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Editors Selection IGR 19-1

Glaucoma in the COVID era: Impact of the pandemic on adherence to antiglaucoma medication

Comment by Catherine Jui-Ling Liu & Yu-Chieh Ko on:

96332 The Impact of the Coronavirus Disease 2019 Pandemic on Adherence to Ocular Hypotensive Medication in Patients with Primary Open-Angle Glaucoma, Racette L; Abu SL; Poleon S et al., Ophthalmology, 2022; 129: 258-266

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This study is part of an ongoing 3-year longitudinal study, initiated before the COVID-19 pandemic, to assess adherence to glaucoma medication using Medication Event Monitoring System caps in patients with primary open angle glaucoma (POAG). All 79 participants were prescribed the same glaucoma medication throughout the 300 days of the study: 150 days before and 150 days after the declaration of the COVID-19 emergency. The authors found the overall mean adherence worsened from 83.6% before the pandemic to 68% 1 year later, although adherence of many participants (48%) improved during the crisis. The segmented regression analysis suggested that adherence declined 28 days after the breakpoint. Psychometric measures of resilience and confrontive coping are positively and negatively associated with change in adherence, respectively, which echoes to a previous study showing that coping with the COVID-19 pandemic varies in individuals having various psychosocial characteristics.¹

One finding which may be noteworthy is a 28-day lag in adherence decline after declaration of the crisis. Ophthalmologists may take advantage of this prime time to set up telemedicine systems and expand the capacity of mail delivery of medicine to home or neighborhood pharmacies

We congratulate the authors for providing new information about adherence to glaucoma medication during the pandemic. However, medication adherence could be affected by many factors. Besides the 9 study limitations the authors acknowledged in their article, another shortcoming is the small number of mostly part-time employed participants (95%) with a mean age of 71±8 years who were using few glaucoma medications (median 1 with IQR 1): a very selective group of POAG patients. One finding which may be noteworthy is a 28-day lag in adherence decline after declaration of the crisis. Ophthalmologists may take advantage of this prime time to set up telemedicine systems and expand the capacity of mail delivery of medicine to home or neighborhood pharmacies. Communication with one familiar ophthalmologist via telemedicine may effectively increase a patient's resilience and facilitate good adherence.²

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