegemeinschaftChiemsee Augen TagesklinikPrienDeutschland
  3. 3.AugenarztHeidelbergDeutschland

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