The Maccabi Glaucoma Study

Abstract

Purpose: To describe treatment patterns, adherence, and persistence with initial therapy among glaucoma patients in the community. Materials and Methods: A population-based historical prospective cohort study, using the electronic medical databases of Maccabi Healthcare Services, a 2 million member health maintenance organization in Israel. Newly diagnosed glaucoma patients between 2003 and 2010, who purchased at least 1 antiglaucoma medication, were followed up to December 31, 2012. Outcome measures included medication adherence analyzed by proportion of days covered by drugs during follow-up time, and persistence with initial therapy measured by time until switch or discontinuation of first-line therapy. Results: A total of 5934 incident definite glaucoma patients were identified, 13% of whom were nonadherent with therapy (covered PP=0.42). Persistence with initial line of therapy varied by type of medication, with prostaglandin initiators exhibiting the highest persistence (13% reduced likelihood of switch or discontinuation as compared with β-blockers, PP<0.01). Conclusions: This large-scale analysis of real-world use of glaucoma medications reveals that adherence to glaucoma therapy is associated with medication type, patient’s sex, age, socioeconomic status, type of glaucoma, follow-up visits, and baseline intraocular pressure.