PURPOSE: To evaluate persistency with monotherapy in the treatment of glaucoma in patients new to pharmacological management. METHODS: This population-based, retrospective cohort study, using managed care administrative claims data, included patients who were 20 years of age and older and who initiated monotherapy with betaxolol, brimonidine, dorzolamide, latanoprost, or timolol between May 1999 and January 2001. Follow-up continued through January 31, 2001, and prescription refill records for all ocular hypotensive medications were extracted for the full 21-month study period. The primary outcome measures were discontinuation and change (switching/adding on) of the index ocular hypotensive medication. Rates of discontinuation and discontinuation/change were compared using Cox regression methods; survival curves were generated. RESULTS: In all, 14,539 patients were prescribed any ocular hypotensive drug during the study period, and 2850 patients met all inclusion criteria. Patients treated with betaxolol, brimonidine, dorzolamide, or timolol were significantly (p < 0.05) more likely to discontinue and to discontinue/change the index therapy than were those treated with latanoprost. Results were confirmed in analyses adjusted for age and sex. CONCLUSIONS: Patients initially treated with latanoprost monotherapy are more persistent than those who begin treatment with beta-blockers, brimonidine, or the carbonic anhydrase inhibitor dorzolamide. Greater persistency with an initial ocular hypotensive therapy may improve health outcomes and reduce long-term costs to patients and health plans by limiting the increased resource use associated with discontinuations or changes in therapy.
PURPOSE: To evaluate persistency with monotherapy in the treatment of glaucoma in patients new to pharmacological management. METHODS: This population-based, retrospective cohort study, using managed care administrative claims data, included patients who were 20 years of age and older and who initiated monotherapy with betaxolol, brimonidine, dorzolamide, latanoprost, or timolol between May 1999 and January 2001. Follow-up continued through January 31, 2001, and prescription refill records for all ocular hypotensive medications were extracted for the full 21-month study period. The primary outcome measures were discontinuation and change (switching/adding on) of the index ocular hypotensive medication. Rates of discontinuation and discontinuation/change were compared using Cox regression methods; survival curves were generated. RESULTS: In all, 14,539 patients were prescribed any ocular hypotensive drug during the study period, and 2850 patients met all inclusion criteria. Patients treated with betaxolol, brimonidine, dorzolamide, or timolol were significantly (p < 0.05) more likely to discontinue and to discontinue/change the index therapy than were those treated with latanoprost. Results were confirmed in analyses adjusted for age and sex. CONCLUSIONS:Patients initially treated with latanoprost monotherapy are more persistent than those who begin treatment with beta-blockers, brimonidine, or the carbonic anhydrase inhibitor dorzolamide. Greater persistency with an initial ocular hypotensive therapy may improve health outcomes and reduce long-term costs to patients and health plans by limiting the increased resource use associated with discontinuations or changes in therapy.
Authors: Alfonso Arias; Konrad Schargel; Fernando Ussa; Maria I Canut; Amelia Y Belén Robles; Belén Martí Sánchez Journal: Clin Ophthalmol Date: 2010-04-26
Authors: Philippe Denis; Christophe Baudouin; Alain Bron; Jean-Philippe Nordmann; Jean Paul Renard; Jean François Rouland; Eric Sellem; Mourad Amrane Journal: BMC Ophthalmol Date: 2010-02-24 Impact factor: 2.209
Authors: Joel M Fain; Sameer Kotak; Jack Mardekian; Jason Bacharach; Deepak P Edward; Steven Rauchman; Teresa Brevetti; Janet L Fox; Cherie Lovelace Journal: BMC Ophthalmol Date: 2011-06-13 Impact factor: 2.209