Predictors and long-term patterns of medication adherence to glaucoma treatment in Denmark-an observational registry study of 30 100 Danish patients with glaucoma.

BACKGROUND: Self-treatment with glaucoma medication (eye drops) has been associated with adherence challenges. Poor adherence results in worse outcomes in terms of visual field loss. OBJECTIVE: To investigate patterns in medication adherence among Danish patients with glaucoma in relation to selected predictors of adherence, long-term adherence patterns, and long-term societal economic consequences of poor adherence. METHODS AND ANALYSIS: This register-based study included 30 100 glaucoma patients followed for 10 years between 2000 and 2018. Glaucoma was identified from the Danish national registers by diagnosis of Open Angle Glaucoma and/or by redeemed prescriptions of glaucoma medication. Logistic regression models were applied to estimate patient characteristics related to medical adherence. Diagnosis-related group fees were applied to estimate healthcare costs. RESULTS: High adherence in the first year(s) of treatment was less likely among men (ORfirst year: 0.78, 95% CI: 0.75 to 0.82), younger individuals and among those with a positive Charlson Comorbidity Index (CCI) score (ORfirst year/CCI≥3: 0.71, 95% CI: 0.63 to 0.80). Adherence in the first year and in the first two years was associated with adherence in the fifth (ORfirst year: 4.55, 95% CI: 4.30 to 4.82/ORfirst two years: 6.47, 95% CI: 6.10 to 6.86) as with adherence in the 10th year with slightly lower estimates. Being medical adherent was related to higher costs related to glaucoma medication after 5 and 10 years comparing with poor adherence, whereas poor adherence was associated with a marked increase in long-term costs for hospital contacts. CONCLUSION: Increasing age, female sex and low comorbidity score are correlated with better adherence to glaucoma treatment. Adherence in the first years of treatment may be a good predictor for future adherence. In the long term, patients with poor adherence are overall more expensive to society in terms of hospital contacts.

Handling of unused prescription drugs--knowledge, behaviour and attitude among Swedish people.

Unused prescription drugs can pose a security risk particularly for children or addicts; and they can pose an environmental risk if they are not disposed of properly through correct destruction. The general recommendation in Sweden is to return the unused medicines to a pharmacy. The Swedish Association of the Pharmaceutical Industry AB (LIF) has together with the Swedish retail chain Apoteket AB conducted surveys in 2001, 2004 and 2007 to investigate the level of knowledge in the general public on this issue. The result from the survey in 2007 shows, inter alia: 85% knew that correct disposal was to return unused medicines to a pharmacy and 43% had in fact returned their medicines to a pharmacy during the last 12 months. Of those who saved their medicines, 55% implied they would in the future return it to a pharmacy. 50% answered that they returned the unused medicines for environmental reasons and 42% answered that they worry about the environmental impact of medicines. Comparing the results from the earlier surveys it can be concluded that an increasing number of the Swedish population does return unused medicines to a pharmacy for correct disposal. Environmental concerns are getting more important than security concerns as a reason for returning unused medicines to a pharmacy and a growing fraction is worried about the environmental impact of pharmaceuticals.