Glaucoma Medication Persistence Rates in Ontario – A Population Study

Theme: Glaucoma
What: Glaucoma
Part of: Glaucoma I: Medical / Glaucome I: Médical
When: 5/31/2024, 11:15 AM - 12:45 PM
Where: Room | Salle 801

Abstract

Purpose:

Effective medical treatment is a vital aspect in glaucoma management. However, despite the success of intraocular pressure lowering therapy, glaucoma medication persistence - defined as the act of continuing the treatment for the prescribed duration - remain suboptimal. Numerous factors can contribute to medication non-persistence. To date, there has been no comprehensive population-based study examining glaucoma medication persistence in Ontario, Canada. This is the first study that employs a big-data approach to elucidate treatment persistence patterns for glaucoma eye drops in this province.

Study Design:

In this proof-of-concept study, we collaborated with the Institute for Clinical Evaluative Sciences (ICES) and conducted a retrospective population-based study utilizing data from Ontario’s publicly funded healthcare system.

Methods:

All individuals diagnosed with glaucoma who initiated medication between January 1, 2011, and December 31, 2016, were included in the study. Glaucoma was defined as patients using one or more glaucoma medications, accompanied by at least one visual field test within four months before or up to two years after medication initiation. Medication persistence was defined as maintaining a continuous supply of medications for up to two years. Partial persistence was for patients who intermittently maintained medications within the two-year period; and transient users had less than 3 refills. We further analyzed potential factors, such as age, sex and socioeconomic status (SES), that can influence medication persistence.

Results:

From the ICES database, we identified 75,055 glaucoma patients (Figure 1). Among them, 13,150 were transient medication users (Group 1). In contrast, 61,905 patients belonged to the consecutive group. Of these, 17,462 (28.2%) achieved full persistence (Group 2); 31,125 (50.3%) patients (Group 3) experienced more than 90 days of medication interruption but later resumed their medications. The no-persistent group (Group 4, 21.5%) discontinued medications after 3 consecutive refills. The average age, average number of comorbidities, SES and sex distribution in each group are outlined in Figure 1. Among these factors, there is both an association between persistence group and SES (p<0.01), and with gender (p<0.001). Specifically, the no-persistence group have higher proportion of patients with low SES than the full-persistence group (19% vs 17%).

Conclusions:

Our study underscores the prevalence of low persistence (28.2%) for glaucoma medications in Ontario over a 2-year period. As the next step, we will further examine other potential factors related to suboptimal medication persistence. This knowledge will facilitate the refinement of both medical practice and social policies, with the overarching aim of providing enhanced support to individuals who are grappling with these challenges.

Presenter(s)

Presenting Author: Tianwei Ellen Zhou

Additional Author(s):

Zhengjing Jimmy Hu, Trillium Health Partners

Michael Yang, Prism Eye Institute

Marko Popovic, Department of Ophthalmology & Vision Sciences, University of Toronto

Laura Rosella, Trillium Health Partners, Temerty Faculty of Medicine (University of Toronto)

Matthew Schlenker, Department of Ophthalmology & Vision Sciences, University of Toronto

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