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The Impact of the Coronavirus Disease 2019 Pandemic on Adherence to Ocular Hypotensive Medication in Patients with Primary Open-Angle Glaucoma.
Racette, Lyne; Abu, Sampson Listowell; Poleon, Shervonne; Thomas, Tracy; Sabbagh, Nouran; Girkin, Christopher A.
  • Racette L; Department of Ophthalmology and Visual Sciences, School of Medicine, University of Alabama at Birmingham, Birmingham, AL. Electronic address: lracette@uabmc.edu.
  • Abu SL; Department of Ophthalmology and Visual Sciences, School of Medicine, University of Alabama at Birmingham, Birmingham, AL.
  • Poleon S; Department of Optometry and Vision Science, School of Optometry, University of Alabama at Birmingham, Birmingham, AL.
  • Thomas T; Department of Ophthalmology and Visual Sciences, School of Medicine, University of Alabama at Birmingham, Birmingham, AL.
  • Sabbagh N; Department of Internal Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, AL.
  • Girkin CA; Department of Ophthalmology and Visual Sciences, School of Medicine, University of Alabama at Birmingham, Birmingham, AL.
Ophthalmology ; 129(3): 258-266, 2022 03.
Article in English | MEDLINE | ID: covidwho-1540882
ABSTRACT

PURPOSE:

Emerging evidence suggests that the coronavirus disease 2019 (COVID-19) pandemic is disrupting health behaviors such as medication adherence. The objective of this study was to determine whether adherence to ocular hypotensive medication was affected by the pandemic and to identify factors associated with this change.

DESIGN:

In this cohort study, we used a controlled interrupted time series design in which the interruption was the declaration of the COVID-19 pandemic in the United States on March 13, 2020. The 300-day monitoring period, which evenly bracketed this declaration, started on October 16, 2019, and ended on August 10, 2020.

PARTICIPANTS:

Patients with primary open-angle glaucoma enrolled in an ongoing longitudinal National Institutes of Health-funded study initiated before the onset of the pandemic were selected if they were prescribed ocular hypotensive medication and had adherence data spanning the 300-day period.

METHODS:

We applied segmented regression analysis using a "slope change following a lag" impact model to obtain the adherence slopes in the periods before and after the segmentation. We compared the 2 slopes using the Davies test. MAIN OUTCOME

MEASURES:

The main outcome measure was daily adherence to ocular hypotensive medication, defined as the number of doses taken divided by the number of doses prescribed, expressed in percent. Adherence was measured objectively using Medication Event Monitoring System caps. We assessed the associations between change in adherence and demographic, clinical, and psychosocial factors.

RESULTS:

The sample included 79 patients (mean age, 71 years [standard deviation, 8 years]). Segmented regression identified a breakpoint at day 28 after the declaration of the pandemic. The slope in the period after the breakpoint (-0.04%/day) was significantly different from zero (P < 0.001) and from the slope in the period before the breakpoint (0.006%/day; P < 0.001). Mean adherence in the period before the segmentation breakpoint was significantly worse in Black patients (median, IQR 80.6%, 36.2%) compared with White patients (median, IQR 97.2%, 8.7%; chi-square, 15.4; P = 0.0004). A significant positive association was observed between the Connor-Davidson resilience score and the change in slope between the periods before and after the breakpoint (P = 0.002).

CONCLUSIONS:

Adherence to ocular hypotensive medication worsened during the COVID-19 pandemic and seems to be related to patient resilience. This collateral consequence of the pandemic may translate into vision loss that may manifest beyond its containment.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Glaucoma, Open-Angle / Medication Adherence / SARS-CoV-2 / COVID-19 / Antihypertensive Agents Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Qualitative research Limits: Aged / Female / Humans / Male / Middle aged Country/Region as subject: North America Language: English Journal: Ophthalmology Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Glaucoma, Open-Angle / Medication Adherence / SARS-CoV-2 / COVID-19 / Antihypertensive Agents Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Qualitative research Limits: Aged / Female / Humans / Male / Middle aged Country/Region as subject: North America Language: English Journal: Ophthalmology Year: 2022 Document Type: Article