How Medication Adherence Affects Disease Management in Veterans with Glaucoma: Lessons Learned from a Clinical Trial.
How Medication Adherence Affects Disease Management in Veterans with Glaucoma: Lessons Learned from a Clinical Trial.
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药物依从性如何影响青光眼退伍军人的疾病管理：临床试验的经验教训。
DOI：
10.1159/000528857
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发表时间：
2023
影响因子：
2.1
通讯作者：
Muir,KellyW
中科院分区：
文献类型：
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作者：
Buehne,KristenL;Rosdahl,JulliaA;Hein,AaronM;Woolson,Sandra;Olsen,Maren;Kirshner,Miriam;Sexton,Malina;Bosworth,HaydenB;Muir,KellyW
引言我们对一项随机对照试验进行了二次真实世界临床评估，以确定青光眼药物依从性干预如何影响随机化后12个月参与者的临床结局。参与者包括退伍军人在VA眼科诊所与药物治疗青光眼谁报告的遵守和他们的同伴，如果适用，MethodsThe治疗组接受了青光眼教育会议与下降管理指令和虚拟提醒从一个“智能瓶”（AdhereTech）为他们的滴眼液。对照组接受一般眼保健课和关闭提醒功能的智能奶瓶。病历提取确定每组中的参与者是否在随机化后12个月内因眼内压控制不足而经历视野进展、额外的青光眼药物或手术或激光的建议。主要的结局指标是疾病进展，定义为视野进展或青光眼治疗的升级，在12个月后randomization.Results36与32%的干预（n = 100）与对照组（n= 100），分别经历了疾病的加剧。干预组和对照组之间在强化方面没有差异（干预组与对照组的比值比：1.20; 95%置信区间：[0.67，2.15]），包括年龄、种族和疾病严重程度。在逻辑回归模型中。那些研究日期包括COVID-19大流行期间的人在各组之间均匀分布。ConclusionsA多方面干预改善了青光眼6个月的药物依从性，并没有影响随机分组后12个月测量的临床结局。12个月可能不足以看到这种干预的临床效果，或者需要超过6个月的干预。
IntroductionWe conducted a secondary, real-world clinical assessment of a randomized controlled trial to determine how a glaucoma medication adherence intervention impacted the clinical outcomes of participants at 12 months post-randomization. Participants included veterans at a VA eye clinic with medically treated glaucoma who reported poor adherence and their companions, if applicable.MethodsThe treatment group received a glaucoma education session with drop administration instruction and virtual reminders from a “smart bottle”(AdhereTech) for their eye drops. The control group received a general eye health class and the smart bottle with the reminder function turned off. Medical chart extraction determined if participants in each group experienced visual field progression, additional glaucoma medications, or a recommendation for surgery or laser due to inadequate intraocular pressure control over the 12 months following randomization. The main outcome measure was disease progression, defined as visual field progression or escalation of glaucoma therapy, in the 12 months following randomization.ResultsThirty-six versus 32% of the intervention (n= 100) versus control (n= 100) groups, respectively, experienced disease intensification. There was no difference between the intervention and control groups in terms of intensification (intervention vs. control group odds ratio: 1.20; 95% confidence interval:[0.67, 2.15]), including when age, race, and disease severity were accounted for in the logistic regression model. Those whose study dates included time during the COVID-19 pandemic were evenly distributed between groups.ConclusionsA multifaceted intervention that improved medication adherence for glaucoma for 6 months did not affect the clinical outcomes measured at 12 months post-randomization. Twelve months may not be long enough to see the clinical effect of this intervention or more than 6 months of intervention are needed.