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Patient satisfaction with glaucoma therapy: reality or myth?

Authors Lemij H, Hoevenaars J, van der Windt C, Baudouin C, Stolz J

Received 8 December 2014

Accepted for publication 3 February 2015

Published 4 May 2015 Volume 2015:9 Pages 785—793


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Dr Scott Fraser

Hans G Lemij,1 Juliette GMM Hoevenaars,2 Cees van der Windt,3 Christophe Baudouin4

On behalf of the GOAL Study Investigators

1Glaucoma Service, Rotterdam Eye Hospital, Rotterdam, 2VieCuri Medisch Centrum, Venlo, 3Ziekenhuis Rivierenland, Tiel, the Netherlands; 4Quinze-Vingts National Hospital and Vision Institute, Paris, France

Abstract: While safe and effective treatments for glaucoma exist, their effectiveness is compromised by poor compliance. Patients who have problems with their topical glaucoma medication are acknowledged to be at higher risk for poor compliance, frequent medication switching, and surgery. Patient satisfaction with therapy and its associated benefits have until recently taken second place to efficacy. The present study is a transverse cross-sectional epidemiological survey among glaucoma patients receiving therapy with prostaglandin analogs. The primary objective was to determine and characterize patient satisfaction with glaucoma therapy, and the secondary objective was to identify factors that may contribute to poor patient satisfaction. Ophthalmologists in the Netherlands included 199 patients and 164 were analyzed. Patients were predominantly elderly with early, primary, open angle glaucoma. Eighty-nine percent of them stated they were satisfied or very satisfied with their treatment. However, signs of ocular surface disorder on ophthalmological examination were evident in 44% of patients, corneal fluorescein staining was positive in 28% of patients, and 38% of patients were using tear substitutes. The prevalence of blepharitis/meibomian gland dysfunction and dry eye was more than twice as high after the commencement of therapy compared with before therapy. Univariate analysis revealed that patient dissatisfaction with their glaucoma therapy was statistically significantly (P<0.001) associated with the presence of ocular surface disease, hyperemia, ocular signs, symptoms upon and between instillation, and the use of tear substitutes. Apparently, patients in the present study are satisfied with their treatment; 89% expressed satisfaction compared with only 11% who professed dissatisfaction. The results suggest that even if local adverse events and ocular surface disease, in particular, contribute to glaucoma patient dissatisfaction, only a minority of patients expressed such dissatisfaction. At the time of the study, most (94%) of the patients included were receiving preserved preparations. Further studies should evaluate the influence of preservative on patient satisfaction.

Keywords: prostaglandin analogs, cross-sectional study, compliance, adherence, ocular surface disease, dry eye, meibomian gland dysfunction

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