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Editors Selection IGR 22-1
Medical Treatment: Patient Acceptance of Sustained-Release Glaucoma Medications
Comment by Steve Mansberger on:
76539 Patient Acceptance of Sustained Glaucoma Treatment Strategies, Varadaraj V; Kahook MY; Ramulu PY et al., Journal of Glaucoma, 2018; 27: 328-335
Varadaraj and colleagues surveyed patient acceptance of sustained delivery of ocular hypotensive therapies. Sustained delivery may be an important method to treat glaucoma considering poor adherence with ocular hypotensive eye drop medications.1 Yet, there is a paucity of information on patient acceptance of sustained therapies currently undergoing investigation. The researchers administered electronic surveys to 163 participants from two sites: Johns Hopkins University (JHU) and University of Colorado. The majority of participants would accept sustained-delivery therapies [contact lenses (59%), ring inserts (51%), punctal plugs (57%) or subconjunctival injections (52%)] in order to avoid surgery. They found similar acceptance if sustained therapies were deemed more effective than drops (range 47% to 56%), and lower acceptance when they would reduce or eliminate drops (range 23% to 42%). Patients most often preferred contact lenses and punctal plugs.
The study did not evaluate the association between severity of glaucoma and acceptance of sustained therapy. One could theorize that those patients needing surgery would be more likely to accept a sustained therapy. Because the study was located at tertiary referral centers, the authors suggest that the study populations may not be representative of all glaucoma patients. Interestingly, the study found differences in acceptance rates between study sites (Colorado participants were less likely (0.48 times the odds, p = .01 in multivariable model)) of JHU participants to accepting sustained delivery therapy. Examining this difference may uncover differences in severity of glaucoma, different practice patterns, or acceptability of 'usual' vs. 'new' treatments. Overall, this study suggests that sustained delivery of glaucoma medications may be an accepted treatment in the majority of glaucoma patients if it was more effective than drops or helped them avoid surgery.
Sustained delivery of glaucoma medications may be an accepted treatment in the majority of glaucoma patients if it was more effective than drops or helped them avoid surgery
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