Changes in adherence and associated factors among patients on newly introduced prostaglandin analog and timolol fixed-combination therapy

Figures & data

Figure 1 The two leaflets: leaflet A explains how to correctly instill the eye drops (A), whereas leaflet B explains the clinical relevance of IOP reduction in glaucoma care (B), in addition to how to correctly instill the eye drops.

Note: Reprinted from American Journal of Ophthalmology, 126(4), Collaborative Normal-Tension Glaucoma Study Group, The effectiveness of intraocular pressure reduction in the treatment of normal-tension glaucoma, 498–505, Copyright © 1998, with permission from Elsevier.³²
Abbreviation: IOP, intraocular pressure.

Table 1 Demographics of the enrolled patients upon entry

Parameters	Values
Age (years)	68.4±12.2
Gender, n (male/female)	1,690/1,907
Subject number per glaucoma subtype, n
POAG	1,852
NTG	1,373
XFG	14
OH	228
Preoperative logMAR	0.012268±0.20071
Pre-MD (dB)	−4.03±5.69
Pre-IOP (higher eye, mmHg)	16.1±3.8
Period of past treatment (years)	3.14±1.1
Number of eye drops (range)	1.93±0.78 (1–4)
Experiencing difficulty seeing	69.5%
Experiencing visual field loss	31.8%

Note: Data shown as mean ± SD unless indicated otherwise.

Abbreviations: POAG, primary open-angle glaucoma; NTG, normal tension glaucoma; XFG, pseudoexfoliation glaucoma; OH, ocular hypertension; logMAR, the logarithm of the minimum angle of resolution; MD, mean deviation; IOP, intraocular pressure.

Table 2 Changes in the questionnaire survey outcomes between study entry and the return visit

Parameters	At entry	Revisit
Number of eye drops (range)	1.93±0.78 (1–4)	1.34±0.54 (1–5)
Nonadherent* (P<0.0001)
No	2,600	2,960
Yes	997	637
Burden of instillation of eye drops§ (P	<0.0001)
No	2,136	2,368
Slightly yes	1,294	1,132
Yes	158	88
Acceptable bottles of eye drops	2.39±1.00	2.33±0.97
Acceptable frequency of instillation	2.36±1.02 (time)	2.37±1.00 (time)
When instillation was forgotten§ (P<0.0001)
Morning	32.2%	24.1%
Noon	31.1%	34.4%
Evening	21.0%	17.7%
Before sleep	15.8%	23.9%
Who performed the instillation
Self	96.7%	96.3%
Family member	2.9%	3.4%
Medical helper	0.4%	0.3%
Use of eye drop aids (yes)	2.9%	3.2%
Interval between eye drop instillation§ (P<0.0001)
Consecutive	6.0%	4.5%
1 minute	7.8%	6.8%
3 minutes	10.8%	10.0%
>5 minutes	75.4%	78.7%

Notes:

* Chi-square test;

§ Wilcoxon signed-rank test. Data shown as mean ± SD unless indicated otherwise.

Figure 2 Effects of PGTFC introduction on patient attitude.

Notes: (A) Relief of burden due to PGTFC introduction. (B) Decreased forgetting of eye drop use in response to PGTFC introduction. (C) Decreased hyperemia and discomfort in response to PGTFC introduction. (D) Preference regarding the PGTFC.
Abbreviation: PGTFC, prostaglandin analog and timolol fixed-combination eye drops.

Table 3 Factors associated with adherence

Parameters	P-value	Odds ratio	Lower 95% CI	Upper 95% CI
Nonadherent, reported by patient at entry	<0.0001	8.157	6.4008	10.4327
Nonadherent, reported by ophthalmologist at entry	0.035	1.2946	1.0178	1.6436
Acceptable frequency of one-day instillation at entry	0.034	0.8386/one time	0.7126	0.9861
Acceptable frequency of one-day instillation at revisit	0.002	0.7733/one time	0.6570	0.6570
Burden of eye drop use at revisit	0.005	2.3374	1.3014	4.1454
Leaflet A/B	0.058	1.2144	0.9936	1.450

Abbreviation: CI, confidence interval.

Figure 3 Change in the percentage of correct answers between study entry and the return visit.

Abbreviation: Q, question.

Figure S1 (A) Questionnaire for patients. (B) Questionnaire for ophthalmologists.

Abbreviation: MD, mean deviation.

Figure S2 Questionnaire for patients when revisiting the hospital or medical clinic.

Collaborative Normal-Tension Glaucoma Study GroupThe effectiveness of intraocular pressure reduction in the treatment of normal-tension glaucomaAm J Ophthalmol199812644985059780094

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