Evaluation of adherence to morning versus evening glaucoma medication dosing regimens

Malik Y Kahook¹, Robert J Noecker²

¹Department of Ophthalmology, The Rocky Mountain Lions Eye Institute, University of Colorado Health Sciences Center, Aurora, CO, USA; ²UPMC Eye Center, Eye and Ear Institute, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA

Purpose: Compare patient adherence to glaucoma therapy with morning versus evening dosing schedules.

Methods: Retrospective chart review of 41 consecutive patients who had used the Travatan™ Dosing Aid (Alcon, Fort Worth, TX). Patients had been nonrandomly assigned morning or evening dosing at initiation of usage. Dosing aid data was recorded and analyzed using paired student t-tests where appropriate. Adherence was defined as the dose being administered within 3 hours of the prescribed dosing time.

Results: Records of 18 patients in the morning group and 23 in the evening group were reviewed. Average time of use was 51.06 ± 4.94 days for the morning group and 50.65 ± 5.38 days for the evening group (p = 0.80). Patients taking the morning dose were less likely to miss an entire day of dosing (days missed in morning group = 3.33 ± 1.33; evening group = 5.87 ± 1.52, p < 0.001). The overall adherence rate was not statistically different between groups (morning group = 82.72 ± 7.32%; evening group = 78.96 ± 6.12%, p = 0.08) although the morning group tended to be more adherent to therapy. Patients in the morning group were also more likely to take their drops later rather than miss the entire day’s dose.

Conclusions: The rate of adherence for both the morning and evening dosing groups was better than previously reported. Dosing drops in the morning, rather than in the evening, may lead to fewer entirely missed days of glaucoma eye drop therapy.

Keywords: adherence, travoprost, dosing, glaucoma, medication, therapy, compliance