Patient Acceptance of Sustained Glaucoma Treatment Strategies

J Glaucoma. 2018 Apr;27(4):328-335. doi: 10.1097/IJG.0000000000000913.

Abstract

Purpose: To assess patient acceptance of different methods for delivering sustained-release, intraocular pressure (IOP)-lowering medications.

Methods: Electronic surveys were administered to 150 patients at 2 glaucoma clinics. Participants were questioned on their willingness to accept: (1) drug-eluting contact lenses, (2) ring inserts (3) punctal plugs, and (4) subconjunctival injections as alternatives to IOP-lowering eye drops based on various success levels. Multivariable logistic regression models determined the association between device type and treatment acceptance adjusting for age, sex, study site, cost burden of drops, and previous contact lens use.

Results: The majority (69%) of participants were 55 to 74 years of age, and white (65%), and half were female. The majority of participants would accept contacts (59%), rings (51%), plugs (57%), and subconjunctival injections (52%) if they obviated glaucoma surgery; fewer would accept these devices if they reduced (23% to 35%) or eliminated (27% to 42%) drops. Most participants would also accept contacts (56%), plugs (55%), and subconjunctival injections (53%) if they were more effective than eye drops, whereas only 47% would accept a ring; fewer would accept any device if it were equally or less effective than drops. Participants were also 36% (95% confidence interval=0.44-0.92; P=0.02) less likely to accept rings and 32% (95% confidence interval=0.47-0.98; P=0.04) less likely to accept subconjunctival injections as compared with contacts.

Conclusion: Most glaucoma patients considered sustained drug-delivery modalities acceptable alternatives to IOP-lowering eye drops, but only when they were said to obviate surgery or demonstrate greater efficacy than eye drops.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Antihypertensive Agents / administration & dosage*
  • Antihypertensive Agents / adverse effects
  • Contact Lenses / adverse effects
  • Contact Lenses / psychology
  • Contact Lenses / statistics & numerical data
  • Cross-Sectional Studies
  • Delayed-Action Preparations / administration & dosage
  • Drug Delivery Systems* / adverse effects
  • Drug Delivery Systems* / psychology
  • Drug Delivery Systems* / statistics & numerical data
  • Female
  • Glaucoma / epidemiology
  • Glaucoma / psychology*
  • Glaucoma / therapy*
  • Glaucoma Drainage Implants* / adverse effects
  • Glaucoma Drainage Implants* / psychology
  • Glaucoma Drainage Implants* / statistics & numerical data
  • Humans
  • Intraocular Pressure / drug effects
  • Male
  • Middle Aged
  • Ophthalmic Solutions / administration & dosage
  • Ophthalmic Solutions / adverse effects
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Patient Compliance / statistics & numerical data
  • Surveys and Questionnaires
  • Tonometry, Ocular

Substances

  • Antihypertensive Agents
  • Delayed-Action Preparations
  • Ophthalmic Solutions