A considerable number of glaucoma patients do not take their eyedrop medications as prescribed, the results of a recent study reveal. The results of a follow-up study, however, suggest that adherence can be improved among these patients with text or voice message reminders. Both studies were published online on May 15, 2014, in JAMA Ophthalmology.
The original study assessed medication adherence among patients from a university-based glaucoma clinic who had been prescribed once-daily prostaglandin eyedrops.
Patients were given a medication bottle equipped with an electronic cap in which to store their eyedrops during the 3-month study period. To measure adherence, the cap recorded each time the container was opened. In addition, patients completed mental status and depression tests and answered questions about their health and attitudes toward medication adherence.
The results indicated that 82.8% of patients were adherent for at least 75% of the study period, and that 17.2% were nonadherent. Nonadherent patients were less likely to know the name of their glaucoma medications, less likely to agree that remembering to use their eyedrops was easy, and more likely to strongly agree that eyedrops can cause problems. Patients who were nonadherent were also more likely to admit to missing doses of the medication and to report a lower estimate of adherence.
The 70 nonadherent patients were then randomized to receive automated medication reminders or to a control group for the follow-up study. Based on medication data from a personal health record, patients in the intervention group received daily text or voice messages reminding them to take their glaucoma medication.
The results indicated that the reminders significantly improved adherence to using the eyedrops. Among the 38 patients who received the messages, the median adherence rate increased from 53% to 64%. Adherence did not significantly change among control group patients. When the analysis was restricted to the 20 patients in the intervention group who completed the study, the adherence rate increased from 54% to 73%.
In addition, 84% of the patients who received the daily reminders agreed they were helpful and said they would continue to use them after the study. Implementing the intervention would only cost about $20 per year per patient, a JAMA press release estimates.
“This is an effective method to improve adherence that could realistically be implemented in ophthalmology practices with a minimum amount of effort on the part of the practice or the patient,” the study authors conclude.