Editors Selection (IGR: 9-3) | International Glaucoma Review #197

Editors Selection IGR 9-3

Medical treatment: Cooperation with medical therapy

Comment by Joseph Caprioli on:

12482 Noncompliance with ocular hypotensive treatment in patients with glaucoma or ocular hypertension an evidence-based review, Olthoff CM; Schouten JS; van de Borne BW et al., Ophthalmology, 2005; 112: 953-961

Meta-analysis often usefully summarizes what is known about an area. Olthoff et al. (660) reviewed many of the papers on cooperation with medical glaucoma therapy. They conclude that we know the following facts:

Noncompliance with prescribe therapy is common;

It may be a cause of worse visual outcomes;

No patient characteristics accurately identify non-compliers;

Patients underreport their non-compliance;

Monitoring ideally should use mechanical devices;

Pharmacy refill data are probably less accurate predictors of cooperation;

Educational efforts may be useful in improving compliance;

Compliance may be better with simpler regimens (fewer drops/day, less complex schedules of medications);

Patients probably comply better if they make more doctor visits.

More research is needed into the cooperation of patients with therapy. In order to do so, medication monitors that electronically measure actual drop use are needed. Interventions that might influence cooperation should be studied in detail.

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