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Glaucoma Medication Adherence in Veterans and Influence of Coexisting Chronic Disease

Asefzadeh, Baharak OD, MS; Rett, Douglas OD; Pogoda, Terri K. PhD; Selvin, Gerald OD; Cavallerano, Anthony OD

doi: 10.1097/IJG.0000000000000044
Original Studies

Background: The aim of this study was to characterize veterans’ adherence to glaucoma medications and follow-up eye care, and to examine the influence of coexisting chronic conditions such as posttraumatic stress disorder (PTSD)/anxiety.

Patients and Methods: A retrospective review of computerized medical records was performed for 161 veterans taking topical glaucoma medications. Medication possession ratio (MPR) was calculated using pharmacy data. Mean follow-up ratio (FUR) was calculated using the number of days between visits.

Results: Among the health conditions examined, the most prevalent was hearing loss (0.34), followed by arthritis (0.29), PTSD, or other anxiety disorder (0.27), and dementia or other memory disorder (0.09). The average rates of MPR and FUR were 0.69±0.20 and 0.84±0.19, respectively.

Group comparisons found that patients with hearing loss had higher MPR compared with patients without hearing loss, and patients who were white had higher FUR than African American patients. When demographic and health characteristics were examined simultaneously in multiple linear regressions, hearing loss emerged as a significant predictor of MPR, and being older was significantly related to FUR. Younger age was also associated with MPR and being white (vs. African American) or having a PTSD/other anxiety disorder was related to FUR, although these findings did not reach statistical significance.

Conclusions: FUR was better than MPR in a veteran population being treated for glaucoma.

Hearing loss was significantly related to higher MPR, whereas being older was significantly associated with higher FUR. These characteristics should be taken into consideration in future programs to improve adherence to glaucoma care.

VA Boston Health Care System, Eye Clinic, Jamaica Plain Campus, Jamaica Plain, MA

Disclosure: The authors declare no conflict of interest.

Reprints: Baharak Asefzadeh, OD, MS, VA Boston Health Care System, Eye Clinic, Jamaica Plain Campus, 8th Floor (112), 150 South Huntington Avenue, Jamaica Plain, MA 02130 (e-mail:

Received July 30, 2012

Accepted January 10, 2014

© 2014 by Lippincott Williams & Wilkins.