US Pharm. 2015;40(6):36-38.

Electronic monitoring to measure medication adherence by patients with glaucoma documented that many of them did not regularly use prescribed eyedrops, according to results of a new study. A second study found that intervention of text or voice messages appeared to help patients with adherence.

Patients who were treated with once-daily prostaglandin eyedrops were recruited from a university-based glaucoma clinic. Patients were given a container with an electronic cap in which to store their eyedrops. The cap recorded each time the container was opened.

Of the 407 patients who completed the 3-month adherence assessment, 337 (82.8%) took their medication correctly on at least 75% of days. The other 70 patients (17.2%) (deemed nonadherent) were less likely to be able to name their glaucoma medication, less likely to agree that remembering to use the medication was easy, and more likely to agree with the sentiment that eydrops can cause problems.

The barriers to medication adherence by patients with glaucoma are complex. There is a growing body of work on improving adherence.

The 70 nonadherent patients in the related study that assessed medication adherence were randomized to an intervention (n = 38) or to a control group (n = 32) where they received no additional intervention. The intervention consisted of daily messages, either text or voice, reminding patients to use their glaucoma medication. A personal health record was used to store lists of patient medications and reminder preferences.

The median adherence rate in the 38 patients in the intervention increased from 53% to 64%. There was no change in the control group. Patients in the intervention (84%) agreed the reminders were helpful and that they would continue to use them outside the study. Implementing the intervention is estimated to cost about $20 per year per patient.

“We found that a telecommunication-based reminder linked to a personal health record can increase adherence with once-daily glaucoma medications. This finding is important because it supports an intervention that is feasible in terms of time and cost for a typical ophthalmology practice,” researchers concluded.