A nationwide survey of factors influencing adherence to ocular hypotensive eyedrops in Japan
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Few reports have investigated the status of adherence in Japan on a large scale. We aimed to investigate the status of adherence to topical glaucoma treatment and its associated factors.
A nationwide survey was conducted as a prospective fashion. Participants in this survey were subjects with primary open-angle glaucoma, normal-tension glaucoma, or ocular hypertension or pseudoexfoliation glaucoma who had been prescribed anti-glaucoma ophthalmic eyedrops and whose ophthalmologist considered prescribing any fixed combination of ocular hypotensive eyedrops for the first time between 2011 and 2012. Subjects and their attending ophthalmologists independently completed a questionnaire by utilizing a fixed combination of ocular hypotensive eyedrops.
A total of 1358 ophthalmologists from 1071 medical institutions participated in this survey. We registered 4430 subjects (2049 males and 2381 females). In total, data from 3853 subjects (87.6%) were analyzed after inclusion of subjects based on inclusion and exclusion criteria. Good adherence was defined as not forgetting instillation during the past week. Rates of good adherence reported by subjects and ophthalmologists were 72.4 and 78.5%, respectively (P < 0.0001). The consistency of adherence evaluation between subjects and ophthalmologists was moderate [kappa score 0.5025 (95% confidence interval 0.4740–0.5309)]. Significant factors associated with adherence were size of clinic, age, gender, number of types of ocular hypotensive eyedrops, ease of instillation, preferred number of eyedrops, preferred frequency of instillation of eyedrops, and knowledge of glaucoma.
Adherence to ocular hypotensive eyedrops among Japanese subjects was relatively good. Concordance of adherence between subjects’ reports and ophthalmologists’ responses was moderate. Size of clinic, number of types of ocular hypotensive eyedrops, ease of instillation, preferred number of eyedrops, preferred frequency of instillation of eyedrops, and knowledge of glaucoma were associated with adherence among Japanese glaucoma subjects.
KeywordsAdherence Eyedrops Fixed combination Glaucoma Intraocular pressure Japan
The authors deeply appreciate the cooperation of the participating subjects and ophthalmologists. Kenji Kashiwagi MD, PhD has full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. The authors have no proprietary or commercial interests in any materials discussed in this article. Pfizer Japan Inc. financially supported this study, but Pfizer Japan Inc. had no roles in designing or conducting the study; collecting, managing, analyzing, or interpreting the data; or preparing, reviewing, or approving the manuscript.
Conflict of interest
The authors have no proprietary or commercial interests in any materials discussed in this article.
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