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Abstract #27825 Published in IGR 13-1
Medical decision, persistence of initial treatment, and glaucoma progression in a Brazilian reference hospital
Paula JS; Filho JAR; Cecchetti DFA; Nagatsuyu DT; Rodrigues MLV; Rocha EMArquivos Brasileiros de Oftalmologia 2010; 73: 141-145
Purpose: To evaluate the initial medical decision regarding primary open-angle glaucoma (POAG) treatment in a referral center, and to assess the relationship between the persistence of treatment and the disease progression in cases managed exclusively with medication. Methods: A retrospective chart review was performed for 65 patients with primary open-angle glaucoma referred to a tertiary hospital. The following clinical data were analyzed: initial medication, persistence of treatment, best corrected visual acuity, visual field mean deviation index, cup/disc ratio, and intraocular pressure. Patients were classified into four categories in order to verify the clinical evolution. Results: The mean number of visits/year was 4.4 (plus or minus) 3.5, and the follow-up period was 40.7 (plus or minus) 22.8 months. Mean persistence time was 12.9 (plus or minus) 13.9 months. By six and twelve months, respectively, 39.1% and 62.5% of patients had discontinued the initially prescribed regimen, mainly by adding to (42%) or changing (26%) the course of treatment. Thirteen patients (21%) were reclassified to a worse category of primary open-angle glaucoma, however, despite this trend, no significant correlation was found between shorter persistence and primary open-angle glaucoma worsening. Conclusions: Persistence rates with initial therapy schemes were low, as measured by medical decisions to change the course of treatment. Therefore, improvement in the initial medical decision is crucial in order to offer a more stable and effective treatment for primary open-angle glaucoma. LA: Portuguese
J.S. Paula. Departamento de Oftalmologia, Escola de Medicina de Ribeirao Preto, Universidade de Sao Paulo, Av. Bandeirantes, 3.900 - 12o andar, Ribeirao Preto (SP), Brazil. jspaula@fmrp.usp.br
Classification:
11.17 Cooperation with medical therapy e.g. persistency, compliance, adherence (Part of: 11 Medical treatment)
6.20 Progression (Part of: 6 Clinical examination methods)
