Original articleAdherence with Topical Glaucoma Medication Monitored Electronically: The Travatan Dosing Aid Study
Section snippets
Study Organization
The study protocol had 2 phases: phase 1 was a prospective, observational cohort study of patient adherence to travoprost therapy when using the DA to administer drops (described in this article); phase 2 was a randomized, controlled trial to improve adherence for those found to have low adherence in phase 1 (subject of a subsequent report). Patients were recruited from the Glaucoma Services of the Wilmer Eye Institute and the Scheie Eye Institute. Institutional review boards at both centers
Results
Study recruitment began in August 2006 and ended in June 2007. A total of 282 patients were identified between the 2 sites; 86 (30%) withdrew before 3 months, leaving 196 subjects (70%) with complete data on drop-taking behavior at 3 months. The reasons why 30% of patients did not complete the study included: side effects (n = 33/86 [38%]), use of travoprost without the DA device (n = 15/86 [17%]), lost to follow-up (n = 12/86 [14%]), patient report that DA device interferes with using drops (n
Discussion
It has been hypothesized and reported that medication adherence would be improved by a simpler drug regimen.25, 26, 27, 28, 29 By contrast, the authors found that once-daily prostaglandin adherence was not substantially better than previously reported drop taking with β-blockers twice daily or pilocarpine 4 times daily.13, 14 After 3 months of electronic monitoring with the DA, the mean adherence rate for travoprost was 71% in the current cohort of patients. Kass et al13, 14 used an electronic
Acknowledgments
The authors thank Sameer Ahmed, MD, who helped with patient recruitment; Lei Zhang, MS, and Maureen Maguire, PhD, who contributed statistical assistance; and Stacy Boxley, COA, and Vanessa Kellner, BA, who provided patient enrollment and protocol support.
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Manuscript no. 2008-469.
Available online: December 12, 2008.
Financial Disclosure(s): The author(s) have made the following disclosure(s):
David S. Friedman - Consultant, Honoraria, Research Support - Alcon.
Harry A. Quigley - Consultant, Honoraria, Research Support - Alcon.
No conflicting relationship exists for any other authors.
Supported in part by the National Institutes of Health, Bethesda, Maryland (PHS research grants nos.: EY01765 [Core Facility Grant, Wilmer Institute], NIH K12 EY015398 [Dr Okeke]); a grant from The Paul & Evanina Bell Mackall Foundation Trust, New York, NY (Dr Okeke); and by an unrestricted gift from Alcon, Inc., Fort Worth, Texas.