Risk Factors for Poor Adherence to Eyedrops in Electronically Monitored Patients with Glaucoma
Risk Factors for Poor Adherence to Eyedrops in Electronically Monitored Patients with Glaucoma
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DOI：
10.1016/j.ophtha.2009.01.021
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发表时间：
2009-06-01
期刊：
影响因子：
13.7
通讯作者：
Quigley, Harry A.
中科院分区：
文献类型：
--
作者：
Friedman, David S.;Okeke, Constance O.;Quigley, Harry A.
目的：目的：确定青光眼每日一次局部治疗依从性差的危险因素。设计：前瞻性、观察性队列研究。参与者：2006年8月至2007年6月期间，在Scheie或威尔默眼科研究所接受前列腺素类似物治疗的1只眼或多只眼青光眼患者共196例。方法：从每例患者中获得人口统计学资料、眼病史和对青光眼知识、健康信念和滴眼液行为等访谈问题的回答。所有患者均使用Travatan给药辅助装置（DA; Alcon Laboratories Inc.，沃斯堡，德克萨斯州）按规定给予曲伏前列素。设备收集在3个月，和使用的数据下载的下降使用的软件提供的DA. Patients服用75%的doses.Main结果措施：不良adherence.Results的风险因素：八十七例患者（44.4%的196例受试者在3个月的可评估数据）使用DA的75%或更少的监测天。在单变量分析中，较贫穷的坚持者更有可能是≥ 80岁，是非洲裔美国人，报告不太好的健康状况，报告更高的抑郁症，收入较低，并在Scheie眼科研究所接受治疗。多变量分析（调整教育和收入）发现，年龄，种族/民族，不到优秀的健康状况与穷人adherence.Conclusions：那些未能采取超过75%的眼药水剂量更有可能是非洲裔美国人，并报告健康状况不佳。最年轻和最年长年龄组的患者依从性较差，尽管这一发现并不总是具有统计学意义。进一步研究驱动这些关联的因素，并开发预测模型，以帮助筛选低依从性是必要的。财务披露：专有或商业披露可在参考文献后找到。Ophthalmology 2009; 116：1097-1105（C）2009，美国眼科学会。
Purpose: To identify risk factors for poor adherence to topical once daily therapy for glaucoma.Design: Prospective, observational cohort study.Participants: A total of 196 patients with glaucoma who were being treated with a prostaglandin analog in 1 or more eyes at the Scheie or Wilmer Eye Institutes between August 2006 and June 2007.Methods: Demographics, ocular history, and responses to interview questions about glaucoma knowledge, health beliefs, and drop-taking behaviors were obtained from each patient. All patients used the Travatan Dosing Aid (DA; Alcon Laboratories Inc., Fort Worth, TX) to administer travoprost as prescribed. Devices were collected at 3 months, and the data of drop use were downloaded using software provided with the DA. Patients taking 75% of doses.Main Outcome Measures: Risk factors for poor adherence.Results: Eighty-seven patients (44.4% of the 196 subjects with evaluable data at 3 months) used the DA on 75% or less of the monitored days. In univariate analysis, poorer adherers were more likely to be = 80 years of age, to be African American, to report less than excellent health, to report higher amounts of depression, to have lower income, and to be treated at the Scheie Eye Institute. Multivariate analysis (adjusting for education and income) found that age, race/ethnicity, and less than excellent health were associated with poor adherence.Conclusions: Those who failed to take more than 75% of eyedrop doses were more likely to be African American and to report poor health. Those in the youngest and oldest age groups were less adherent, although this finding was not always statistically significant. Further research into the factors driving these associations and into developing predictive models to assist in screening for low adherence are warranted.Financial Disclosure(s): Proprietary or commercial disclosure may be found after the references. Ophthalmology 2009; 116:1097-1105 (C) 2009 by the American Academy of Ophthalmology.